清热祛湿通络方联合西医常规治疗湿热蕴结型急性痛风性关节炎临床研究

目的观察清热祛湿通络方联合西医常规治疗湿热蕴结型急性痛风性关节炎(AGA)患者的临床疗效。方法将104例湿热蕴结型AGA患者按照随机数字表法分为2组,对照组51例予西医常规治疗,治疗组53例在对照组基础上联合清热祛湿通络方治疗。2组均治疗1周后统计疗效,比较2组治疗前后中医症状(包括关节疼痛、关节红肿、关节发热、口渴、小便短黄及心烦不安)评分、实验室指标[包括血尿酸(UA)、红细胞沉降率(ESR)、C-反应蛋白(CRP)、白细胞介素1β(IL-1β)及肿瘤坏死因子α(TNF-α)]及血液流变学指标[包括全血黏度(高切)、全血黏度(低切)及全血还原黏度]水平变化情况,比较2组治疗期间不良反应发生情况。结果治疗组总有效率96.23%(51/53),不良反应总发生率13.21%(7/53),对照组总有效率84.31%(43/51),不良反应总发生率29.41%(15/51),治疗组总有效率高于对照组(P<0.05),不良反应总发生率低于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医症状关节疼痛、关节红肿、关节发热、口渴、小便短黄、心烦不安评分及总分均降低(P<0.05),且治疗组治疗后关节疼痛、关节红肿、关节发热、小便短黄评分及总分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后实验室指标UA、ESR、CRP、IL-1β及TNF-α水平均降低(P<0.05),且治疗组治疗后UA、ESR、CRP、IL-1β及TNF-α水平均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后血液流变学指标全血黏度(高切)、全血黏度(低切)及全血还原黏度水平均降低(P<0.05),且治疗组治疗后血液流变学指标全血黏度(高切)、全血黏度(低切)及全血还原黏度水平均低于对照组(P<0.05)。结论清热祛湿通络方联合西医常规治疗湿热蕴结型AGA疗效确切,可有效改善患者中医症状,降低UA水平,减少不良反应的发生,其作用机制可能与抑制炎性反应、改善血液流变学指标有关。

梅花针配合穴位敷贴治疗急性痛风性关节炎42例

目的:观察梅花针配合穴位敷贴治疗急性痛风性关节炎的临床疗效。方法:将42例急性痛风性关节炎患者采用梅花针和穴位敷贴治疗两个疗程共10d后评定综合疗效。结果:近期治愈8例,显效19例,有效12例,无效3例,总有效率92.9%。结论:梅花针配合穴位敷贴治疗急性痛风性关节炎,疗效确切,安全简捷。

针刺配合阿是穴刺络放血治疗急性痛风性关节炎疗效观察

目的针刺配合阿是穴放血治疗急性痛风性关节炎的临床疗效。方法将70例急性痛风性关节炎患者随机分为治疗组38例和对照组32例。治疗组采用针刺配合阿是穴刺络放血治疗,对照组采用常规药物治疗。观察两组治疗前后血尿酸及C反应蛋白含量变化情况,比较两组临床疗效。结果两组治疗1、2个疗程后血尿酸及C反应蛋白含量与同组治疗前比较,差异均具有统计学意义(P<0.01)。治疗组治疗2个疗程后C反应蛋白含量与对照组比较,差异具有统计学意义(P<0.05)。治疗组总有效率为84.2%,对照组为81.3%,两组比较差异具有统计学意义(P<0.05)。结论针刺配合阿是穴刺络放血是一种治疗急性痛风性关节炎的有效方法。

乌蔹莓软膏外敷对痛风急性关节炎期湿热蕴结型持续时间和疼痛程度的影响

目的:观察乌蔹莓软膏外敷对痛风急性关节炎期湿热蕴结型持续时间和疼痛程度的影响。方法:按照随机平行对照的原则将60例合格受试者随机分为试验组和对照组各30例,给予相同的基础治疗,试验组在此基础上外敷乌蔹莓软膏于患处,每日换药1次。观测指标:急性关节炎期的持续时间和治疗前后症状积分的差值。结果:试验组的急性关节炎期的持续时间和治疗前后症状积分的差值与对照组相比差异明显(P<0.05)。结论:乌蔹莓软膏外敷可以缩短痛风急性关节炎期湿热蕴结型持续时间并减轻患者疼痛程度。

