Clinical observation on prevention of chemotherapy infection in gastric cancer by moxa-stick moxibustion plus rhG-CSF and its effect on immune function

Objective:To observe the effect of moxa-stick moxibustion plus recombinant human granulocyte-colony stimulating factor(rhG-CSF)in preventing chemotherapy infection in gastric cancer and its effect on immune function.Methods:A total of 70 patients with gastric cancer treated by chemotherapy were randomly divided into an observation group and a control group,with 35 cases in each group.The control group was given rhG-CSF,and the observation group was given additional moxa-stick moxibustion on the basis of rhG-CSF.Both groups were treated for 2 chemotherapy cycles,totally 6 weeks.The number of patients with infection,the duration of infection and the duration of continuous use of antibiotics were observed.The leukocytes and granulocytes counts,the levels of tumor necrosis factor-a(TNF-a)and interferon-γ(IFN-γ)were measured before and after treatment,and the levels of CD4,CD8 and natural killer(NK)cells were analyzed.Results:The infection rate of the observation group was significantly lower than that of the control group(P<0.05),and the duration of infection and the duration of continuous use of antibiotics were also shorter(P<0.05).After treatment,the leukocytes and granulocytes counts in the two groups were higher than those before treatment(all P<0.05).After treatment,the levels of TNF-α and IFN-γ of the patients in the two groups were improved(all P<0.05),and there were significant differences between the observation group and the control group(P<0.05).After treatment,the numbers of CD4,CD8,and NK cells in the observation group increased significantly(all P<0.05);but the changes in the control group were not significant(P>0.05).Conclusion:Moxa-stick moxibustion plus rhG-CSF can significantly reduce the incidence and severity of chemotherapy infection in gastric cancer,increase the leukocytes and granulocytes counts,and regulate the levels of inflammatory factors,which may be related to the improvement of the immune function of the patients.

Clinical observation on the correlation between moxibustion sensation and distance of moxa stick

Objective： To explore the correlation between moxibustion sensation and distance of moxa stick and provide reference for clinical practice.Methods： A total of 16 healthy volunteers aged 18-35 years old in college were recruited and given mild moxibustion at Shousanli（LI 10）, Zusanli（ST 36）, Shenshu（BL 23） and Tianshu（ST 25） with moxa stick, and the occurrence and frequency of moxibustion sensation were recorded at distances of 5 cm, 4 cm, 3 cm and 2 cm. Mild moxibustion scale was used to count the score.Results： Warm was the main moxibustion sensation, burning pain and soreness decreased with the rise of distance; for the same acupoint, score of mild moxibustion scale increased with the decrease of distance; score ranged between 5.5 and 6.5at distance 3 cm, which was the most comfortable distance for volunteers.Conclusion： The distance of 3 cm is the most comfortable distance in mild moxibustion.

Comparative Study on the Analgesic Effects of Different Moxibustion Methods with Tai-yi Moxa Stick in Treating Primary Dysmenorrhea

Objective: To compare the therapeutic effects of two different moxibustion methods both with tai-yi moxa stick in treating primary dysmenorrhea. Methods: Forty-three patients were randomized into two groups by the random number table according to their treatment orders. The causalgic group was intervened by causalgic stimulation with tai-yi moxa stick while the tepid group was treated by mild thermal stimulation with tai-yi moxa stick. Shiqizhui(EX-B 8) was selected for both groups. Visual analogue scale(VAS) was used for observation before and during the treatment by every 10 min to compare the clinical efficacies between the two groups. Results: Before treatment, there was no statistically significant difference in pain intensity between the two groups(P>0.05). After treatment, both groups achieved significant improvements in pain intensity(P < 0.05), but the inter-group difference in pain intensity was still statistically insignificant(P > 0.05), but the difference was enlarged comparing with that before treatment. The pain relief during the first 10 min of treatment was slower in the causalgic group than that in the tepid group. However, during the later 20 min, the pain relief in the calsalgia group gradually outpaced that in the tepid group. Conclusion: The two moxibustion methods with tai-yi moxa stick both have a good instant analgesic effect in treating primary dysmenorrhea. For patients with primary dysmenorrhea, if 30 min is regarded as the treatment time, mild stimulation was suggested to be used for the first 10 min, and causalgic stimulation for the later 20 min to achieve a better curative effect.

