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Objective:To systematically assess the efficacy and safety of acupuncture therapy for essential hypertension.Methods:A computerized literature search of the Chinese National Knowledge Infrastructure(CNKI),Chongqing VIP Database(CQVIP),Wanfang Academic Journal Full-text Database(Wanfang),China Biology Medicine Disc(CBM),PubMed,Excerpta Medica Database(EMBASE),and Cochrane Library was conducted to retrieve randomized controlled clinical trials on acupuncture as the main intervention for the treatment of essential hypertension published from the inception of the database to 30 January 2021.The risk-of-bias assessment was carried out for each included study according to the Cochrane Handbook.Data analysis was performed using Review Manager 5.4.1 and Stata 15.0.Results:After the screening,46 randomized controlled trials involving a total of 3 859 subjects were included.Primary outcomes included changes in the diastolic blood pressure after intervention[eight studies showed that the acupuncture plus antihypertensive drug group was better than the antihypertensive drug monotherapy group[mean difference(MD)=1.45,95%confidence interval(CI)(0.48,2.43),P=0.004,fixed effects model;I2=39%]and changes in the systolic blood pressure after intervention{11 studies showed that the acupuncture plus antihypertensive drug group was better than the antihypertensive drug monotherapy group[MD=8.60,95%CI(7.12,10.07),P<0.00001,fixed effects model;I2=26%]}.The secondary outcome was antihypertensive efficacy,12 studies of acupuncture monotherapy group[risk ratio(RR)=1.20,95%CI(1.12,1.28),P<0.00001,fixed effects model;I2=36%]and 15 studies of acupuncture combined with antihypertensive drug group[RR=1.27,95%CI(1.20,1.34),P<0.00001,fixed effects model;I2=6%]showed better results than the antihypertensive drug monotherapy group in antihypertensive efficacy.In terms of the adverse events,four studies showed that the acupuncture monotherapy group had fewer adverse events than the antihypertensive drug monotherapy group[RR=0.10,95%CI(0.04,0.25),P<0.00001,fixed effects model;I2=0%].Conclusion:Acupuncture combined with antihypertensive drugs is superior to antihypertensive drugs alone in reducing blood pressure,and acupuncture therapy is effective and safe for the treatment of essential hypertension with fewer side effects.However,there is still a lack of high-quality multicenter randomized double-blinded controlled trials in this field.Rigorous large-sample clinical trials are needed to validate these findings.
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Objective: To observe the clinical efficacy of herbal cake-partitioned moxibustion for ulcerative colitis (UC) and elucidate its mechanism by targeting the vitamin D receptor (VDR) signaling pathway. Methods: A total of 63 patients with UC were randomly divided into an observation group (30 cases, treated with herbal cake-partitioned moxibustion) and a control group (33 cases, treated with sham herbal cake-partitioned moxibustion). Moxibustion treatment was performed at Qihai (CV6) and bilateral Tianshu (ST25) and Shangjuxu (ST37), 3 times per week for 12 weeks. The total effective rate, visual analog scale (VAS) score for abdominal bloating and pain, and hospital anxiety and depression scale (HADS) score were compared between the two groups. Enzyme-linked immunosorbent assay was used to detect the concentrations of serum C-reactive protein (CRP), 25-hydroxyvitamin D [25(OH)D], and interleukin-12 (IL-12)/interleukin-23 (IL-23) p40. Immunohistochemistry was used to observe the expression levels of VDR and regenerating gene Ⅳ (Reg Ⅳ) proteins in colonic mucosa. The expression levels of VDR, cytochrome p45027B1 (CYP27B1), and Reg Ⅳ mRNAs were detected by real-time fluorescence quantitive polymerase chain reaction. Results: After treatment, the total effective rate in the observation group was 86.7％, which was significantly higher than 51.5％ in the control group (P<0.05). After treatment, the VAS scores for abdominal bloating and pain in the observation group were significantly decreased (P<0.01), as well as the HADS-depression subscale (HADS-D) and HADS-anxiety subscale (HADS) scores (P<0.05), while only the VAS score for abdominal pain in the control group was reduced (P<0.05), and the improvements of the scores in the observation group were more significant than those in the control group (P<0.05). After treatment, the serum CRP concentrations in both groups and the IL-12/IL-23 p40 concentration in the observation group were significantly decreased (P<0.05), and the concentrations in the observation group were lower than those in the control group (P<0.05). The expression levels of VDR protein and mRNA in the colon in both groups were all increased (P<0.01), and the expression levels of Reg Ⅳ protein and mRNA and CYP27B1 mRNA were all decreased in the two groups (P<0.05 or P<0.01); the improvements in the observation group were more notable than those in the control group (P<0.05 or P<0.01). Conclusion: Herbal cake-partitioned moxibustion can effectively alleviate abdominal pain and diarrhea in patients with UC, improve depression and anxiety disorders, and regulate the expression of related proteins in the VDR signaling pathway. The mechanism may be related to inhibiting intestinal inflammation by reducing the release of the proinflammatory cytokine IL-12/IL-23 p40.