小剂量激素治疗急性痛风性关节炎58例

目的:探讨小剂量激素治疗急性痛风性关节炎的临床疗效。方法:将116例急性痛风性关节炎患者随机分为两组,治疗组服用小剂量激素强的松,10mg,1次/d,对照组服用秋水仙碱0.5mg,3次/d。观察服药后第1天,第3天,两组症状改善时间、C-反应蛋白、血沉下降情况及副作用的差异。结果:治疗组有效率100%,对照组86.2%,两组比较差异有统计学意义,小剂量激素治疗组关节炎疼痛缓解时间6.2±0.5h,对照组疼痛缓解时间11.2±0.6h,两组比较差异有统计学意义。治疗组治疗后第1天及第3天C-反应蛋白及血沉均较对照组下降明显,差异有统计学意义。小剂量激素治疗组无明显不良反应,应用秋水仙碱组,消化道副作用发生率高。结论:小剂量激素治疗急性痛风性关节炎,有良好的临床疗效,起效快,症状缓解迅速,无明显不良反应。

针灸配合拔罐治疗痛风性关节炎疗效观察

目的观察针灸配合拔罐治疗痛风性关节炎的临床疗效。方法将76例痛风性关节炎患者随机分为治疗组46例和对照组30例。治疗组采用针灸配合拔罐治疗,对照组采用药物治疗。比较两组临床疗效。结果治疗组治疗3个疗程后痊愈率和总有效率分别为54.3%和97.8%,对照组分别为40.0%和80.0%,两组比较差异均具有统计学意义(P<0.05)。结论针灸配合拔罐是一种治疗痛风性关节炎的有效方法。

N6-甲基腺苷修饰相关基因在痛风性关节炎患者外周血单个核细胞中的表达及临床意义

目的探讨N6-甲基腺苷(m6A)修饰相关基因在原发性痛风性关节炎(GA)患者外周血单个核细胞(PBMC)中的表达及其可能的作用。方法收集2023年10月至12月期间在川北医学院附属医院风湿免疫科门诊就诊的急性期痛风患者(AG组)、间歇期痛风患者(IG组)、年龄及性别匹配的健康体检者(HC组)各45例。采用实时荧光定量逆转录聚合酶链反应(RT-qPCR)检测m6A修饰相关基因[甲基转移酶3(METTL3)、甲基转移酶14(METTL14)、Wilms肿瘤1相关蛋白(WTAP)、肥胖相关蛋白(FTO)、AlkB同系物5(ALKBH5)、胰岛素样生长因子2-mRNA结合蛋白(IGF2BP)2、IGF2BP3、含YTH结构域结合蛋白1(YTHDF1)和含YTH结构域蛋白2(YTHDC2)]在3组PBMCs中的表达水平,并与临床指标进行相关分析。计量资料符合正态分布采用方差分析或t检验,非正态检验用Kruskal-Wallis H检验和Mann-Whitney U检验分析数据。采用受试者特征曲线(ROC)评估m6A修饰相关基因对诊断GA的价值。结果①IGF2BP2(Z=-3.59,P<0.001)、WTAP(Z=-5.25,P<0.001)、METTL14(Z=-3.62,P<0.001)、YTHDF1(Z=-2.12,P=0.034)、YTHDC2(Z=-2.00,P=0.045)在痛风组(AG+IG患者)与HC组表达差异均有统计学意义。其中,IGF2BP2在GA组[28.08(17.99,47.06)×10^(-4)]的表达显著高于HC组[19.23(12.90,25.78)×10^(-4)],WTAP、METTL14、YTHDF1和YTHDC2在GA组[298.61(213.61,377.80)×10^(-4),9.94(6.43,13.46)×10^(-4),52.63(28.22,72.77)×10^(-4),40.24(20.74,73.32)×10^(-4)]的表达均显著低于HC组[398.45(339.88,454.89)×10^(-4),13.27(11.07,15.85)×10^(-4),64.43(43.61,87.10)×10^(-4),53.11(36.37,79.28)×10^(-4)];进一步亚组分析发现IGF2BP2、WTAP、METTL14、YTHDF1、YTHDC2在3组间表达中差异均有统计学意义(H=19.62、31.73、13.14、16.64、28.90,P均≤0.001),WTAP和METTL14在AG组[311.13(234.96,426.67)×10^(-4)(Z=-3.27,P=0.001),9.64(5.21,15.21)×10^(-4)(Z=-2.71,P=0.008)]与IG组[272.27(203.29,347.95)×10^(-4)(Z=-5.78,P<0.001),10.40(6.88,12.88)×10^(-4)(Z=-3.54,P=0.003)]的表达均低于HC组[398.45(339.88,454.89)×10^(-4),13.27(11.07,15.85)×10^(-4)],但AG与IG之间差异无统计学意义(P>0.05);YTHDF1和YTHDC2在AG组[38.10(16.19,56.78)×10^(-4),24.31(14.35,42.77)×10^(-4)]均显著低于IG组[64.13(48.28,74.40)×10^(-4)(Z=-3.54,P<0.001),65.49(39.89,91.23)×10^(-4)(Z=-4.96,P<0.001)]和HC组[64.43(43.61,86.92)×10^(-4)(Z=-3.51,P<0.001),53.11(36.37,79.28)×10^(-4)(Z=-4.25,P<0.001)],但IG与HC组间差异无统计学意义(P>0.05);IGF2BP2在AG组[25.32(16.40,40.43)×10^(-4)]和HC组[19.23(12.90,25.78)×10^(-4)]均显著低于IG组[31.10(22.60,49.58)×10^(-4)](Z=-2.46,P=0.014;Z=-4.54,P<0.001),但AG和HC比较差异无统计学意义(P>0.05)。②Spearman相关分析显示:在GA患者中,IGF2BP2、METTL14和YTHDF1的表达分别与血浆葡萄糖(r=0.22,P=0.037)、血尿酸(r=0.38,P=0.003)和总胆固醇(r=0.23,P=0.034)呈正相关,WTAP与血浆葡萄糖呈负相关(r=-0.25,P=0.020)。③5个差异基因联合预测GA的ROC曲线下面积(95%CI)为0.90(0.84,0.95)。结论m6A修饰相关基因在GA中存在异常表达且与GLU和UA等临床指标相关,推测其可能参与GA的发病及对评估GA患者代谢有一定的参考价值。

