“足全息综合治疗仪”治疗“风关痛”的临床观察

“风湿寒性关节肌肉疼痛”,简称“风关痛”,属于中医“痹病”范畴的一种常见病和多发病,它不仅给患者造成疼痛之苦,并影响关节功能活动导致生活和工作的不便。“足全息综合治疗仪”是根据中医传统理论研制的内病外治理论与现代科技相结合,集电、热、磁、温灸诸法于一体的一种保健仪器。为验证该仪器对“风关痛”的保健作用,我们于1998年9月～1998年10月进行了临床观察,现将结果报告如下。

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.

中药熏蒸治疗风湿寒性关节痛160例临床观察

风湿寒性关节痛(风关痛),是指人体感受风湿寒邪引起的以关节、肌肉疼痛为主要临床表现的疾病。本病属于常见病、多发病。我们应用中药熏蒸疗法治疗风关痛160例,取得了较好疗效,现报告如下。

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.

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.

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.

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.

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.

Effect of moxibustion on N-methyl-D-aspartate receptor subtype 2B expression in hippocampus of rheumatoid arthritis model rats

Objective:To observe the effect of moxibustion on the expression of N-methyl-D-aspartic acid(NMDA)receptor subtype 2B(NR2B)in the hippocampus of rheumatoid arthritis(RA)rats,and to explore the analgesic mechanisms of moxibustion in RA treatment.Methods:Sixty male Sprague-Dawley rats were randomly divided into a normal group,a model group,a moxibustion group,a moxibustion+NMDA receptor antagonist(AP-5)group,and a moxibustion+NMDA receptor agonist(NMDA)group,with 12 rats in each group.Except for the normal group,rats in the other four groups were treated with complete Freund's adjuvant in a windy,cold,and damp environment to replicate RA models.Rats in the moxibustion group received suspended moxibustion with moxa sticks at Shenshu(BL23)and Zusanli(ST36),and the two points were used alternately.After intraperitoneal injection of AP-5 or NMDA,rats in the moxibustion+AP-5 group and the moxibustion+NMDA group received the same moxibustion intervention as in the moxibustion group,once a day for 15 d.The thermal withdrawal latency(TWL)of rats in each group was detected before and after modeling and after the 15-day intervention.After the 15-day intervention,hematoxylin-eosin staining was performed to observe the pathological changes in knee joints.The real-time fluorescence quantitative polymerase chain reaction method was used to detect the mRNA expression of NR2B in the hippocampus;Western blotting assay was used to detect the protein and the phosphorylated protein expression of hippocampal NR2B.Results:The synovial tissue was proliferated,the synovial lining was significantly thickened,the pannus was formed,and the cartilage and bone tissues were significantly damaged in the model group.After intervention,the pathological morphology of the knee joints in the moxibustion group,the moxibustion+AP-5 group,and the moxibustion+NMDA group was significantly improved,and the improvement in the moxibustion+AP-5 group was more notable than that in the moxibustion+NMDA group.Compared with the normal group,the TWL was significantly decreased(P<0.01),and the mRNA,protein,and phosphorylated protein expression levels of hippocampal NR2B were significantly increased in the model group(P<0.01).Compared with the model group,the TWL of each intervention group was significantly increased(P<0.01 or P<0.05),and the mRNA,protein,and phosphorylated protein expression levels of hippocampal NR2B were significantly decreased(P<0.01).Compared with the moxibustion group,the TWL was significantly increased(P<0.01),and the mRNA,protein,and phosphorylated protein expression levels of hippocampal NR2B were significantly decreased in the moxibustion+AP-5 group(P<0.01);the TWL was significantly decreased(P<0.01),and the mRNA,protein,and phosphorylated protein expression levels of hippocampal NR2B were significantly increased in the moxibustion+NMDA group(P<0.01).Conclusion:Moxibustion reduces hyperalgesia in RA inflammatory rats.The analgesic effect may be related to the decrease in the expression and phosphorylation levels of NR2B in the hippocampus.