Study on Burning Temperature Versus Time Graph of Moxa Sticks in a Novel Animal Moxibustion Device

Objective: To invent a novel animal experimentation moxa device and intend to solve temperature fluctuations during moxa stick burning in animal moxibustion test. Methods: Smokeless moxa sticks of 4 mm in diameter and 120 mm in length were selected in this trial. The target temperature was(47±1) ℃. The burning temperature versus time graph of moxa sticks during un-interfered time period were recorded when the distances between moxa sticks and thermometer were 2 mm, 3 mm and 4 mm respectively. In addition, the total lengths of burned moxa stick ashes within 0-5 min were recorded. Then the moxa stick burning temperature versus time graph after intervention was measured. Results: The maximum temperatures during test duration when the distances were 2 mm, 3 mm and 4 mm were(47.37±0.25) ℃,(42.62±2.05) ℃ and(35.50±0.40) ℃respectively the total lengths of burned ashes from 0-5 min were(5.1±0.08) mm,(12.17±0.44) mm,(14.8±0.31) mm,(17.25±0.17) mm and(19.82±0.67) mm respectively with a distance of 2 mm between a moxa stick and the testing area, remove 5 mm ashes every 2 min, then the maximum and minimum temperatures within 10 min were(48.37±0.47) ℃and(47.12±0.25) ℃, showing no statistical significance(P=0.12). Conclusion: The novel animal experimentation moxa device can help to maintain relatively constant moxa stick burning temperature during test period.

Therapeutic efficacy observation on moxibustion with moxa of different storage years for moderate-to-severe primary knee osteoarthritis

Objective:By observing the differences in Western Ontario and McMaster Universities osteoarthritis index(WOMAC)and visual analog scale(VAS)scores in moxibustion treatment for moderate-to-severe primary knee osteoarthritis(KOA)with moxa of different storage years(3-year moxa and 1-year moxa from Qichun,Huanggang City,Hubei Province,China)through a randomized clinical trial,to objectively evaluate the differences in therapeutic efficacy of moxibustion with moxa of different storage years.Methods:A total of 63 patients with moderate-to-severe KOA who met the inclusion criteria were randomized into moxibustion group 1 and moxibustion group 2 by central randomization method,with 32 cases in moxibustion group 1 and 31 cases in moxibustion group 2.Moxibustion group 1 was treated with moxa stored for 3 years,and moxibustion group 2 was treated with moxa stored for 1 year.Dubi(ST 35),Neixiyan(EX-LE 4)and Heding(EX-LE 2)were selected in both groups,and the treatment lasted 20 min per time,3 times a week.The immediate efficacy was compared after 6 times of treatment,and long-term efficacy was compared at follow-up 4 weeks after the end of treatment.Results:During the treatment,there were 2 dropouts in moxibustion group 1,and 1 dropout in moxibustion group 2.The total effective rate in the two groups was 83.3%and 60.0%,respectively.Followed up at 4 weeks after the end of treatment,the total effective rate in the two groups was 80.0%and 66.7%,respectively.There were no statistical differences between the two groups(both P>0.05).After treatment and 4 weeks after the end of treatment,the WOMAC and VAS scores in both groups decreased significantly compared with those before treatment(all P<0.01);the scores of stiffness item of WOMAC in moxibustion group 1 were lower than those in moxibustion group 2(both P<0.05);there were no statistical differences in the scores of pain item and dysfunction item of WOMAC,and VAS scores between the two groups(all P>0.05).Conclusion:Moxibustion with moxa of different storage years(stored for 3 years and 1 year)both can improve the pain,stiffness and motor function in patients with moderate-to-severe KOA.While moxa stored for 3 years has a better therapeutic efficacy in improving stiffness of the knee joint than that stored for 1 year.

Effect of moxibustion on tumor necrosis factor-α and nuclear transcription factor kappa B in ankle joints of rats with rheumatoid arthritis

Objective： To observe the effect of moxibustion on the expressions of tumor necrosis factor-α（TNF-α） and nuclear transcription factor kappa B（NF-κB） proteins in ankle joints of rats with rheumatoid arthritis（RA）, and to explore the anti-inflammatory mechanism of moxibustion in the treatment of RA. Methods： Adjuvant arthritis（AA） rat models were induced and used as rat models of RA. Rats were randomly divided into a normal group, a model group, a moxibustion group and a saline group. Rats in the normal and model groups were not treated; rats in the moxibustion group accepted treatment by moxibustion at Zusanli（ST 36） and Shenshu（BL 23） after modeling; rats in the saline group were injected with 0.15 mL saline to the bottom of the left hind paw and had no other treatments. Hematoxylin-eosin（HE） staining was used to observe the histopathological changes of rats＇ ankle joints under light microscope. Immunohistochemistry was used to observe the expressions of TNF-α and NF-κB in ankle joints of rats. Results： Compared with the normal group, the rats＇ ankle joints in the model group showed disorganization, joint surface defect, and significantly increased mean optical density（MOD） of TNF-α and NF-κB（all P〈0.05）. After moxibustion treatment, rats in the moxibustion group showed repaired ankle tissues, smooth joint surface without defects, decreased MOD of TNF-α and NF-κB than those in the model group（all P〈0.05）. Rats in the saline group had no damage to ankle joints, while TNF-α and NF-κB were significantly different from those in the model group（P〈0.05）. Conclusion： Moxibustion could down-regulate the expressions of NF-κB and TNF-α protein in ankle joints of RA rats, and produce an anti-inflammatory effect to promote tissue repair.