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Objective: To observe the effect of moxibustion on the colonic mucosal barrier of rats with ulcerative colitis (UC) induced by dextran sulfate sodium (DSS). Methods: Forty male Sprague-Dawley rats were randomly divided into a normal group and a modeling group, with 20 rats in each group. Rats in the modeling group were subjected to preparing experimental UC models by drinking 4％ DSS for seven consecutive days. Two modeled rats and two normal rats were randomly selected for model identification. After the success of UC model was confirmed, the remaining 18 modeled rats were randomly divided into three groups, a model group, a model + herbal cake-partitioned moxibustion group, and a model + mild moxibustion group, with six rats in each group; the remaining normal rats were randomly divided into three groups, a normal group, a normal + herbal cake-partitioned moxibustion group, and a normal + mild moxibustion group, with six rats in each group. After 7 d of intervention with the herbal cake-partitioned moxibustion or the mild moxibustion, hematoxylin-eosin (HE) staining technique was used to observe the pathological changes of colon tissue under a light microscope; Western blotting and/or immunohistochemical techniques were used to detect the protein expression levels of Occludin, Claudin, junction adhesion molecular 1 (JAM1), mucin 2 (MUC2), and transforming growth factor beta1 (TGF-β1) in rat colon tissue. Results: Compared with the normal group, the colon tissue was severely damaged, the pathological score was significantly increased, and the protein expression levels of Occludin, Claudin, JAM1, MUC2, and TGF-β1 were significantly decreased in the model group (P<0.01); while there were no significant differences in the colonic histopathological score, protein expression levels of Occludin, Claudin, JAM1, MUC2, and TGF-β1 in the normal + herbal cake-partitioned moxibustion group and the normal + mild moxibustion group (P>0.05). Compared with the model group, the model + herbal cake-partitioned moxibustion group and the model + mild moxibustion group showed repaired colon tissue, ulcer healing, significantly reduced pathological score, and significantly increased protein expression levels of JAM1, MUC2, and TGF-β1 (P<0.05); the Occludin protein expression level in the colon tissue of the model + mild moxibustion group was increased (P<0.01). Conclusion: Neither herbal cake-partitioned moxibustion nor mild moxibustion influences the colonic histopathology and intestinal mucosal barrier-related protein expression in the normal rats; both herbal cake-partitioned moxibustion and mild moxibustion can up-regulate the protein expression levels of JAM1, MUC2, and TGF-β1 in the colon tissue of UC rats. Mild moxibustion can up-regulate Occludin protein expression. This may be a mechanism of moxibustion in reducing colonic mucosa inflammation in UC.
