Efficacy of knee-balancing manipulation plus heat-sensitive moxibustion for knee osteoarthritis and its influence on CTX-Ⅰ,TRACP-5b,ADAMTS-4,and MMP-3

Objective To observe the efficacy of knee-balancing manipulation plus heat-sensitive moxibustion in treating knee osteoarthritis(KOA)and its impact on the expression of C-telopeptide of type I collagen(CTX-Ⅰ),tartrate-resistant acid phosphatase 5b(TRACP-5b),A disintegrin and metalloproteinase with thrombospondin motifs 4(ADAMTS-4),and matrix metalloproteinase 3(MMP-3).Methods A total of 134 unilateral KOA patients were randomized into a knee-balancing group,a heat-sensitive moxibustion group,and a joint intervention group.The knee-balancing group received knee-balancing Tuina(Chinese therapeutic massage)manipulation for treatment.The heat-sensitive moxibustion group received heat-sensitive moxibustion treatment.The joint intervention group received the heat-sensitive moxibustion in addition to the knee-balancing manipulation.The intervention period lasted for four weeks.After the treatment,and at the 2-week and 6-week follow-ups,the three groups were assessed using the visual analog scale(VAS)for knee joint pain and Western Ontario and McMaster Universities arthritis index(WOMAC),and clinical efficacy was also evaluated.The enzyme-linked immunosorbent assay was adopted to detect the expression levels of serum CTX-Ⅰ,TRACP-5b,ADAMTS-4,and MMP-3.Results The knee-balancing group had 44 participants,but one dropped out;there was no dropout case among the 44 participants in the heat-sensitive moxibustion group;among the 46 participants in the joint intervention group,two cases dropped out.After the treatment,and at the 2-week and 6-week follow-ups,the total effective rate was found higher in the joint intervention group than in the knee-balancing and heat-sensitive moxibustion groups(P<0.05).Compared with the baseline,the VAS and WOMAC scores and the serum levels of CTX-Ⅰ,TRACP-5b,ADAMTS-4,and MMP-3 decreased significantly in all three groups after treatment and at the 2-week and 6-week follow-ups(P<0.05).At the same three time points,the VAS and WOMAC scores and serum levels of CTX-Ⅰ,TRACP-5b,ADAMTS-4,and MMP-3 were lower in the joint intervention group than in the knee-balancing and heat-sensitive moxibustion groups(P<0.001).Conclusion Either used alone or combined,the knee-balancing manipulation and heat-sensitive moxibustion therapy can improve the symptoms and down-regulate the serum levels of CTX-Ⅰ,TRACP-5b,ADAMTS-4,and MMP-3 in KOA patients,producing durable efficacy;nevertheless,a more significant efficacy can be achieved by combining the two methods.

Curative effect of heat-sensitive moxibustion on chronic persistent asthma: a multicenter randomized controlled trial

OBJECTIVE:To compare the curative effects of heat-sensitive moxibustion with conventional drugs on chronic persistent asthma and seek a valuable therapy to replaceWestern Medicine.METHODS:The participants in this multi-center,randomized,and controlled study were randomly divided into two groups:group A(n=144),treated with heat-sensitive moxibustion(50 sessions)and group B(n=144),treated with Seretide(salmeterol50μg/fluticasone 250μg,twice a day).The scores of asthma control test(ACT),forced expiratory volume in 1 second(FEV1),peak expiratory flow(PEF),and attack frequency were measured after 15,30,60,and 90 days of treatment.Patients followed up3 and 6 months after treatment.RESULTS:There was a significant difference(P=0.0002)in the ACT score and lung function between the two groups after 3 months of treatment and(P=0.000 03)during the follow-up visits.In addition,heat-sensitive moxibustion reduced attack frequency in the period from inclusion to the6-month follow-up visit.CONCLUSION:This study shows that heat-sensitive moxibustion may have a comparable curative effect toSeretide(salmeterol/fluticasone)on asthma.

Key Points and Solutions to Enhance the Curative Effects of Moxibustion Therapy

Objective： To elucidate the key effects of moxibustion points and quantity of moxibustion used in order to enhance the curative effect of moxibustion therapy. Methods： It analyzed the occurrence rules of acupoint heat-sensitization and its relationship to the moxibustion location and dose, in view of the original definition of acupoints in Nei Jing （Internal Canon） and the acupoint heat-sensitization in clinical practice. Results： （1） The original definition of acupoint is the reflecting area of a disease on surface of the body, which is individualized, motive and sensitive; （2） The location in which heat-sensitization is generated relating to a heat-sensitive acupoint, which therefore depicts the best choice for point selection and also the most accurate area to give moxibustion; （3） The heat-sensitization time can be taken as a clinical index to quantify the moxibustion dose, in order to apply sufficient moxibustion for each individual. Conclusion： The key points for enhancing the curative effect of moxibustion therapy are to identify heat-sensitive points and a scientific moxibustion dose.