Effect of heat-sensitive moxibustion plus psychological intervention on SP, 5-HT and quality of life in patients with irritable bowel syndrome

Objective： To observe the effect of heat-sensitive moxibustion plus psychological intervention on serum contents of substance P（SP） and 5-hydroxytryptamine（5-HT）, as well as the quality of life（QOL） in patients with irritable bowel syndrome（IBS）. Methods： A total of 120 IBS patients were divided into three groups by random sampling method, 40 cases in each group. The heat-sensitive moxibustion group received heat-sensitive moxibustion, the psychological intervention group received psychological intervention, while the observation group received both methods. The therapeutic efficacy was evaluated after 3 courses of treatment. Results： After treatment, the therapeutic efficacy of the observation group was better than that of the heat-sensitive moxibustion group and the psychological intervention group（P〈0.01）, and the heat-sensitive moxibsution group was better than the psychological intervention group（P〈0.05）. In comparing the bowel symptom scale（BSS）, the observation group was better than the other two groups（P〈0.05）, and there was a significant difference between the heat-sensitive moxibustion group and the psychological intervention group（P〈0.05）. In the comparison of QOL, the observation group was significantly superior to the other two groups（P〈0.05）, and there was a significant difference between the heat-sensitive moxibustion group and psychological intervention group（P〈0.05）. In comparing serum SP and 5-HT, the observation group was markedly better than the other two groups（P〈0.05）, and there were significant differences between the heat-sensitive moxibustion group and psychological intervention group（P〈0.05）. The self-rating anxiety scale（SAS） and self-rating depression scale（SDS） were used to estimate the mental state of the three groups, revealing that the observation group was better than the heat-sensitive moxibustion group and the psychological intervention group（P〈0.05）, and there were significant differences between the latter two groups（P〈0.05）. Conclusion： Heat-sensitive moxibustion plus psychological intervention can regulate the levels of SP and 5-HT, improve BSS, SDS, SAS and QOL in treating IBS.

Moxibustion at Front-Mu Point of Abdomen for Intestinal Dysbacteriosis in Rats

Objective：To study the moxibustion at Guanyuan（CV 4）and Tianshu（ST 25）on intestinal dvsbacteriosis in rats.Methods：Fifty Wistar rats,clearing grade,were randomly divided into 5 groups,a normal group,a model group,a medical group,and a Guanyuan（CV 4）group and a Tianshu（ST 25）group,with 10 rats in each group.The rats were treated with Lincomycin Hydrochloride via intragastric administration for developing models.The model rats were treated with medicine and moxibustion respectively.0.1 g fresh rat feces in each group were cultured on the selective culture medium of bifidobacterium species（BS）,lactobacillus（LBS）,enterobactefiaceae（EB）and enterococcus（EC）.The growth and quantity of the bacterial colony were tested by biochemical identification tubes and turbidimetry.Results：Moxibustion at Guanyuan（CV 4）increased BS and LBS while moxibustion at Tianshu（ST 25）improved EB and EC.Conclusion：Moxibustion at Front-Mu points Of different body parts selectively regulated advantaged probiotics for treating intestinal dysbactenosis.

Effects of moxibustion at different times on prostaglandin and vasopressin levels in uterine tissues of rats with dysmenorrhea due to cold-dampness retention

