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Objective: To explore the potential mechanism of acupuncture and moxibustion in treating Crohn disease (CD) by evaluating the changes in histamine and inflammatory factors in the skin tissue at Tianshu (ST25) of rats.Methods: Fifty-eight Sprague-Dawley rats were randomly divided into a normal group (n=14) and a CD-modeling group (n=44). Rats in the CD-modeling group received enema with 2,4,6-trinitrobenzene sulfonic acid plus ethanol to establish CD models. The enema was repeated once every 7 d for a total of 4 times. After modeling, four modeled rats and four normal rats were randomly selected for model identification. After the CD model was successfully established, the remaining rats in the CD-modeling group were randomly divided into a model group, an acupuncture group, a moxibustion group, and a Western medication group, with ten rats in each group. The rats in the acupuncture and moxibustion groups were treated with acupuncture or moxibustion at Tianshu (ST25) and Shangjuxu (ST37); the rats in the Western medication group were treated with mesalazine enteric-coated tablets by gavage for continuous 7 d. After the intervention, the colon tissue of rats in each group was collected. After gross observation, hematoxylin-eosin (HE) staining was performed to further observe the pathological changes. The expression of histamine in the skin tissue at Tianshu (ST25) was detected by enzyme-linked immunosorbent assay. The expression of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-18, IL-10, and IL-6 in the skin tissue at Tianshu (ST25) was detected by Western blotting. Results: Compared with the normal group, the colonic wall of rats in the model group showed cobblestone-like changes, local ulcers, and polyps in dark red and thickening and hardening. HE staining showed local loss of mucosal epithelial layer and formation of slit-like ulcers, destruction of mucosal glands, edema, and infiltration of inflammatory cells in lamina propria and submucosa, and occasional formation of sarcoid-like granuloma. The levels of histamine and IL-6 were significantly up-regulated (P<0.01, P<0.05), and the levels of TNF-α, IL-18, and IL-10 were significantly down- regulated (P<0.01 or P<0.05) in the skin tissue at Tianshu (ST25) of rats in the model group. Compared with the model group, the pathomorphological damage of the colon tissue of rats in the acupuncture group, moxibustion group, and Western medication group was significantly improved. The levels of histamine and IL-6 were significantly down- regulated (P<0.01, P<0.05), and the level of IL-10 was significantly up-regulated (P<0.01) in the skin at Tianshu (ST25) of rats in the acupuncture group. The levels of histamine and IL-6 were significantly down-regulated (P<0.01, P<0.05), and the levels of TNF-α, IL-18, and IL-10 were significantly up-regulated (P<0.01 or P<0.05) in the skin tissue at Tianshu (ST25) of rats in the moxibustion group. The level of histamine was significantly down-regulated (P<0.01), and the levels of IL-18 and IL-10 were significantly up-regulated (P<0.05, P<0.01) in the skin tissue of rats in the Western medication group. Compared with the acupuncture group, the level of IL-10 in the skin tissue at Tianshu (ST25) of rats in the moxibustion group was significantly up-regulated (P<0.01). Conclusion: The inflammatory responses in the skin tissue at Tianshu (ST25) may be the external manifestation of CD. Significant differences in the regulation of inflammatory responses in the skin tissue at Tianshu (ST25) between acupuncture and moxibustion exist, which may be caused by the differences in the stimulation characteristics between acupuncture and moxibustion.
