System evaluation and Meta analysis on clinical effi cacy of heat-sensitive moxibustion in treatment of cervical spondylotic radiculopathy

Objective To systematically evaluate the efficacy of heat-sensitive moxibustion in treatment of cervical spondylotic radiculopathy（CSR）. Methods Chinese National Knowledge Infrastructure（CNKI）, China Biology Medical（CBM） database, Chinese Science and Technology Periodical Database（VIP）, Wan Fang Data, Pubmed and Cochrane Library were retrieved to search the randomized controlled trials（RCT） on heat-sensitive moxibustion in treatment of CSR, and Meta analysis was conducted by applying Rev Man 5.3 software. Results Eventually, 10 papers were included in this study, including 1008 subjects. Meta analysis result showed： the total effective rate of treatment group was higher than that of control group, and the difference was statistically significant [RR=1.13, 95%CI（1.06, 1.21）, Z=3.54, P=0.000 4]; the cure rate of treatment group was higher than that of control group, and the difference was statistically significant [RR=1.80, 95%CI（1.52, 2.13）, Z=6.82, P〈0.000 01]; the improvement of short-form Mc Gill pain questionnaire（SF-MPQ） of treatment group was superior to that of control group, and the difference was statistically significant [MD=–4.44, 95%CI（–6.38,-2.50）, Z=4.49, P〈0.000 01]; visual analogue scale（VAS） of treatment group was lower than that of control group, and the difference was statistically significant [MD=-0.36, 95%CI（-0.50, –0.23）, Z=5.42, P〈0.00001]; and the improvement of interleukin-6（IL-6） of treatment group was superior to that of control group, and the difference was statistically significant [MD=–7.32, 95%CI（-11.49, –3.14）, Z=3.44, P=0.000 6]. Conclusion It is indicated from the Meta analysis result that the clinical efficacy of heat-sensitive moxibustion or acupuncture combined with heat-sensitive moxibustion in treatment of CSR is superior to that of simple acupuncture or traditional suspended moxibustion, providing a new therapeutic method for treatment of CSR. However, the abovementioned conclusion still needs to be confirmed through randomized blind controlled trials with high quality and large sample size since the sample size of included studies was small, and the quality was low.

Effect of warming yang and supplementing kidney moxibustion therapy on the NF-κB signaling pathway of vascular dementia rats

Objective： To observe the effect of warming yang and supplementing kidney moxibustion therapy on the behavioristics and the expression levels of hippocampal IL-1β, TNF-α and NF-κB related genes and proteins of vascular dementia（VD） rats, and to explore the mechanism of warming yang and supplementing kidney moxibustion therapy in inhibiting VD inflammatory response. Methods Seventy-eight SD rats, except 10 rats as sham operation group（group A）, were established into VD models by applying the ischemia reperfusion method in bilateral common carotid arteries. 30 models were successful and were randomly divided into model group（group B）, moxibustion group（group C） and western medication group（group D）, with 10 rats in each group. After modeling, suspended moxibustion was conducted at ＂Dàzhuī（大椎GV 14）＂,＂Mìngmén（命门GV 4）＂ and ＂Guānyuán（关元CV 4）＂ of the rats in group C for15 min/time. The intervention was performed for once a day, and intervention for 4 consecutive weeks was needed. Intragastric administration with nimodipine（2 mgkg-1d-1） was carried out in the rats in group D for 4 consecutive weeks. Morris water maze test was adopted for behavioral test in the rats in each group. HE staining was conducted in order to observe the pathological changes. RT-qPCR method and Western blot method were used for detecting the expression levels of hippocampal IL-1β, TNF-αand NF-κB related genes and proteins.Results： After modeling, the Morris water maze escape latency of rats in operation groups was obviously longer than that in group A（P〈0.05）. According to HE staining results, the arrangement of neurons in group B was incompact, the cell membranes were undefined, the cytoplasm was heterogeneous, karyopyknosis was found, the amount of necrosis increased, and the number of inflammatory cells significantly increased. Compared with group B, the number of inflammatory cells significantly reduced in group C and group D, and the amount of neuron necrosis also reduced. After intervention, compared with group B, the expression levels of TNF-a, p-IκB and NF-κBp65 mRNA in the hippocampal of the rats in group C and group D significantly decreased（all P〈0.05）, compared with group B, the expression levels of IL-1β, TNF-α and NF-κBp65 mRNA in the hippocampal of rats in group C and group D also significantly decreased（all P〈0.05）.Conclusion： Warming yang and supplementing kidney moxibustion therapy may inhibit the NF-κB signaling pathway and reduce the inflammatory response through lowering the expression levels of IL-1β,TNF-α and NF-κB mRNA in the brain, thus achieving the purpose of treating VD.