Effect of Electroacupuncture on NLRP3 Inflammasome and Morphology of Uterine in Rats with Primary Dysmenorrhea Based on Meridian Acupoint Viscera Correlation Theory

Objective:To explore the relationship between acupoints and the uterus in primary dysmenorrhea(PDM)and observe the effects of electroacupuncture(EA)on NLRP3 inflammasome and morphology of uterine tissues in rats.Materials and Methods:Rats were divided into four groups:Control,PDM,EA,and nonacupoint EA(sham)groups.Writhing reactions in the rats were carefully monitored.Prostaglandin E2(PGE2)and prostaglandin F2α(PGF2α)levels in the rat serum were measured using the enzyme-linked immunosorbent assay.To assess the damage,the histomorphology of the rat uterus was examined using the optical and electron microscopy.Western blotting was performed to determine the nucleotide-binding oligomerization domain carboxy-terminal leucine-rich repeat domain and amino-terminal pyrin domaincontaining protein 3(NLRP3),apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),and cysteinyl aspartate specific proteinase-1(caspase-1),interleukin-1β(IL-1β),and IL-18.Results:Compared with the control group,the PDM group exhibited significant increases in both writhing times and scores,with a high pathological score of the uterine tissue.Serum PGF2αlevels were significantly elevated,whereas PGE2 levels were significantly reduced.In addition,the expression levels of NLRP3,ASC,caspase-1,IL-1β,and IL-18 significantly increased(P<0.001).The EA group showed opposite effects from the PDM group(all P<0.05).The sham group exhibited significantly higher writhing time,serum PGF2αlevels,and expression levels of NLRP3,ASC,caspase-1,IL-1β,and IL-18 than the EA group.In contrast,serum PGE2 levels in the sham group were significantly lower than those in the EA group(all P<0.05).Conclusions:NLRP3 infiammasome activation in PDM triggers pathological inflammation.Sanyinjiao(SP6)and Guanyuan(CV4)had specific effects on PDM.EA of SP6 and CV4 may treat PDM by inhibiting inflammation and protecting the morphological structure of the uterus.

Discussion on Relationship Between Meridians and Viscera of Decreased Ovarian Reserve from the Perspective of"Preventive Treatment of Disease"by Acupuncture

Based on extensive historical data,clinical experience,and modern scientific research,we discuss the relationship between meridians and viscera of decreased ovarian reserve(OR)from the perspective of"preventive treatment of disease"by acupuncture.It is believed that the endogenous protection mechanism of acupuncture in"preventive treatment of disease"lies in harmonizing Yin and Yang and dredging meridians;stimulating righteousness and rejecting the evil outside;preventing disease;co-cultivating body and spirit,and regulating emotions.The incidence ofOR dysfunction is closely related to the uterus-related meridians and viscera.The mechanism of acupuncture treatment of OR dysfunction may be related to reproductive endocrine hormone levels,ovarian tissue morphology,immune system,granulosa cell apoptosis,and related signal transduction pathways.The clinical effect of acupuncture treatment of diminished OR is reflected in improving menstruation and ovulation;improving OR function,promoting pregnancy;improving local ovarian microenvironment;improving negative emotions,improving quality of life,and thus affecting pregnancy outcomes.This article summarizes the mechanism of action and clinical effect of acupuncture in the treatment of decreased OR function based on recent findings,analyzes the advantages and disadvantages of acupuncture in the treatment of disease,and provides the rationale for the clinical application of acupuncture in the treatment of decreased OR function.

Hypercholesterolemia treated with medicinal pad-separated moxibustion:A randomized clinical trial

Objective:To assess the effect of medicinal pad-separated moxibustion for reducing low-density lipoprotein cholesterol(LDL-C)in the patients with hypercholesterolemia.Design:Clinical randomized controlled trial with blinding for outcome assessors and statisticians.Setting:Department of Acupuncture-Moxibustion and Tuina,Department of Physical examination of the First Affiliated Hospital of Hunan University of Chinese Medicine and three community health centers adjacent to the Hospital and University,from July 2015 to December 2017.Patients:60 patients with hypercholesterolemia(elevated LDL-C).Interventions:The therapeutic lifestyle change(TLC)was provided in both groups.In the experiment group,medicinal pad-separated moxibustion was applied using two groups of acupoints(Group No.1:Jùquē[巨阙CV14],Tiānshū[天枢ST25]and Fēnglóng[丰隆ST40]).(Group No.2:Xīnshū[心俞BL15],Gānshū[肝俞BL18]and Píshū[脾俞BL20])alternatively for 3-5 times a week.In the control group,Simvastatin tablets were administered orally by the patients in accordance with instructions in the medication guides(10 mg/d).Main outcome measures:Change of LDL-C after 12 weeks of treatment compared with the baseline.Results:After 12 weeks of treatment,LDL-C was reduced in both the medicinal pad-separated moxibustion group and the simvastatin group compared with that at baseline(both P<0.05).The difference on change of LDL-C was not significant between groups(P>0.05).At week 4 of follow-up,LDL-C was reduced compared with that at baseline in the medicinal pad-moxibustion group(P<0.05),and the difference on change of LDL-C was significant between groups(P<0.05).At week 12 of follow-up,the difference on change of LDL-C was not significant when compared with the baseline in each group(both P>0.05)and between groups(P>0.05).In comparison with values before treatment,the values of triglyceride(TC)and triacylglycerol(TG)were reduced in both groups(all P<0.05),while value of highdensity lipoprotein cholesterol(HDL-C)was increased in the medicinal pad-separated moxibustion group after 12 weeks of treatment(P<0.05).The change of TG and HDL-C values were significantly different between groups(both P<0.05).At week 4 of follow-up,values of TC and TG were lower(both P<0.05)and HDL-C was higher(P<0.05)when compared with that at baseline in the medicinal pad-separated moxibustion group;and value of TC was lower and HDL-C higher in the medicinal pad-separated moxibustion group compared with that in the simvastatin group(both P<0.05).At week 12 of follow-up,compared with that at baseline,all blood lipid outcomes were not significantly different either within(P>0.05)or between groups(P>0.05).Conclusion:Medicinal pad-separated moxibustion could reduce LDL-C and increase HDL-C in patients with hypercholesterolemia.However,these results need to be further verified by study with large sample size.