Objective： To observe the effects of moxibustion at different times on prostaglandin E_2（PGE_2）, prostaglandin F2α（PGF_（2α））and arginine vasopressin（AVP）, in the uterine tissues of rats with dysmenorrhea due to cold-dampness retention, and to explore the differences and possible mechanisms of moxibustion at different times in easing pain in dysmenorrhea due to cold-dampness retention.Methods： Forty-three female Wistar rats were randomly divided into a blank control group（n=7）, a model group（n=9）,a pre-moxibustion group（n=9）, an immediate-moxibustion group（n=9） and a pre-moxibustion plus immediatemoxibustion group（n=9）. Rat models of primary dysmenorrhea due to cold-dampness retention were established using（0±1） ℃ ice water immersion method combined with injection of estradiol benzoate for 10 d, followed by injection of oxytocin on the 11 th day. Rats in the 3 intervention groups received moxibustion to Shenque（CV 8） and Guanyuan（CV 4）, 10 min for each acupoint, once a day. Rats in pre-moxibustion group were given mild moxibustion, beginning on the 8th day during modeling, for 3 continuous days; rats in immediate-moxibustion group were given one time mild moxibustion, immediately after injection of oxytocin on the 11 th day during modeling; rats in pre-moxibustion plus immediate-moxibustion group were given mild moxibustion, beginning on the 8th day during modeling till immediately after injection of oxytocin on the 11 th day during modeling, for 4 continuous days. The level of PGF_（2α） in the rat uterine tissues was measured by enzyme-linked immunosorbent assay（ELISA）, and the levels of PGE_2 and AVP in rat uterine tissues were measured by radioimmunoassay.Results： Compared with the blank control group, the levels of PGF_（2α） and AVP, the PGF_（2α）/PGE_2 ratio in the model group were significantly increased（P〈0.01）, and the PGE_2 level was significantly decreased（P〈0.01） in the rat uterine tissues in the model group. Compared with the model group, the writhing latency was significantly prolonged, the writhing number and the total writhing score were all decreased in the pre-moxibustion group, the immediate-moxibustion group and the pre-moxibustion plus immediate-moxibustion group（all P〈0.01）; the levels of PGF_（2α） and AVP, and the PGF_（2α）/PGE_2 ratio were all significantly decreased（P〈0.05, P〈0.01）, and the PGE_2 level was significantly increased（P〈0.01） in the rat uterine tissues of the 3 treatment groups. Compared with the pre-moxibustion group, the writhing number and the total writhing score were all decreased in the immediate-moxibustion group and the pre-moxibustion plus immediate-moxibustion group（all P〈0.01）, the writhing latency was significantly prolonged in the pre-moxibustion plus immediate-moxibustion group（P〈0.01）; the levels of PGF_（2α） and PGF_（2α）/PGE_2 ratio were significantly decreased（P〈0.05, P〈0.01）, and the PGE_2 level was significantly increased（P〈0.01） in rat uterine tissues in the immediate-moxibustion group and the pre-moxibustion plus immediate-moxibustion group. Compared with the immediate-moxibustion group, the writhing latency was significantly prolonged and the writhing number wasdecreased（all P〈0.05）, and the total writhing score was decreased（P〈0.01） in the pre-moxibustion plus immediatemoxibustion group; the PGF_（2α） level and the PGF_（2α）/PGE_2 ratio were significantly decreased（P〈0.01）, and the PGE_2 level was significantly increased（P〈0.01） in rat uterine tissues in the pre-moxibustion plus immediate-moxibustion group.Conclusion： Moxibustion at different times all can produce obvious analgesic effects on dysmenorrhea due to cold-dampness retention in rats, and pre-moxibustion plus immediate-moxibustion ranks the top. The mechanism of this analgesic effect may be via the regulation of abnormal PGF_（2α）, PGE_2 and AVP levels, to effectively inhibit the spastic contraction of uterine smooth muscle in dysmenorrhea rat, thereby improving the ischemia and hypoxia in uterus.

Clinical observation on heat-sensitive moxibustion plus lactulose for postoperative constipation of mixed hemorrhoid due to spleen deficiency

Objective:To observe the clinical effect of heat-sensitive moxibustion plus lactulose oral liquid for postoperative constipation of mixed hemorrhoid.Methods:A total of 70 patients were randomized into a treatment group and a control group,with 35 cases in each group by a random number table.Patients in the control group received lactulose oral liquid alone,while those in the treatment group received additional heat-sensitive moxibustion at Shenque(CV 8).The treatment was given once a day for 15 consecutive days.The defecation interval time,defecation duration,the scores of stool form,visual analog scale(VAS)and patient assessment of constipation quality of life questionnaire(PAC-QOL),as well as the serum substance P(SP)and nitric oxide(NO)levels were measured before and after treatment.Results:After treatment,the stool form score,defecation interval time and defecation duration in the two groups dropped significantly(all P<0.05),and they were lower in the treatment group than in the control group(all P<0.05).After treatment,the VAS scores in the two groups dropped significantly(both P<0.05),and it was lower in the treatment group than in the control group(P<0.05).After treatment,the PAC-QOL scores in the two groups dropped significantly(both P<0.05),and it was lower in the treatment group than in the control group(P<0.05).After treatment,the serum SP and NO levels in the two groups improved significantly(all P<0.05),and showed statistically significant differences between the treatment group and the control group(both P<0.05).Conclusion:Heat-sensitive moxibustion plus lactulose oral liquid can improve stool form,shorten defecation interval time and defecation duration,alleviate defecation pain,and improve quality of life(QOL)for patients with postoperative constipation of mixed hemorrhoid,which may be related to the regulation of the SP and NO levels.