基于复杂网络探究针灸治疗急性痛风性关节炎的临床特点

目的:基于复杂网络探讨针灸治疗急性痛风性关节炎(AGA)的选穴和穴位配伍规律,以及疗法的应用特点,为AGA的针灸治疗提供参考依据。方法:检索中国知网(CNKI)、重庆维普数据库(CQVIP)、万方数据知识服务平台(Wanfang)、中国生物医学文献服务系统(SinoMed)、PubMed、科学网(WOS)和荷兰医学文摘数据库(EMBASE)从建库至2023年3月31日的针灸治疗AGA文献。根据纳入及排除标准筛选文献后建立针灸处方数据库。应用SPSS Modeler 18.1和Gephi 0.9.7软件对腧穴进行关联规则分析和复杂网络分析。结果:共筛选145篇文献,提取382条针灸处方,涉及104个腧穴,总使用频次1288次。使用频次最高的腧穴为阿是穴,经脉选用以足太阴脾经、足阳明胃经较多;疗法以毫针刺和放血较为常见。关联规则结果显示“阿是穴-足三里”、“三阴交-足三里”支持度最高,体现了远近配穴、表里配穴的原则。对主穴进行复杂网络分析,获得了以阿是穴、足三里、三阴交、阴陵泉及太冲为主的核心腧穴配伍组合。配穴选择包括辨证取穴和辨部取穴,注重对证候和关节相关症状的改善。结论:针灸治疗AGA遵循主穴与辨证或辨部位配穴相结合原则,主穴选择注重调理本虚之脏腑,配穴选择注重对证和症的改善,重视疗法效应特异性。

