Cupping mark color is believed to be related to the mechanism and efficacy of cupping therapy, but exploration of the factors influencing its depth has so far been limited.

We recruited 100 patients with fibromyalgia and 100 healthy volunteers (aged 18–75 years) from Dongfang Hospital Beijing University of Chinese Medicine (Beijing, China), and nearby communities. A survey was conducted to collect demographic data and the Traditional Chinese Medicine (TCM) constitution of participants. Cupping was then performed at six acupoints (bilateral Feishu [BL 13], Xinshu [BL 15], and Ganshu [BL 18]) for 10 min, and the resulting color of each cupping mark was rated according to a cupping color rating chart. Statistical multiple linear regression analysis was carried out using SPSS 22.0 to determine the correlation between cupping mark color and possible influencing factors including health status, TCM constitution type, sex, age, and body mass index (BMI).

A total of 33 males (16.5%) and 167 females (83.5%), with an average age of 42.08 years, completed the survey. Forty-four participants (22%) were classified as yang-deficiency constitution, 38 (19%) as balanced constitution, and 26 (13%) as phlegm-dampness constitution. The average score of cupping mark color was 4.38. Sex (β = −1.025, P = 0.001) and health status (β = −0.678, P = 0.003) were significant factors influencing cupping mark color: female participants had lighter marks than males, and fibromyalgia patients had lighter marks than healthy volunteers. TCM constitution type, age, and BMI were not associated with cupping mark color.

This cross-sectional study of 200 participants did not reveal any correlation between TCM constitution type and cupping mark color. However, given the limited sample size, future studies with larger cohorts are warranted.