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Objective: To observe the clinical effect and syndrome scores improvements of herbal cake-partitioned moxibustion (HPM) and ginger-partitioned moxibustion (GPM) in treating ulcerative colitis (UC). Methods:A total of 65 eligible cases were randomly divided into a HPM group (n=32) and a GPM group (n=33) according to their visiting order. Bilateral Tianshu (ST 25) and Dachangshu (BL 25) were selected for the HPM or the GPM treatment once daily, 12 d as a treatment course with a 3-day interval, 6 courses in all. The clinical effect, syndrome scale and Mayo scale were evaluated and compared between the two groups. Results:Of the 65 cases enrolled, 2 cases dropped out in the HPM group and 3 cases dropped out in the GPM group, 30 cases of each group finished the treatment courses. The total effective rate is 93.3% in HPM group and 86.7% in the GPM group, there was no statistically significant difference in the total effective rate between the two groups (P>0.05); there were statistically significant differences between the two groups in score evaluation of lasting time of abdominal pain and frequency of diarrhea, HPM is prior to GPM (P=0.032,P=0.044). There are no statistical significant differences between the two groups in scores evaluation of general symptom, three main symptoms, quality of life (QOL), frequency and severity of abdominal pain, times, and pattern of diarrhea (allP>0.05). There was a statistical significant difference in the improvement of Mayo score between the two groups, and HPM was superior to GPM (P=0.048). Conclusion:HPM and GPM are both promising ways to treat UC, and the total effect is quite similar. HPM is superior to GPM in the improvement of lasting time of abdominal pain and frequency of diarrhea, and also the Mayo score.
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Objective:To evaluate and compare electroacupunctures (EA) with different parameters and moxibustion at different temperatures influencing the activation of mast cells (MC) in Tianshu (ST 25) regions of visceral hyperalgesia model rats. Methods:Rats (except for model group) respectively accepted 1 mA or 3 mA EA or moxibustion at 43 or 4 to℃℃stimulate Tianshu (ST 25) points after randomization of the fifty visceral hyperalgesia model rats, and then were compared with that in model and normal groups. Number, degranulation numbers, degranulation rates in Tianshu (ST 25) regions MC of rats in each group were observed using toluidine blue staining. Abdominal withdrawl reflex (AWR) score was used to evaluate the rat visceral hyperalgesia reactions. Results:Compared with the normal group and the model group, MC numbers (P0.05); AWR scores in 1 mA EA group under the stimulation of 0 mmHg or 80 mmHg were significantly higher than that in the normal group (P<0.01); AWR score in 3 mA EA group under the stimulation of 0 mmHg was significantly higher than that in the normal group (P<0.01), and AWR scores in 3 mA EA group under the stimulation of 20 mmHg or 80 mmHg were also higher than that in the normal group (P<0.05). AWR scores were higher in 1 mA EA group under the stimulation of 40 mmHg or 80 mmHg than that in 4℃ moxibustion group (P<0.05); AWR score was higher in 3 mA EA group under the stimulation of 40 mmHg than that in 4℃ moxibustion group (P<0.05). Conclusion:There are differences among EA of different parameters and moxibustion of different temperatures in activating on Tianshu (ST 25) regions MC of visceral hyperalgesia model rats, as well as in improving the visceral hyperalgesia reaction. The effect of 4℃ moxibustion is the most significant.
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Objective:To observe the effect of moxibustion on learning and memory abilities, corticosterone and glucocorticoid receptor (GR) in subacute aging rats. Methods:Twenty four Sprague-Dawley (SD) rats were randomly divided into a normal group, a model group and a moxibustion group, 8 rats in each group. Rats in the model group and the moxibustion group were subcutaneously injected with 25% D-galactose [125 mg/(kg·bw)] for 40 d continuous; rats in the normal group were injected with saline at the same position for 40 d continuous. Rats in the moxibustion group were given mild moxibustion at bilateral Shenshu (BL 23) at the same time of modeling; rats in the normal group and the model group were only identically grabbed without moxibustion for 40 d. The learning and memory abilities of rats were observed using the Morris water maze at the end of the experiment. Abdominal aorta blood and thymus were collected after water maze experiment. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum corticosterone level, and immunohistochemical method was used to detect the expression of thymus GR. Results:Compared with the normal group, rats in the model group showed that a significantly longer escape latency time (P<0.01) on the third and the fourth days; number of times crossing the platform in 70 s significantly reduced (P<0.01); activity times in the fourth quadrant significantly decreased (P<0.05); serum corticosterone levels increased (P<0.01); thymus GR expression decreased (P<0.05). Compared with the model group, rats in the moxibustion group showed that the escape latency times were significantly shorter on the third, the fourth and the fifth days (P<0.01,P<0.05); number of times crossing the platform in 70 s significantly increased (P<0.05); activity times in the fourth quadrant significantly increased (P<0.05); serum corticosterone levels decreased (P<0.05); thymus GR expression increased (P<0.05). Conclusion:Moxibustion could improve the learning and memory abilities of subacute aging rats, down-regulate serum corticosterone levels, and increase thymus GR content.