FORTY-EIGHT CASES OF ACUTE GOUTY ARTHRITIS TREATED COMPREHENSIVELY WITH ELECTROACUPUNCTURE AND WARMING MOXIBUSTION

Objective To probe into the effects on acute gouty arthritis treated comprehensively with electroacupuncture (EA) and warming moxibustion. Methods 70 cases were randomized into treatment group (48 cases), in which the EA+warming moxibustion was applied; and controlled group (22 cases), in which, colchicine was prescribed for oral administration. Results The statistical outcomes after 1 course treatment in treatment group: 28 cases were cured (58.33%), 18 cases improved (37.50%) and the total effective rate was 95.83%. In controlled group: 12 cases (54.55%) were cured, 8 cases improved (36.36%) and the total effective rate was 90.91%. The therapeutic effects of two groups were basically consistent, without significant different (P>0.05). But, concerning to side effect, there was no any toxic side effects in the group treated with EA+warming moxibustion, and the occurrence rate in the group treated with colchicine was 40.91%. Conclusion Electroacupuncture+warming moxibustion achieves good therapeutic effects without any side effects.

Treatment of 60 Cases of Gouty Arthritis with Modified Simiao Tang

Objective:To observe the clinical effect of a modified Simiao Tang (加味四妙汤 Modified Decoction of Four Wonderful Drugs) for gouty arthritis and its influence on uric acid in blood. Methods: 120 cases of gouty arthritis were randomly divided into the treatment group and control group with 60 cases in each group. Modified Simiao Tang (MST) was orally administered to the patients in the treatment group and allopurinol tablet was orally administered to the patients in the control group. The clinical effects of two groups were evaluated after one-week treatment and uric acid (UA) and C-reactive protein (CRP) levels in blood were determined after 1-month treatment. Results: The total effective rate in the treatment group was significantly higher than in the control group, 86.7% vs. 68.3% (P< 0.01). And the treatment group was also significantly better than the control group in decreasing UA and CRP (P<0.05 or P<0.01). Conclusions: MST can significantly improve the symptoms and signs of gouty arthritis and decrease the levels of UA and CRP. It is good for gouty arthritis.

OBSERVATION ON THE THERAPEUTIC EFFECT OF ACUPOINT INJECTION FOR TREATMENT OF GOUTY ARTHRITIS

In the present paper, 60 cases of gouty arthritis patients were randomly divided into acupuncture group (n=30) and acupoint injection group (n=30). In these two groups, the tender point was used as the main acupoint, combined with Taichong (LR 3), Yinbai (SP 1), Sanyinjiao (SP 6), Juegu (GB 39), Xuehai (SP 10), etc. 10% Chishao (Radix Paeoniae Rubra) Injection and dexamethasone were used for acupoint injection. Results indicated that in acupoint injection and acupuncture groups, 15 (50.0%) and 9 (30.0%) cases had marked improvement, 12 (40.0%) and 10 (33.3%) were effective, and 3 (10.0%) and 11(36.7%) failed in treatment, with the total effective rats being 90.0% and 63.3% respectively. Statistical analysis shows that acupoint injection is significantly superior to simple acupuncture in the therapeutic effect (P<0.05).

Fire needling and bloodletting at cleft points in treatment of 35 patients with acute gouty arthritis

Objective To observe the clinical efficacy of fire needling and bloodletting at cleft points for acute gouty arthritis, and to explore its functional mechanism. Methods Thirty-five patients with acute gouty arthritis were enrolled into this study, and fire needling and bloodletting with 10 mL/ time were applied at cleft points of corresponding meridians and collaterals at the affected side. The treatment was conducted for once every other day, and treatment for three consecutive times was needed. Serum uric acid （UA） and pain score were tested in patients before treatment and on the 6th day after treatment, follow-up visit for 3 months was performed in patients who stopped treatment, and recurrence rate was calculated. Results Budzyuski 6-point behavioral rating scale was applied to score pain. T-test was conducted on mean and standard deviation of pain score before treatment （4.09 ＋ 0.82） and after treatment （1.14 ＋ 1.33）, showing that the difference was significant （P〈0.05）; t-test was also conducted on mean and standard deviation of serum UA before treatment [（555.34 ＋ 53.09） pmol/L] and after treatment [（414.23 ＋ 67.04） pmol/L], showing that the difference was significant （P〈0.05）; among the 35 patients with acute gouty arthritis, 14 patients were cured （40.0%）, improvement was found in 19 patients （54.3%）, and effectiveness was found in 33 patients （94.3%）. Based on follow-up visit for 3 months in 33 patients with efficacy, recurrence was found in 3 patients （9.1%）. Conclusion Fire needling and bloodletting at cleft points is an effective method in treatment of acute gouty arthritis with significant analgesic effect, efficacy of reducing serum UA, high cure rate and low recurrence rate, which is worth of being generalized clinically.