Therapeutic effect of heat-sensitive moxibustion plus medications for senile osteoporosis and its effect on serum BMP-2 and OPG levels

Objective:To observe the clinical efficacy of heat-sensitive moxibustion plus medications on senile osteoporosis(SOP),and to explore the related mechanisms.Methods:A total of 70 elderly participants with osteoporosis were randomly divided into an observation group and control group,with 35 cases in each group.The control group was treated with conventional drugs,and the observation group was treated with heat-sensitive moxibustion on the basis of the conventional drugs.Both groups were treated for 3 months.Before and after treatment,assessed the visual analog scale(VAS)and Oswestry disability index(ODI)scores,determined the bone mineral density of the participants'lumbar spine(L2-L4)and left femoral neck,and detected the participants'serum bone morphogenetic protein-2(BMP-2)and osteoprotegerin(OPG)levels.Results:After treatment,the VAS scores of both groups were lower than before treatment(both P<0.05),and the VAS score of the observation group was significantly lower than that of the control group(P<0.05).After treatment,the bone mineral density values of the lumbar spine and left femoral neck in both groups were significantly higher than before treatment(both P<0.05),and the bone mineral density values of the observation group were higher than those of the control group(P<0.05).After treatment,the ODI scores of the two groups were lower than those before treatment(both P<0.05),and the ODI score of the observation group was lower than that of the control group(P<0.05).After treatment,the serum BMP-2 and OPG levels in the observation group were significantly higher than those in the control group(both P<0.05).Conclusion:Heat-sensitive moxibustion plus medications for SOP can significantly relieve patients'pain,improve dysfunction,and increase bone density,which may be related to the improvement of the serum BMP-2 and OPG levels.

Observation on therapeutic efficacy of thunder-fire moxibustion for hypomenorrhea after induced abortion

Objective:To observe the clinical efficacy of thunder-fire moxibustion for hypomenorrhea after induced abortion.Methods:A total of 74 patients with hypomenorrhea after induced abortion were randomized into two groups,with 37 cases in each group.The control group was treated with conventional hormone sequential therapy,and the observation group was treated with thunder-fire moxibustion.The course of treatment was 3 menstrual cycles.The traditional Chinese medicine(TCM)symptom scores,menstrual volume,endometrial thickness and the sex hormone levels were observed before and after treatment.The clinical efficacy was compared after treatment.Results:The total effective rate in the observation group and the control group was 91.4%and 73.5%,respectively,and the difference between the two groups was statistically significant(P<0.05).After treatment,the TCM symptom scores in both groups decreased significantly(all P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).The menstrual volume,endometrial thickness and each sex hormone level of the patients in both groups were significantly improved after treatment(all P<0.05),and the improvements in the observation group were more significant than those in the control group(all P<0.05).Conclusion:Thunder-fire moxibustion can significantly improve the clinical symptoms of patients with hypomenorrhea after induced abortion;it can increase menstrual volume and endometrial thickness,and regulate the sex hormone levels,producing a better curative effect than the conventional hormone sequential therapy.

Experimental study on the effect of different moxibustion durations on rats with rheumatoid arthritis