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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 explore the mechanism of herbal cake-partitioned moxibustion in Crohn disease (CD) treatment by observing the effect of herbal cake-partitioned moxibustion on protein expressions of colonic M2 macrophage marker CD206, AMP-activated protein kinase (AMPK) and tuberous sclerosis complex (TSC) 2. Methods: Twenty-six specific pathogen free male rats were randomly divided into a normal group, a model group and a herbal cake-partitioned moxibustion group. The CD model was prepared by enema with the mixture of 5％ (W/V) 2,4,6- trinitrobenzene sulfonic acid (TNBS) and 50％ ethanol at 2:1 (volume ratio). After the model was successfully prepared, rats in the herbal cake-partitioned moxibustion group received herbal cake-partitioned moxibustion at Qihai (CV 6) and bilateral Tianshu (ST 25). Hematoxylin-eosin (HE) staining was used to observe the histopathological changes of rat colon; immunohistochemical technique was used to detect the expression of colonic CD206 protein; Western blot, immunofluorescence, and real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) technologies were used to detect the protein and mRNA expressions of colonic AMPK and TSC2. Results: Compared with the normal group, rats in the model group showed damaged colonic mucosa, missing of the epithelial layer, thickened submucosa, vascular proliferation, massive infiltration of monocytes and lymphocytes, and cracked ulcers that reached the muscle layer. Rats in the herbal cake-partitioned moxibustion group showed reduced intestinal inflammation and healing intestinal epithelium ulcers. Compared with the normal group, rat colonic CD206 protein expression, and the protein and mRNA expressions of colonic AMPK and TSC2 were decreased in the model group (all P<0.01); compared with the model group, rat colonic CD206 protein expression was increased (P<0.01), as well as the protein and mRNA expressions of AMPK and TSC2 in the herbal cake-partitioned moxibustion (all P<0.05). Conclusion: Herbal cake-partitioned moxibustion can reduce intestinal inflammation in CD rats, increase colonic CD206 protein expression, and up-regulate the protein and mRNA expressions of colonic AMPK and TSC2.
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Objective:To observe the effect of moxibustion on the protein and mRNA expressions of corticotropin-releasing factor (CRF)and corticotropin-releasing factor receptor 1 (CRFR1) in hypothalamus of trinitrobenzene sulfonic acid (TNBS)-induced experimental colitis rats,and to explore the central mechanisms of moxibustion in improving visceral pain and the pain-related emotions in experimental colitis rats.Methods:Thirty-six Sprague-Dawley (SD) rats were randomly divided into a normal group (NG),a model group (MG),a herb-partitioned moxibustion group (HPMG) and a sham herb-partitioned moxibustion group (SHPMG).Except the NG,rats in the remaining three groups all received TNBS enema to establish experimental colitis models.The HPMG received herb-partitioned moxibustion (HPM) at bilateral Tianshu (ST 25) and Qihai (CV 6) for intervention;for the SHPMG,the herbal cakes and moxa cones were only placed on the acupoints but not ignited;rats in the MG and NG were only fixed in the same way as those in the HPMG but did not receive any treatment.At the end of the intervention,the abdominal withdrawal reflex (AWR) score,the open field test (OFT) score and the elevated plus maze (EPM) score were observed to measure the changes in visceral pain and pain-related emotions of the rats.The enzyme-linked immunosorbent assay (ELISA) was used to examine the expressions of CRF and CRFR1 proteins in hypothalamus;the fluorescence-based quantitative polymerase chain reaction (PCR) was used to detect the expressions of CRF and CRFR1 mRNAs in hypothalamus.Results:Compared with the NG,the AWR score increased significantly and the OFT and EPM scores dropped significantly in the MG (all P＜0.05),and the expressions of hypothalamic CRF and CRFR1 proteins and mRNAs increased significantly (all P＜0.01).Compared with the MG and SHPMG,the AWR score dropped significantly and the OFT and EPM scores increased significantly in the HPMG (all P＜0.01),and the expressions of hypothalamic CRF and CRFR1 proteins and mRNAs decreased significantly (all P＜0.05).There were no significant differences between the MG and the SHPMG (all P＞0.05).Conclusion:HPM can down-regulate the abnormally increased expressions of CRF and CRFR1 proteins and mRNAs in hypothalamus of the TNBS-induced experimental colitis rats,which is plausibly one of its action mechanisms in mitigating visceral pain and the pain-related emotions in the experimental colitis rats.