Clinical observation on electroacupuncture plus Jiawei Jinhuanggao(Supplemented Golden Yellow Paste) for gouty arthritis

Objective： To observe the clinical effect of electroacupuncture（EA） plus self-made Jiawei Jinhuanggao（Supplemented Golden Yellow Paste） for gouty arthritis. Methods： A total of 80 cases with gouty arthritis were randomly allocated into an observation group（n=40） and a Western medication group（n=40）. Cases in the observation group received EA and external application of self-made Jiawei Jinhuanggao（Supplemented Golden Yellow Paste）, whereas cases in the Western medication group took Colchicine and Allopurinol tablets orally. After 10 d of treatment, the pain, joint swelling and uric acid in blood were observed. In addition, the follow-up was conducted 6 months after end of the treatment to evaluate the long-term effect. Results： After treatment, there were no between-group statistical differences in pain and uric acid in blood（P〈0.05）; and there were between-group statistical differences in joint swelling and relapse rate（P〈0.05）. The total effective rate was 97.5% in the observation group, versus 95.0% in the Western medication group, showing no statistical difference（P〈0.05）. Conclusion： EA plus Jiawei Jinhuanggao（Supplemented Golden Yellow Paste） has safe and long-term efficacy for gouty arthritis efficacy.

Points selection pattern in acupuncture-moxibustion treatment of gouty arthritis:an analysis based on bibliometrics

To discuss the selection pattern of points and meridians in acupuncture-moxibustion treatment of gouty arthritis （GA） by analyzing clinical literatures related to GA, and to provide reference for acupuncture-moxibustion treatment of GA. Methods： Clinical literatures related to GA treated with acupuncture-moxibustion published between January 1981 and July 2017 were collected from Chinese databases. The points, meridians, frequency and treatment methods were analyzed. Results： A total of 78 studies were included. For meridians, the top 5 meridians used were the Spleen Meridian （67 times）, Liver Meridian （59 times）, Stomach Meridian （53 times）, Kidney Meridian （49 times） and Large Intestine Meridian （44 times）. For points selection, the leading 5 points were Taichong （LR 3） （79 times）, Taibai （SP 3） （68 times）, Sanyinjiao （SP 6） （61 times）, Taixi （KI 3） （57 times） and Yinlingquan （SP 9） （55 times）. For major and adjunct points, the 5 most significant major points were Taichong （LR 3） （79 times）, Taibai （SP 3） （68 times）, Sanyinjiao （SP 6） （61 times）, Yinlingquan （SP 9） （37 times） and Taixi （KI 3） （32 times）. The 5 most significant adjunct points were Yanglingquan （GB 34） （31 times）, Fenglong （ST 40） （30 times）, Xuehai （SP 10） （29 times）, Taixi （KI 3） （25 times） and Quchi （LI 11） （21 times）. For treatment methods, the top 5 methods used were acupuncture-moxibustion alone for 15 studies, acupuncture-moxibustion combined with medicina electroacupuncture combined with bloodletting for 5 studies studies, acupuncture combined with medicinal herbs for 11 herbs for 10 studies, acupuncture alone for 7 studies, and Conclusion： The main meridians chosen in acupuncture-moxibustion treatment of GA were the Spleen, Liver, Stomach, Kidney and Large Intestine Meridians, conforming to the syndrome differentiation principle of tonifying spleen and kidney, clearing heat and draining dampness. Points mainly locate at lower limbs and feet around the affected area, which was a reflection of peripheral treatment function of points. The data mining results of meridian and point selection in acupuncture-moxibustion treatment of GA conform to the disease and syndrome differentiation theory and provide references for acupuncture-moxibustion treatment of GA.

