Objective To evaluate the clinical efficacy and safety of moxibustion combined with immunotherapy in patients with advanced non-small cell lung cancer (NSCLC), based on the traditional Chinese medicine (TCM) theory of reinforcing healthy qi and eliminating pathogenic factors.

Methods Seventy patients with advanced NSCLC of the lung-spleen qi deficiency syndrome who were admitted to Nanchong Central Hospital from March 2025 to March 2026 were enrolled and divided by stratified randomization into a moxibustion group (immunotherapy combined with moxibustion, n = 35) and an immunotherapy group (immunotherapy alone, n = 35). In addition to tislelizumab immunotherapy, patients in the moxibustion group received moxibustion at Zusanli (ST36), Shenque (CV8), Guanyuan (CV4), and Qihai (CV6) five times per week for 9 weeks. Short-term objective efficacy, immune function indicators proportions of CD3⁺, CD4⁺, and CD8⁺ T cells and the ratio of CD4⁺ T cells to CD8⁺ T cells (CD4⁺/CD8⁺), TCM syndrome scores, and quality of life were compared between the two groups.

Results After treatment, the proportions of CD3⁺ and CD4⁺ T cells and the CD4⁺/CD8⁺ ratio were higher in the moxibustion group than in the immunotherapy group (all P ＜ 0.05), whereas no statistically significant between-group difference was observed in the proportion of CD8⁺ T cells (P ＞ 0.05). The TCM syndrome score was lower in the moxibustion group than in the immunotherapy group, while the scores for functional dimensions and overall health status were higher (all P ＜ 0.05). The short-term disease control rate was higher in the moxibustion group (91.4%) than in the immunotherapy group (74.3%), with a statistically significant difference (P ＜ 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05).

Conclusions Moxibustion combined with immunotherapy can enhance cellular immune function, alleviate the burden of TCM symptoms and signs, improve quality of life, and enhance short-term efficacy in patients with advanced NSCLC, with a favorable safety profile, demonstrating the synergistic advantages of the TCM principle of reinforcing healthy qi and eliminating pathogenic factors and immunotherapy.