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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 prevention effect of Tui-pushing the Large Intestine Meridian plus point sticking at Tianshu (ST 25) for post-stroke constipation. Methods:Seventy eligible patients with post-stroke constipation were randomized into a treatment group and a control group, 35 cases in each group. Both groups were intervened by conventional treatment and care in Western medicine, while the treatment group was also by Tui-pushing the Large Intestine Meridian and point sticking at Tianshu (ST 25). The treatment lasted for 14 d. Therapeutic efficacy was evaluated by the first defecation time, constipation incidence and Chinese stroke scale (CSS) score. Results:After treatment, the first defecation time was (1.86±0.74) d in the treatment group, shorter than (2.77±0.83) d in the control group; constipation incidence was 14.3% in the treatment group, significantly lower than 37.1% in the control group, and the between-group differences in the two items were statistically significant (bothP<0.05). CSS score in both groups dropped significantly after treatment (bothP<0.05); the improvement in the treatment group was better than that in the control group, and the inter-group difference was statistically significant (P<0.05). Conclusion: Tui-pushing the Large Intestine Meridian plus point sticking at Tianshu (ST 25) can effectively prevent post-stroke constipation, and can also promote the rehabilitation of nerve functions.
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Objective: To compare the different therapeutic effects of acupuncture and Phenolphthalein for constipation due to intestinal qi stagnation. Methods:A total of 50 patients with constipation due to intestinal qi stagnation were randomly divided into an acupuncture group and a medication group by the random digital table, 25 cases in each group. The patients in the acupuncture group were treated by puncturing Gongsun (SP 4), Sanyinjiao (SP 6), Taichong (LR 3), Zusanli (ST 36), Shangjuxu (ST 37), Hegu (LI 4), Lieque (LU 7), and Tianshu (ST 25), once every day, and 7 d as one course, for continuous 3 courses; while the patients in the medication group were given Phenolphthalein, 7 d as one course, for continuous 3 courses. Compared the Cleveland clinic constipation score (CCS) between the two groups after one course, 3 courses and 3 months after the treatment, as well as the frequency of defecation within one week. Results:After one week of treatment, CCS scores and frequency of defecation per week were significantly changed in both groups compared with those before treatment (P<0.05), and CCS scores and frequency of defecation per week were improved more significantly in the patients of the medication group than in those of the acupuncture group (P<0.01). After 3 weeks of treatment, CCS scores and frequency of defecation per week were significantly changed in both groups compared with those before treatment (P<0.05), and CCS scores and frequency of defecation per week were improved more significant in the patients of the acupuncture group than in those of the medication group (P<0.05). Three months after the end of treatment, CCS scores and frequency of defecation per week were significantly changed in both groups compared with those before treatment (P<0.05), and CCS scores and frequency of defecation per week were improved more significantly in the patients of the acupuncture group than in those of the medication group (P<0.05). Conclusion:Acupuncture and medication are effective in the treatment of constipation due to intestinal qi stagnation. Their short-term therapeutic effect is similar, but the long-term therapeutic effect is better in the acupuncture group than in the medication group.
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Objective To observe the clinical efficacy of deep needling at Tianshu (ST25) with electroacupuncture in treating post-stroke constipation. Method Forty-eight patients with post-stroke constipation were randomized into an electroacupuncture (EA) group and a medication group, 24 cases in each group. The EA group was intervened by deep needling at Tianshu with EA, while the medication group was by Cong Rong Tong Bian oral liquid. After 1 treatment course, the constipation symptom score was observed and the clinical efficacy was calculated. Result After 1 treatment course, the symptom score, total effective rate, recovery plus markedly-effective rate of the EA group were superior to that of the control group, and the inter-group differences were statistically significant (P<0.05). Conclusion Deep needling at Tianshu with EA can significantly enhance the clinical efficacy in treating post-stroke constipation and improve the quality of life.
