Effects of herbal cake separated moxibustion on Tim-4 and ubiquitination of PD-1 in rabbits with immunosuppression / 中国针灸

OBJECTIVE@#To observe the effects of herbal cake separated moxibustion on macrophage effector molecule T-cell immunoglobulin and mucin-domain containing-4 (Tim-4) and ubiquitination of programmed cell death protein 1 (PD-1) in rabbits with immunosuppression, and to explore the possible mechanism on herbal cake separated moxibustion in improving immunosuppression.@*METHODS@#Thirty-two big-ear white rabbits were randomly divided into a normal group, a model group, a moxa stick moxibustion group and a herbal cake separated moxibustion group, 8 rabbits in each group. Except the normal group, the immunosuppression model was established by intraperitoneal injection of cyclophosphamide of60 mg/kg in the other 3 groups. "Shenque" (CV 8), "Shenshu" (BL 23), "Zusanli" (ST 36), etc. were selected in both the moxa stick moxibustion group and the herbal cake separated moxibustion group. Moxa stick moxibustion was applied in the moxa stick moxibustion group, one cone at each acupoint; herbal cake separated moxibustion was applied in the herbal cake separated moxibustion group, 5 cones at each acupoint. The intervention was given once every other day for 10 times in both groups. Leukocyte content in peripheral blood was detected by blood cell analyzer; the positive expression of PD-1 in CD+4 T lymphocytes, CD+8T lymphocytes and CD+68 macrophages in peripheral blood was measured by flow cytometry, the serum levels of interleukin 2 (IL-2), CD8, CD68 and Tim-4 were detected by ELISA, and the expression of Tim-4 and F-box only protein 38 (FBXO38) in the liver and spleen tissues was measured by immunohistochemistry.@*RESULTS@#Compared with the normal group, in the model group, white blood cell count (WBC) and percentage of neutrophils (NEU%) were decreased while percentage of lymphocyte (LYM%) was increased (P<0.01) in peripheral blood; the positive expression rates of PD-1 in CD+4 T lymphocytes, CD+8T lymphocytes and CD+68 macrophages in peripheral blood were increased (P<0.01); the serum levels of IL-2, CD68 and Tim-4 were increased (P<0.01), the serum level of CD8 was decreased (P<0.01); the average optical density (AOD) of Tim-4 in the liver tissue and FBXO38 in the liver and spleen tissues was increased (P<0.01). Compared with the model group, in the moxa stick moxibustion group and the herbal cake separated moxibustion group, WBC and NEU% were increased (P<0.01); the positive expression rates of PD-1 in CD+4 T lymphocytes, CD+8T lymphocytes and CD+68 macrophages in peripheral blood were decreased (P<0.01); the serum levels of IL-2, CD68 and Tim-4 were decreased (P<0.01), the serum levels of CD8 were increased (P<0.01); the AOD of Tim-4 and FBXO38 in the liver tissue and FBXO38 in the spleen tissue was decreased (P<0.01, P<0.05). Compared with the moxa stick moxibustion group, in the herbal cake separated moxibustion group, the positive expression rate of PD-1 in CD+68 macrophages in peripheral blood was increased (P<0.05); serum level of Tim-4 was increased (P<0.01); AOD of Tim-4 in the liver tissue was decreased (P<0.05).@*CONCLUSION@#Herbal cake separated moxibustion can improve immunosuppression by regulating the expression of macrophage effector molecule Tim-4 and the FBXO38 mediated ubiquitination of PD-1, Tim-4 may be one of the specific indexes of immunomodulation involving with herbal cake separated moxibustion.

Effect of mild moxibustion with moxa stick and infrared mild moxibustion on skin blood perfusion at Waiguan (TE 5) / 中国针灸