Chief physician Zhang Tang-fa＇s experience of acupuncture for gouty arthritis

Skillful in the treatment of gouty arthritis （GA） by integrated therapies of Chinese and Western medicine, chief physician Zhang Tang-fa proposes to ＇deal with the exterior with the needles, and attack the interior with the drugs, by integrated application of acupuncture and herbal medicine＇, in combination with comprehensive intervention of dietetic therapy and health education. In the treatment of GA, he adopts the syndrome differentiation based upon the pathogenic factors, in combination of syndrome differentiation based upon the six meridians, to reinforce and benefit the spleen and kidney, clear away heat and remove dampness as the therapeutic principle. By acupuncture mainly at the acupoints of the Spleen and Liver Meridians, he also proposes to select the acupoints by the theory of Na Zi Fa （earthly branch method） ofZi Wu Liu Zhu （midnight-noon ebb-flow）, and to puncture the surrounding area of the involved joints shallowly by multiple needles as the major needling method, simultaneously with the reinforcing and reducing manipulations based upon the respiration. In the treatment, acupuncture and acupoint-injection are often used. In diet, low purine diet is often suggested. In health education, the patients are often instructed to understand the disease correctly, eliminate fears and cooperate with doctor＇s treatment positively.

Treatment of Acute Gouty Arthritis by Blood-letting Cupping plus Herbal Medicine

Objective:To observe the therapeutic effect of blood-letting cupping plus herbal medicine for acute gouty arthritis.Methods:The 34 cases of acute gouty arthritis were treated by blood-letting cupping plus herbal medicine.Results:21 cases were cured and 13 cases improved.Conclusion:The therapeutic effect of this therapy was satisfactory for gouty arthritis.

Experimentally investigating the effect of buccal acupuncture on analgesic time-effect characteristics and monoamine neurotransmitters

Objective： To investigate the analgesic time-effect characteristics and changes in concentrations of rabbit＇s hypothalamic 5-hydroxytryptamine （5-HT） and noradrenaline （NE） caused by buccal acupuncture in the rheumatoid arthritis （RA） rabbits, and to reveal the analgesic central mechanism of buccal acupuncture, thereby providing a theoretical basis for the treatment of pain by buccal acupuncture. Methods： Forty rabbits were randomly divided into a normal group, a model group, a body acupuncture group, and a buccal acupuncture group, with 10 rabbits in each group. No model was established in the normal group, while equal dose of normal saline was injected at the matched site and time point; rabbits in other groups were subjected to the establishment of RA models using egg protein. From the 27th day of the experiment, rabbits in each group received the designated intervention. Rabbits in the normal group and the model group were fixed for 30 min every day using the same method as those in the other groups. In the acupuncture group, Dubi （ST 35） and Zusanli （ST 36） on bilateral hind limbs were selected. Perpendicular needling （using the needles with 0.25 mm in diameter and 25 mm in length） was performed with twirling manipulation for 15 s at intervals of 5 min. The needles were retained for 30 min and acupuncture was performed once a day. In the buccal acupuncture group, the knee point in the buccal acupuncture and needles with a diameter of 0.25 mm and a length of 15 mm were selected. Oblique needling was performed with twirling manipulation for 15 s at intervals of 5 min. The needles were retained for 30 min and acupuncture was performed once a day. The thermal pain thresholds at the O, 5, 15, 30, 60, 120 and 240 rain after the 1st and 10th acupuncture therapy were measured with a PL-200 thermal-inducing pain meter. After the 10th acupuncture therapy, rabbit＇s hypothalamus was removed, and the 5-HT and NE concentrations in the hypothalamus at the peak point of the acupuncture pain threshold curve were determined by high performance liquid chromatography （HPLC）. Results： The analgesic effect was obvious at 5 min after buccal acupuncture started, peaked at 30 min, and decreased to the lowest value at 240 rain. Rabbits in the body acupuncture group began to show significant analgesic effect at 15 min, which was peaked at 30 min, and began to decline at 60 min. The pain threshold at 240 min was still higher than that at 0 mino Compared with the model group, the concentrations of hypothalamic 5-HT in the buccal acupuncture group and the body acupuncture group was significantly increased, and the between-group differences were statistically significant （both P〈0.05）. The NE/5-HT ratios in hypothalamus in the buccal acupuncture group and the body acupuncture group were significantly lower than the ratio in the model group, and the differences were statistically significant （both P〈0.05）; difference in the decrease was statistically significant between the buccal acupuncture group and the body acupuncture group （P〈0.05）. Conclusion： The analgesic effect of buccal acupuncture shows an obvious time-dependent curve. It is characterized by rapid onset of pain relief, rapid increase and decline in pain threshold. 5-HT and NE levels in rabbit＇s hypothalamus can be affected by buccal acupuncture, with increased 5-HT concentration and reduced NE/5-HT rati0.