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Objective To observe the clinical efficacy of deep needling at Tianshu (ST 25) and Fujie (SP 14) plus electroacupuncture in treating severe functional constipation (FC).Method Sixty-three patients with severe FC were randomized into a treatment group of 33 cases and a control group of 30 cases. The treatment group was intervened by deep needling at Tianshu (ST 25) and Fujie (SP 14) plus electroacupuncture, while the control group was by sham electroacupuncture. The Complete Spontaneous Bowel Movement (CSBM), Bristol Stool Scale (BSS), and Patient Assessment of Constipation Quality of Life (PAC-QOL) were evaluated before and after intervention.Result In the treatment group, the CSBM after 2-week, 4-week, and 8-week treatments and CSBM of the 4-week and 12-week follow-up study were significantly different from that before intervention (P<0.05). In the control group, the CSBM after 8-week treatments was significantly different from that before intervention (P<0.05). The CSBM after 2-week, 4-week, and 8-week treatments and CSBM of the 4-week and 12-week follow-up study in the treatment group were significantly different from that in the control group (P<0.05). The BSS scores were significantly changed after 2-week, 4-week, and 8-week treatments in both groups compared to that before intervention (P<0.01,P<0.05). The BSS scores after 2-week, 4-week, and 8-week treatments in the treatment group were significantly different from that in the control group (P<0.01,P<0.05). The item scores of PAC-QOL (physical discomfort, psychosocial discomfort, worries and concerns, and satisfaction scores and global score) were significantly changed after intervention in the treatment group (P<0.05). The item scores of PAC-QOLA including physical discomfort, worries and concerns, and satisfaction and global score were significantly changed after intervention in the control group (P<0.05). After intervention, the PAC-QOL scores of the treatment group were significant different from that of the control group (P<0.05).Conclusion Deep needling at Tianshu (ST 25) and Fujie (SP 14) plus electroacupuncture is an effective method in treating severe FC.
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Objective To observe the clinical efficacy of puncturing Tianshu (ST 25) alone in treating intractable constipation in the elderly.Method Totally 193 senile subjects with intractable constipation were randomized into group A of 57 cases, group B of 73 cases, and group C of 63 cases. Group A was intervened by acupuncture at Tianshu (ST 25), group B was by Lactulose oral solution, and group C was by retention enema. The clinical efficacies and effect-lasting time of the three groups were compared. Result The total effective rate was 89.3% in group A, versus 88.6% in group B and 92.1% in group C, and the between-group differences were statistically insignificant (P>0.05). Of the markedly effective and improved cases, the effect-lasting time in group A was significantly different from that in group B and C (P<0.01).Conclusion Acupuncture at Tianshu (ST 25) alone is an effective method in treating senile intractable constipation.
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Objective:To investigate the efficacy and mechanisms of moxibustion-based treatment of chronic gastritis (CG), and to provide an objective basis for treating CG using moxibustion. Methods:A total of 61 CG patients were divided into an herbal cake-partitioned moxibustion group and a mild-warm moxibustion group. In both treatment groups, bilateral Tianshu (ST 25), Zhongwan (CV 12) and Qihai (CV 6) were selected for moxibustion. Before and after treatment, all the enrolled patients’ gastrointestinal disease-related traditional Chinese medicine (TCM) syndrome scores and visual analog scale (VAS) scores were measured, and the changes in the serum levels of the brain-gut peptides ghrelin, somatostatin (SS) and motilin (MTL) were observed. Results: There was no statistically significant difference between the two groups in the clinical efficacy rate (P>0.05). After treatment, the gastrointestinal disease-related TCM syndrome scores and VAS scores were reduced to varying extents in both groups, the intra-group differences were statistically significant (allP<0.01). In both groups, the serum levels of ghrelin and MTL increased and the serum levels of SS decreased after treatment (allP<0.01). And there were no serious adverse events occurred. Conclusion:Both herbal cake-partitioned moxibustion and mild-warm moxibustion are effective for CG; these two therapies exhibited similar therapeutic efficacy of epigastric discomfort or pain. And both the two therapies act to anti-inflammation, promote the recovery of gastric mucosa and improve the gastric motility, which is possibly their crucial action mechanism in treating CD.
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Objective:To evaluate the short-term and middle-term therapeutic effects and the safety of deep acupuncture at Tianshu(ST 25) for treatment of slow transit constipation(STC).Methods:60 cases of STC were randomly divided into an acupuncture group and a control group.Cleveland Constipation Score(CCS) and colic transit time(CTT) before treatment,2 weeks and 6 months after the treatment were investigated,and the safety was evaluated by clinical,laboratory and imaging indexes.Results:For the short-term therapeutic effect,the treatment group was better than the control group(P