Objective： To observe the effect of different moxibustion durations on rats with rheumatoid arthritis（RA） and to evaluate the relationship between moxibustion amount and moxibustion efficacy. Methods： Eight rats were randomly selected as a normal group from the 40 male Sprague-Dawley（SD） rats, and the other 32 rats were used to establish type Ⅱ collagen-induced RA models. After successful modeling, the 32 rats were randomly divided into a model group, a moxibustion for 20 min group, a moxibustion for 40 min group and a moxibustion for 60 min group, with 8 rats in each group. Rats in the normal group did not receive modeling and moxibustion intervention; rats in the model group did not receive moxibustion after modeling; rats in the moxibustion for 20 min group, the moxibustion for 40 min group and the moxibustion for 60 min group were treated with moxibustion at Shenshu（BL 23） and Zusanli（ST 36） for 20 min, 40 min and 60 min, respectively. Six days were a course of treatment, with a total of 3-course treatments and a 1-day rest between the courses of treatment. After treatment, the serum levels of interleukin（IL）-1β and tumor necrosis factor（TNF）-α, arthritis index（AI） scores, toe volumes and pathological score of synovitis were evaluated in the rats. Results： Compared with the normal group, the serum IL-1β and TNF-α levels, and the toe volumes in the model group were increased, and the differences were statistically significant（P〈0.01）, before the treatment. Compared with the model group, the serum IL-1β and TNF-α levels, toe volumes and arthritis index（AI） scores were significantly decreased in the moxibustion for 20 min group, the moxibustion for 40 min group and the moxibustion for 60 min group（P〈0.05 or P〈0.01）. Compared with the moxibustion for 20 min group and the moxibustion for 60 min group, serum IL-1β and TNF-α levels, toe volumes and AI scores were decreased more significantly in moxibustion for 40 min group, and the differences were statistically significant（P〈0.05 or P〈0.01）. There were no significant differences in serum IL-1β and TNF-α levels, AI scores and toe volumes between the moxibustion for 20 min group and the moxibustion for 60 min group（all P〈0.05）. The synovial histopathological improvement was the most obvious in the moxibustion for 40 min group, when the synovial histopathological changes were compared among the moxibustion for 20 min group, moxibustion for 40 min group and moxibustion for 60 min group. Conclusion： The therapeutic efficacy of moxibustion for 40 min in RA rats was more significant than that of moxibustion for 20 min and moxibustion for 60 min, indicating that the duration of moxibustion is the main factor affecting its therapeutic efficacy.

Observation on Clinical Effects of Moxibustion Therapy plus Medications for Chronic Heart Failure

Objective： To observe the clinical effects in treatment of chronic heart failure with mild moxibustion plus medications. Methods： Sixty cases with chronic heart failure who met the inclusion criteria were randomly divided into two groups, 30 cases in each group. The treatment group was treated with mild moxibustion plus routine medications and the control group was treated only with routine medications, for comparing the clinical effects and relevant indexes of heart functions between the two groups after the treatment. Results： The heart rate （HR）, cardiac output （CO） and left ventricular ejection fraction （LVEF） were obviously improved in the two groups after the treatment （P0.01）, better in the treatment group than those in the control group （P0.01）. The total effective rate was better in the treatment group than that in the control group （P0.05）, indicating that both therapeutic programs were effective for chronic heart failure, but the clinical effect was better in the treatment group. Conclusion： The clinical effect is better in the treatment of chronic heart failure by mild moxibustion plus medications than by single application of medications.

Effects of moxibustion on serum IL-6, IL-8 and TNF-α in rats with experimental rheumatoid arthritis