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Objective: To categorize and summarize the clinical and mechanism studies of the past 30 years on the treatment of Hashimoto’s thyroiditis (HT) with moxibustion, moxibustion plus medication, and acupuncture plus medication, etc., and to analyze the current problems. Methods: The clinical and laboratory studies related to the treatment of HT with acupuncture-moxibustion therapies published before June 2015 were retrieved from MEDLINE, Excerpta Medica Database (EMBASE), China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang) and Chongqing VIP Database (CQVIP). Results:Moxibustion, moxibustion plus medication, and acupuncture plus medication can produce certain therapeutic effects in treating HT. Conclusion:The research on the treatment of HT with acupuncture-moxibustion therapies is rather limited in the amount and content. In the future, standardization should be fortified, specific moxibustion research needs deepening, and the action mechanism of moxibustion should be emphasized.
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Objective:To observe the effect of electroacupuncture (EA) and herbal cake-partitioned moxibustion on anxiety and depression in patients with Crohn’s disease (CD) in remission. Methods:Sixty CD cases were randomly allocated into an EA group (n=30) and an herbal cake-partitioned moxibustion group (n=30) using the random number table by the ratio of 1:1. In addition, 30 healthy subjects were included in a control group. Bilateral Tianshu (ST 25), Qihai (CV 6) and Zhongwan (CV 12) were used in the EA and herbal cake- partitioned moxibustion groups. The treatment was done 3 times a week, for a total of 12 weeks. The efficacy was evaluated using self-rating anxiety scale (SAS), self-rating depression scale (SDS) and traditional Chinese medicine (TCM) symptom scores. Results:Before treatment, the SAS and SDS scores in CD patients were remarkably higher than those in healthy subjects. After EA or herbal cake-partitioned moxibustion treatment, the SAS and SDS scores were significantly decreased in both groups, showing significant intra-group differences (P0.05). Conclusion:Both EA and herbal cake-partitioned moxibustion can significantly decrease abnormally high SAS and SDS scores in CD patients as well as TCM symptom scores. The two therapies share similar effects in alleviating common symptoms and improving anxiety and depression.