Analgesic effect of different moxibustion durations in rheumatoid arthritis rats

OBJECTIVE:To observe the influence of different moxibustion durations on hypothalamic pro-opiomelanocortin(POMC)and prodynorphin(PDYN)mRNA expressions and plasmaβ-endorphin(β-EP)content in rheumatoid arthritis(RA)rats,to understand the mechanism of moxibustion analgesia and its dose-effect relationship.METHODS:Twelve male Wistar rats were randomly selected from 48 male Wistar rats as a normal control group.The RA model was created by raising rats in a windy(blowing with electric fan),cold(6℃±2℃),and wet(80%-90%humidity)environment for 20 days,12 h each day.This was followed byinjectionofFreund'scompleteadjuvant(0.15 mL)into the ankle.Then,rats were randomly divided into a model group,moxibustion groupⅠ,and moxibustion groupⅡ,with 12 rats in each group.In moxibustion groupsⅠandⅡ,moxibustion was given at Shenshu(BL 23)and Zusanli(ST 36)for 20and 40 min,respectively,once daily for 15 days.Hypothalamic POMC and PDYN mRNA expression levels and plasmaβ-EP content were determined.RESULTS:Compared with the normal group,the pressure pain threshold decreased,while the hypothalamic POMC and PDYN mRNA expression levels and plasmaβ-EP content increased in the moxibustion groups(P<0.01).Compared with the model group,the pressure pain threshold,hypothalamic POMC and PDYN mRNA expression levels and plasmaβ-EP content in the moxibustion groups increased significantly(P<0.01).Compared the moxibustion groupⅠ,the pain threshold,hypothalamic POMC and PDYN mRNA expression levels and plasmaβ-EP content in moxibustion groupⅡsignificantly increased(P<0.01).CONCLUSION:Moxibustion has an analgesic effect and increases hypothalamic POMC and PDYN mRNA expression levels and plasmaβ-EP content inRArats.TheanalgesiceffectinmoxibustiongroupⅡisbetterthanthatinmoxibustiongroupⅠ.

Comparative observation of therapeutic effects of acupuncture combined with infrared irradiation and western medicine on acute gouty arthritis

Objective To compare the efficacy difference in treatment of acute gouty arthritis between acupuncture combined with infrared irradiation and Indomethachin, as well as to observe the impacts on liver function. Methods One hundred and sixty cases of gout were randomized into an acupuncture group （80 cases） and an Indomethachin group （80 cases）. In the acupuncture group, acupuncture was applied to Zusanli（足三里 ST 36）, SanyTnjiao （三阴交 SP 6）, Quchi （曲池LI 11）, Xuehai （血海 SP 10）, Yanglingquan （阳陵泉 GB 34） and Ashi points （阿是穴）. Additionally, infrared irradiation was used in the local area. The treatment was given once daily. In the Indomethachin group, Indomethachin was taken orally, 25 mg each time, three times per day. The treatment lasted for 5 days in either group. Separately, before and after treatment, pain severity and the levels of blood uric acid （BUA）, erythrocyte sedimentation rate （ESR）, alanine aminotransferase （ALT） and aspartate aminotransferase （AST） were detected. Additionally, the efficacy and the impacts on liver function were assessed. Results The cured rate was 52.5% （42/80） in the acupuncture group, which was superior to 22.5% （18/80） in the Indomethachin group （P〈0.01）. In the acupuncture group, the analgesic efficacy was better than that in the Indomethachin group （P〈0.01） and the effect on reducing BUA and ERS levels was same as that in the Indomethachin group （all P〉0.05）. After treatment, ALT and AST levels had no changes in the acupuncture group, but they increased apparently in the Indomethachin group （all P〈0.01）. Conclusion Acupuncture combined with infrared irradiation achieves a superior efficacy on acute gouty arthritis as compared with oral medication of Indomethachin and the therapy provides a significant effect on analgesia and does not bring the damage of liver function.