Objective:To observe the effects of moxibustion on serum levels of interleukin(IL)-6,IL-8 and tumor necrosis factor-α(TNF-α),and to explore the effects of moxibustion on inflammatory damaging factors in experimental rheumatoid arthritis(RA)model rats;the relationship between the therapeutic effect of moxibustion on RA and the change in the Toll-like receptor(TLR)signaling pathway was analyzed using Toll-like receptor 4(TLR4)antagonists and agonists.Methods:Fifty Sprague-Dawley(SD)rats were divided into a normal group,a model group,a moxibustion group,a moxibustion plus TLR4 agonist group(agonist group)and a moxibustion plus TLR4 antagonist group(antagonist group)according to the random number table,with 10 rats in each group.Except the normal group,rats in the other four groups were subjected to model preparation with the wind,cold and wet environmental factors plus Freund's complete adjuvant(FCA).Rats in the normal and model groups were not treated;rats in the moxibustion,agonist and antagonist groups started to be treated with the moxibustion(cigarette-type moxa)at bilateral Shenshu(BL 23)and Zusanli(ST 36)from the 4th day after the successful modeling,for 20 min each time with a total of 10 d.Rats in the agonist and the antagonist groups were injected with TLR4 agonist or antagonist[0.1 mg/(kg*bw)]via the tail vein 30 min before moxibustion.The concentrations of serum IL-6,IL-8 and TNF-αin each group were determined by enzyme-linked immunosorbent assay(ELISA).Results:Compared with the normal group,in the model group,the rat's right hind paw swelling was significantly obvious(P<0.01);there was a lot of inflammatory infiltration in the synovial tissues,the surface of the synovial membrane was unsmooth,the synovial membrane was hyperplasia and thicker,and the serum IL-6,IL-8 and TNF-αconcentrations increased significantly(P<0.05).Compared with the model group,the paw swelling degrees of the rats in the moxibustion,the agonist and the antagonist groups reduced significantly(all P<0.01);the swelling degree in the antagonist group was milder than that in the agonist group,but the between-group difference was not statistically significant(P>0.05);inflammatory infiltration and synovial membrane hyperplasia in the synovial tissues of the moxibustion group and the antagonist group were all relieved differently;the decrease of synovial layer number in the moxibustion group was more obvious,and there were no obvious improvements in inflammatory infiltration and synovial thickness in the agonist group;the concentrations of IL-6,IL-8 and TNF-αin the moxibustion group were decreased,and the differences in the IL-6 and TNF-αconcentrations were statistically significant(all P<0.01);there was no significant between-group difference in the IL-8 concentration(P>0.05);the concentrations of serum IL-8 and TNF-αin the agonist group increased significantly(both P<0.01),while the IL-6 concentration decreased without significant difference(P>0.05);the concentrations of IL-6 and IL-8 in the antagonist group decreased but the between-group differences were statistically insignificant(both P>0.05);and the TNF-αconcentration significantly increased(P<0.05).Compared with the moxibustion group,IL-6,IL-8 and TNF-αconcentrations increased in the agonist group,and the differences in the IL-8 and TNF-αconcentrations were statistically significant(both P<0.01);the concentrations of IL-6,IL-8 and TNF-αincreased in the antagonist group,and the differences in the IL-6 and TNF-αconcentrations were statistically significant(both P<0.01);there was no significant difference in the IL-8 concentration between the groups(P>0.05).The serum levels of IL-6,IL-8 and TNF-αin the antagonist group were lower than those in the agonist group(all P<0.05).Conclusion:Moxibustion at Shenshu(BL 23)and Zusanli(ST 36)can reduce the joint swelling degree and inflammation in synovial tissue of RA model rats,decrease the serum levels of IL-6,IL-8 and TNF-αin RA model rats;the decreases of IL-6 and TNF-αare more significant than the decrease of IL8;TLR4 agonist and antagonist can significantly attenuate the effect of moxibustion in inhibiting releases of IL-6,IL-8 and TNF-α,so that the change in TLR signaling pathway affects the effect of moxibustion in inhibiting the releases of IL-6,IL-8 and TNF-α.

Clinical study on mild moxibustion for knee osteoarthritis

Objective: To observe the clinical effect of mild moxibustion for knee osteoarthritis (KOA) and to explore the role of mild moxibustion in relieving pain, reducing stiffness and improving joint dysfunction in patients with KOA. Methods: Eighty patients with KOA were randomly allocated into either a moxibustion group or a medication group by the random number table, with 40 cases in each group. The moxibustion group used mild moxibustion at Neixiyan (EX-LE 5), Dubi (ST 35), Xuehai (SP 10) and Liangqiu (ST 34), 30 min each time, 3 times a week;the medication group was given celecoxib capsule (celebrex), 0.2 g each time, once a day. Both groups were treated for 4 weeks. The visual analog scale (VAS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores were evaluated before and after treatment. The efficacy of the two groups was compared after treatment. Results: After treatme nt, the overall efficacy of the moxibustion group was sign ificantly differ ent from that of the medication group (P<0.05). The VAS and WOMAC scores of the two groups were lower than those before treatment (both P<0.01). The changes in the VAS and WOMAC scores after treatment in the moxibustion group were significantly different from those in the medication group (both P<0.05). After treatment, in single item of WOMAC, the changes in pain and joint dysfunction in the moxibustion group were more statistically significant than those in the medication group (both P<0.05). Conclusion: Mild moxibustion and oral celebrex can reduce the VAS and WOMAC scores of patients with KOA. Mild moxibustion is superior to oral celebrex in relieving pain and improving joint function.

Mechanism study of the transmission of moxibustion heat in human acupoint tissues

Objective: To discuss the topical action characteristics of the biological transmission of moxibustion heat via temperature collection and numerical modeling. Methods: Temperature of moxibustion was measured at multiple points at a distance of 3 cm to obtain the moxibustion temperature field nephograms by the high-accuracy temperature measure array. Finite element analysis was used to imitate the three-dimensional dynamic distribution of temperature in acupoint tissues. Results: Through numerical analysis, the one-dimensional, two-dimensional and three-dimensional distributions of temperature in human acupoint tissues at 5 min of moxibustion were established. The result showed that moxibustion heat mainly tran smitted from the surface of the tissue to the internal, and the in flue nee of moxibusti on heat decreased with the depth of the tissue. The analysis of the nephograms of acupoint tissue temperature at 5,10, 15 and 20 min of moxibustion showed that with the in crease of the moxibusti on time, the temperature in acupoint tissues consta ntly rose, and the transmission depth of moxibustion heat also further expanded inside acupoint. Conclusion: By establishing the three-dimensional dynamic model of heat transmission inside acupoint tissues with the biological parameters of human tissues and the temperature values obtained, this study used finite element analysis software ANSYS 14.0 and discovered the rules in the transmission of heat in body tissues during moxibustion, and the features in moxibustion heat transmission (from the proximal to the distant) and heat penetration (from the surface to the intern al). This study provides theoretical and experime ntal support for the application of moxibusti on in clinical practice.

