ABSTRACT
The clinical questions of acupuncture-moxibustion (Acup-Mox) guidelines are complicated, including not only the curative effect of Acup-Mox intervention measures, but also the operational elements of Acup-Mox. This paper aimed to put forward the idea and process of collecting clinical questions in developing international acupuncture clinical practice guidelines. The experience was collected and the idea of collecting clinical questions of Acup-Mox was formed through expert consultation and discussion in combination with expert opinions. Based on the characteristics of Acup-Mox discipline. This paper put forward the thinking of collecting elements of clinical questions following the intervention-population-outcome-control (I-P-O-C) inquiry process, according to the discipline of Acup-Mox. It was emphasized that in the process of collecting clinical questions, "treatable population" and "alleviable outcome indicators" for a specific Acup-Mox intervention with certain therapeutic effect should be focused on, so as to highlight the pertinence of clinical questions of Acup-Mox guidelines in terms of population and outcome elements.
Subject(s)
Moxibustion , Acupuncture Therapy , AcupunctureABSTRACT
OBJECTIVE: Our previous study demonstrated that moxibustion could promote skin wound healing in rats with full-thickness cutaneous wounds. The present study was designed to observe the effect of moxibustion on the levels of pro-inflammatory and anti-inflammatory cytokines, and proliferation of vascular endothelial cells, so as to explore its mechanisms underlying facilitating wound-healing. METHODS: A total of 84 adult SD male rats were randomly assigned to normal (n＝6), model(n＝39)and moxibustion(n＝39)groups. The skin wound model was established by removal of a piece of full-thickness skin from the median line of the rats' back (about 2 cm below the shoulder blade). Moxibustion was applied to the surrounding area of the focus for 25 min, once daily for 6 days. The blood samples were collected at day 1, 2, 3 and 5 after modeling for assaying serum contents of IL-1α， IL-1β， IL-6, IL-4, IL-10, IL-13, granulocyte-colony stimulating factor (G-CSF), granulocyte macrophagecolony stimulating factor (GM-CSF, an inflammatory mediator), macrophage inhibitory protein-1α (MIP-1α) and vascular endothelial growth factor (VEGF) with liquid chip methods, and the topical wound tissues were collected after trans-cardiac perfusion with 4% paraforma-ldehyde solution for detecting the expression of CD31 proteins by using immunofluorescence staining. RESULTS: After modeling and in comparison with the model group, the contents of serum IL-1α and IL-6 at the 1st day were significantly increased (P<0.05), but notably decreased at the 3rd day after modeling in the moxibustion group (P<0.05). The contents of serum IL-1β on day 1 and 2 were significantly higher in the moxibustion group than those of the model group (P<0.05). After moxibustion, the contents of serum IL-4 and IL-10 were significantly up-regulated on day 1 after modeling (P<0.05), and obviously down-regulated from the 3rd day on (P<0.05). The contents of serum MIP-1α on the 2nd day and serum VEGF on day 1 and 2, and wound-skin VEGF on day 5 were obviously up-regulated in the moxibustion group in comparison with the model group (P<0.05, P<0.01)．. CONCLUSION: Moxibustion promotes the inflammatory response by regulating the levels of both pro-inflammatory and anti-inflammatory cytokines in the early phase of skin wounds in rats, which may be in favor of the transformation from the inflammatory phase to the proliferation phase in advance, promoting wound healing at last.
ABSTRACT
OBJECTIVE: To observe the effect of acupuncture plus moxibustion on the synaptic ultrastructure and expression of synaptic skeleton related proteins in the prefrontal cortex (PFC) of heroin re-addicted rats, so as to reveal its mechanisms underlying improvement of heroin addiction. METHODS: Twenty-four Wister rats (half male and half female) were randomly divi-ded into normal control, model and acupuncture groups (n＝8 in each group). The heroin re-addicted model was established by muscular injection of heroin into the hind limbs for 8 days (incremental 0.8-3.6 mg, once daily for 6 days, and twice daily for 2 days), followed by conventional breeding for 5 days (detoxification), the procedure (addition－detoxification) was repeated 3 cycles. For rats of the acupuncture group, "Baihui" (GV20) was needled with filiform needles which were retained for 30 min, and moxibustion was then applied to bilateral "Shenshu" (BL23) for 30 min. The treatment was conducted once daily during the deto-xification. On the 39th day of experiment, the bilateral prefrontal cortex tissues were sampled for examining the ultrastructure by using transmission electron microscope (TEM) after fixative solution immersion and for determining the expression of genes and proteins of activity-regulated cytoskeleton-associated protein (Arc), microtubule-asso-ciated protein-2 (MAP-2) and microtubule-associated protein Tau (Tau) with quantitative real-time PCR and Western blot, respectively. RESULTS: After modeling, the expression levels of Arc mRNA and protein were significantly up-regulated, and those of MAP-2 and Tau mRNA and proteins ob-viously down-regulated in the model group relevant to the normal control group (P<0.05). Following the intervention, the up-regulated Arc protein and mRNA and the down-regulated MAP-2 and Tau were obviously reversed relevant to the model group (P<0.05). Outcomes of TEM showed unclear pre- and post-membranes of the synapses, narrowing of the synaptic gap and non-uniform of the density of the thickened dense plaque after modeling, which was relatively milder in the acupuncture group. CONCLUSION: Acupuncture plus moxibustion can improve changes of synaptic ultrastructure in heroin re-addicted rats, which may be related to their effect in regulating the expression of some synaptic skeleton proteins and genes.