AIM: To observe the effects of pre-moxibustion on apoptosis and proliferation of gastric mucosal cell in rats with stress-induced ulcer, and to analyze the relationship between those effects and the expression of heat-shock protein 70 (HSP70).METHODS: Sixty healthy Sprague Dawley rats were randomly assigned into four groups, namely group A, B, C and D. The animal model of stress ulcer was established by water immersion and restraint stress. The rats in group A, B, and D served as the restraint, model,and non-acupoint controls, respectively, while those in group C received moxibustion at Zusanli and Liangmen points. Immunohistochemical methodology was used to detect the expression of HSP70, apoptosis index (AI, ×10-6/μm2) and proliferation index (PCNA-LI, × 10-6/μm2).The mucosal expression of transforming growth factor α (TGF-α) was detected by radioimmunoassay.RESULTS: Moxibustion at Zusanli and Liangmen points significantly decreased the gastric injury and the apoptosis of gastric mucosal cells, while markedly increased the mucosal expression of TGF-α and HSP70 as well as the proliferation of gastric mucosal cells.Compared with group A, ulcer index (UI) (26.8 ± 9.8 vs 12.0 ± 5.9, P ＜ 0.01), AI (9.6 ± 4.2 vs 4.4 ± 2.6, P ＜0.05) and expression of HSP70 (9.6 ± 4.2 vs 4.4 ± 2.6,P ＜ 0.05) were significantly increased, but the content of TGF-α (104.7 ± 51.2 pg/mL vs 254.0 ± 86.9 pg/mL, P＜ 0.01) and PCNA-LI (6.9 ± 4.7 vs 14.9 ± 4.6, P ＜ 0.05)were significantly decreased in group B. However, ulcer index values (UI) and AI were obviously lower in group C compared to groups B and D (14.1 ± 5.44 vs 26.8 ± 9.8 and 26.2 ± 7.7, P ＜ 0.01; 3.0 ± 1.6 vs 9.6 ± 44.2 and 8.2 ± 5.2, P ＜0.05, respectively), but content of TGF-α (237.0 ± 72.6 pg/mL vs 104.7 ± 51.2 pg/mL and 154.1 ± 61.3 pg/mL, P ＜0.01) and expression of HSP70 (0.13 ± 0.03 vs 0.08 ± 0.06 and 0.06 ± 0.04, P ＜ 0.05) were higher in group C. Furthermore, the PCNA-LI was significantly higher in group C than in group B (21.6 ± 4.1 vs 6.9 ± 4.7,P ＜ 0.01).CONCLUSION: Moxibustion at Zusanli and Liangmen points has a protective effect on rats gastric mucosa in stress-induced gastric ulcer, which is closely related to its actions in promoting synthesis of TGF-α and proliferation of gastric mucosal cells, suppressing gastric mucosal cell apoptosis, and up-regulating HSP70 expression.