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<p><b>OBJECTIVE</b>To observe the effects and safety of clinical common symptoms of active Crohn's disease at the mild and moderate stages treated with acupuncture and moxibustion.</p><p><b>METHODS</b>One hundred and two patients were randomly divided into an observation group and a control group, 51 cases in each one. Herb-partition moxibustion and acupuncture were used in the observation group. Herbal cakes with(),(),(),(),(),() and() as the main ingredients were used on Tianshu (ST 25), Qihai (CV 6) and Zhongwan (CV 12); acupuncture was used at Zusanli (ST 36), Shangjuxu (ST 37), Sanyinjiao (SP 6), Taixi (KI 3), Gongsun (SP 4) and Taichong (LR 3). Bran-partition moxibustion and shallow acupuncture were applied in the control group. Wheat bran-partition moxibustion in the shape of cake was implemented on the same acupoints as the observation group; shallow acupuncture was used 1~2 cm next to the acupoints. Treatment was given three times a week for 12 weeks, 36 times totally. Clinical effects of eight symptoms were evaluated by TCM symptom score, and the symptoms included abdominal pain (degree, frequency, time), diarrhoea (number, shape and frequency), fatigue, anorexia, borborygmus andflatus, fear of cold, soreness and weakness of waist and knees, tenesmus.</p><p><b>RESULTS</b>After 12-week treatment, the eight symptoms were improved apparently (all<0.05), with the scores of abdominal pain (degree, frequency, time), diarrhoea (shape and frequency), fatigue and anorexia in the observation group decreasing more obviously (all<0.01). There was no statistical significance about the other symptom scores between the two groups (all>0.05).</p><p><b>CONCLUSIONS</b>Herb-partition moxibustion combined with acupuncture achieve safety and efficacy for mild and moderate Crohn's disease, and can improve the clinical common symptoms. Furthermore, their effects on abdominal pain (degree, frequency, time), diarrhoea (shape and frequency), fatigue and anorexia are better than those of bran-partition moxibustion and shallow acupuncture.</p>
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METHODS:A computer-based online research of PubMed, CNKI and VIP databases was performed with the key words of “epigenetic; inflammatory bowel disease; Crohn’s disease; ulcerative colitis; DNA methylation; histone modification; miRNA; moxibustion” in Chinese and English. RESULTS AND CONCLUSION:The correlation of epigenetic modification with inflammatory bowel disease occurrence and development is elaborated. The mechanisms in inflammatory bowel disease have been related from DNA methylation, histone modifications and miRNA targets. The mechanism of moxibustion on inflammatory bowel disease is primarily associated with immune regulation, and its anti-inflammatory mechanism may be affected by epigenetic regulation of inflammatory cytokines.
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BACKGROUND:Warm acup-moxibustion is an effective treatment in Chinese traditional medicine, which combines acupuncture with moxibustion. With an immediate analgesia or/and long-term effect, warm acup-moxibustion has been used clinicaly for acute and chronic pain. OBJECTIVE:To analyze the progress in the studies about clinical application of warm acup-moxibustion as analgesic therapy for acute and chronic pain and to discuss the influential factors. METHODS: CNKI, VIP and Wanfang databases were searched for relevant articles published between January 1995 and July 2015 using the keywords of “warm needling; warm acup-moxibustion; pain; analgesic” in Chinese. According to the exclusion and inclusion criteria, 51 articles were included in result analysis. RESULTS AND CONCLUSION: Compared with ordinary acupuncture, medicine and other treatment methods, warm acup-moxibustion can play an analgesic role in multiple systems, which is better than ordinary acupuncture and Western medicine. Warm acup-moxibustion combined with drugs and acupuncture techniques can increase the analgesic effect and improve joint function activity. Warm acup-moxibustion with the overal regulatory role plays an effective analgesic pain role in the multiple systems and shortens the duration of treatment, which is an effective method for treating pain and worthy of further promotion and application.
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BACKGROUND:Moxibustion products produced in moxibustion, such as moxa smoke, are one of hotspots in moxibustion research. Metabonomics can be used to more comprehensively and systematicaly study the effects of moxibustion products on the body. OBJECTIVE:To investigate the efect of diferent concentrations of moxibustion products on urine metabonomics of rats. METHODS:Forty Sprague-Dawley rats were randomly divided into normal control group, low-dose moxibustion products group, middle-dose moxibustion products group, high-dose moxibustion products group, high-dose moxibustion products recovery group. In the latter four groups, rats from each group were exposed to the mixture of moxibustion products and pure gas at ratios of 0.4:2.0, 0.8:2.0, 1.6:2.0, 1.6:2.0, respectively, 4 hours daily, 5 days weekly, totaly for 60 days. After 60-day high-dose moxibustion products stimulation, rats in the high-dose moxibustion products recovery group were raised in normal air for 21 days. Rats in the normal control group were raised in normal air for 60 days without any moxibustion products. Then we analyzed the changes of urine metabonomics in al group rats. RESULTS AND CONCLUSION: Totaly 108 metabolites were identified in the urine of rats using gas chromatography/time-of-flight mass spectrometry, and 64 metabolites were verified by standard library. There were some positive correlations between changes of typical metabolites and moxibustion product concentrations. The metabolites in the urine were most different between the high-dose moxibustion products group and normal control group. Twenty-two differential metabolites, such as glucuronic acid and vitamin C were mainly involved in 15 sugar and amino acid metabolic pathways, such as ascorbate and aldarate metabolism. These findings indicated that energy metabolism, detoxification and anoxidation increased in rats stimulated by moxibustion products.