Evaluation of the reliability and validity of the modified Morisky scale for patient's compliance with moxibustion

Objective： A questionnaire for the compliance with moxibustion was designed based on the 4-item Morisky scale, and the reliability and validity of the questionnaire was investigated. Methods： A modified Morisky scale was designed based on the 4-item Morisky scale for the compliance with moxibustion, and 146 patients having received moxibustion for over 2 weeks were investigated using this scale to evaluate their compliance with moxibustion; the internal equity and the construct validity of the scale were statistically analyzed. Results： The analysis of reliability showed that in item of internal consistency, the Cronbach＇s α was 0.72 and the split-half coefficient was 0.71, the correlation coefficients between the 4 component scores and the total score ranged 0.67-0.80, and the between-component correlation coefficients ranged 0.24-0.56; the exploratory factor analysis（EFA） totally extracted 1 common factor, and the explicable variation was 55.02%, and the loads of the 4 items were respectively 0.82, 0.81, 0.74 and 0.58. Conclusion： The reliability and validity of the modified Morisky scale for the compliance with moxibustion are acceptable, while several items need further modification and improvement in the expression and content.

Instant effect of moxibustion at different points on electrogastrogram of patients with functional dyspepsia

Objective： To observe different effects of moxibustion at Zusanli （ST 36） and Yanglingquan （GB 34） on electrogastrogram （EGG） of patients with functional dyspepsia （FD）. Methods： A total of 65 cases were randomized into a Zusanli （ST 36） group （n=33） and a Yanglingquan （GB 34） group （n=32） by random serial number, to receive moxibustion therapy to the corresponding point respectively. The 8-lead EGG was used before and after treatment to collect EGG parameter of the gastric body, antrum of stomach, lesser curvature and greater curvature, including the dominant frequency, slow wave percentage, average frequency, response area and motility index. Results： After treatment, the dominant frequency and slow wave percentage were improved in nearly the whole stomach area in Zusanli （ST 36） group, showing statistical significances （both P〈0.05）; the slow wave percentage and average frequency were improved in stomach body and antrum of stomach in Yanglingquan （GB 34） group, showing statistical significances （both P〈0.05）; moxibustion at Zusanli （ST 36） had a significantly higher influence on EGG than Yanglingquan （GB 34）, in which the lifting of slow wave percentage was significantly higher than Yanglingquan （GB 34） group （P〈0.05）. Conclusion： Moxibustion at Zusanli （ST 36） and Yanglingquan （GB 34） has the effect of adjusting abnormal EGG pattern in FD patients. Compared with Yanglingquan （GB 34）, Zusanli （ST 36） has a superior effect in improving EGG in stomach area.

Effect of mild-warm moxibustion on fatigue, immunestate and quality of life in sub-health population

Objective： To observe the effect of mild-warm moxa stick moxibustion on fatigue, immune state and quality of life （QOL） in sub-health population. Methods： A total of 120 cases were randomly allocated into a moxibustion group （n=60） and a Chinese patent medicine （CPM） group （n=60）. People in the moxibustion group were intervened with mild-warm moxa stick moxibustion, once a day; while people in the control group took oral Bu Zhong Yi Qi Won （Spleen/stomach-supplementing and Qi-boosting Pill）, 3 doses a day. Two months made up a course of treatment. The fatigue, immune state and QOL were then observed after one treatment course, followed by a 12-month follow-up. Results： A total of 215 cases completed the clinical trial. After intervention, the fatigue scores, immune parameters and QOL scores were significantly increased in both groups, showing statistical significances （P〈0.05）. There were between-group significant differences in fatigue score, levels of immunoglobulin M （IgM） and IgG, natural killer （NK） cell activity and QOL score （P〈O.05）. After the 22-month follow-up, there were still significant between-group differences in fatigue score, physical health, psychological, social relationships and overall perception of QOL and overall perception of health （P〈0.05）. Conclusion： Mild-warm moxibustion can markedly improve the fatigue, immune state and QOL in sub-health population.