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This study was aimed to investigate the effect of visceral pain and water metabolism on irritable bowel syndrome with diarrhea (IBS-D) model rats by moxibustion and its products. A total of 40 SD rats were randomly di-vided into the normal group, model group, moxibustion group, non-smoke moxibustion group, and moxa smoke group. IBS-D model was induced by colorectal distension with an inflatable balloon. The general condition of rats was ob-served. Visceral pain was assessed by abdominal withdrawal reflex (AWR) scores. The immunohistochemical method was used in the detection of claudin-1, AQP3, AQP8 and Na+/K+-ATPase protein expression. The results showed that compared with the normal group, the AWR scores, claudin-1, AQP3, AQP8 and Na+/K+-ATPase protein expres-sion in the colon were decreased in the model group (P < 0.01). The stool was loose, which was on hair around the anus. After moxibustion, non-smoke moxibustion and moxa smoke stimulation, the stool conditions of IBS-D model rats were improved. The AWR scores were decreased in different degrees (P < 0.05 or P < 0.01). Except Na+/K+-ATPase, expressions of claudin-1, AQP3 and AQP8 in colon were increased in different degrees (P < 0.05 or P <0.01). The comprehensive therapeutic effect showed that moxibustion was better than non-smoke moxibustion; and non-smoke moxibustion was better than moxa smoke stimulation. It was concluded that the combination of warm stimulation, optical radiation and moxa smoke induced best effect in improving visceral pain and water metabolism on IBS-D model rats. Among them, warm stimulation and optical radiation may play the main role.
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The purpose was to investigate the research achievements over the past two decades on moxa smoke produced in the process of moxibustion, in terms of its clinical studies, chemical compositions, safety assessment as well as the mild smoke or smoke-free moxibustion, for revealing the recent dynamic and developing orientation, and promoting its further application, succession and innovation.
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In order to understand the resistance against common antibiotics in clinic and macrolide antibiotic-resistant mechanism of Streptococcus pneumoniae (S.pneumoniae) isolates in Zhejiang area,both K-B slip method and E-test were applied to determine the sensitivity of 138 S.pneumoniae isolates to nine antibiotics,and the ermB and mefE genes in those isolates which associated with macrolide antibiotics-resistance closely were detected by PCR.Subsequently,correlation among ermB and mefE genes and the erythromycin resistance were analyzed.For these 138 S.pneumoniae isolates,93.5% (129/138) of the strains were resistant to erythromycin,but only 2.9%～4.3% strains were resistant to cefotaxim,cefuroxime,amoxicillin and levofloxacin.The positive rate of ermB gene in the isolates (91.3%,126/138) was significantly higher than that of mefE gene (33.3%,46/138) (P<0.05).Both of these two genes existed in 27.5 % (38/138) of the strains and all of the strains without ermB and mefE genes were sensitive to erythromycin.The erythromycin resistance rate (62.5%) of mefE gene positive strains was remarkably lower than that of the mefE&ermB gene positive strains (100%) and the ermB gene positive strains (97.7%) (P<0.05).All the data mentioned above demonstrated that erythromycin is not an appropriate antibiotic to treat the infectious diseases caused by S.pneumoniae.Moreover,ermB is the predominant erythromycin resistance gene in S.pneumoniae isolates and ermB gene could inspire stronger erythromycin resistance than mefE gene.