OBJECTIVES@#To observe the changes of skin blood flow perfusion at Waiguan (TE 5) caused by mild moxibustion with moxa stick and infrared mild moxibustion using laser speckle contrast imaging technology, and to compare the microcirculatory effect during and after both moxibustion methods and explore the dose-response relationship of moxibustion.@*METHODS@#Twenty-four healthy participants were treated with mild moxibustion with moxa stick and infrared mild moxibustion at left Waiguan (TE 5). The record started when the skin temperature reached (44±1) °C, and both moxibustion methods were provided within this temperature range. The 20-minute moxibustion process was divided into four stages (5, 10, 15, and 20 min) using interpolation method, and each participant completed eight interventions with a minimum 24-hour interval between different interventions. The skin surface temperature of the left Waiguan (TE 5) was monitored when both moxibustion interventions were given for 10 min using a TES1306 thermocouple thermometer. The skin microcirculatory blood perfusion units (MBPU) of left Waiguan (TE 5) was measured using a PSIN-01087 laser speckle blood flow imager 1 min before moxibustion, at 5, 10, 15, 20 min during moxibustion and continuously for 20 min after moxibustion in each intervention.@*RESULTS@#The skin surface temperature of the left Waiguan (TE 5) remained within the range of (44±1) °C during both moxibustion methods, with no statistically significant difference (P>0.05). Compared with that before moxibustion, the MBPU of the left Waiguan (TE 5) was increased significantly at 5, 10, 15, and 20 min of both moxibustion methods (P<0.05, P<0.01). Compared with moxibustion for 10, 15 and 20 min, the MBPU of the left Waiguan (TE 5) of moxibustion for 5 min was lower in both moxibustion methods (P<0.01). For both moxibustion methods with the same moxibustion course, the MBPU of the left Waiguan (TE 5) 20 min after intervention was significantly higher than that at 1 min before moxibustion (P<0.001), and there was no significant difference in MBPU between 1 min before moxibustion and 20 min after moxibustion among different groups (P>0.05). Within the same moxibustion method, the MBPU of the left Waiguan (TE 5) 20 min after moxibustion with the intervention of 5 min was lower compared to that of 10, 15, and 20 min of moxibustion (P<0.001), with no significant differences between 10, 15, and 20 min of moxibustion (P>0.05).@*CONCLUSIONS@#When controlling the skin temperature at Waiguan (TE 5) within (44±1) °C, infrared mild moxibustion has similar effects on skin microcirculatory blood perfusion as traditional mild moxibustion with moxa sticks. From a dose-response perspective, microcirculation reached a stable state after 10 min of moxibustion, and moxibustion interventions lasting for more than 10 min shows better therapeutic effects.

Effect of moxibustion on N-methyl-D-aspartate receptor subtype 2B expression in hippocampus of rheumatoid arthritis model rats / 针灸推拿医学（英文版）

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.

Efficacy of mild moxibustion combined with surgery for meniscal injury and its effect on TGF-β1 and PDGF levels in the fluid of knee joint / 针灸推拿医学（英文版）

Objective: To observe the efficacy of mild moxibustion combined with arthroscopic meniscal repair in the treatment of meniscal injury and to explore its action mechanism. Methods: Ninety-eight patients with meniscal injury were divided into a surgery group and a moxibustion plus surgery group by the random number table method, with 49 cases in each group. Both groups received arthroscopic meniscal repair, and the moxibustion plus surgery group was treated with add-on mild moxibustion. The Lysholm score, visual analog scale (VAS) score, and mobility of the affected knee were measured before and after treatment, and transforming growth factor (TGF)-β1 and platelet-derived growth factor (PDGF) levels were measured in the fluid of the affected knee joint. The healing of the meniscus was recorded at a follow-up visit 3 months after the surgery. Results: After treatment, the Lysholm score increased, the VAS score decreased in both groups, and the intra-group differences in both groups were statistically significant (P<0.05). The Lysholm score was higher in the moxibustion plus surgery group than in the surgery group, and the VAS score was lower in the moxibustion plus surgery group than in the surgery group. The differences between groups in both scores were statistically significant (P<0.05). The mobility of the affected knee joint increased in both groups (P<0.05), and it was greater in the moxibustion plus surgery group than in the surgery group (P<0.05). When compared with pretreatment, the levels of TGF-β1 and PDGF in the fluid of the knee joint increased in both groups (P<0.05), and the levels of TGF-β1 and PDGF in the fluid of the affected knee joint were higher in the moxibustion plus surgery group than in the surgery group (P<0.05). The healing of the meniscus in the moxibustion plus surgery group was significantly better than that in the surgery group at the follow-up visit 3 months after the surgery (P<0.05). Conclusion: The effect of mild moxibustion combined with arthroscopic meniscal repair is better than the surgery alone in improving knee function, relieving pain, increasing mobility of the affected knee, and promoting meniscal healing, which may be related to the up-regulation of TGF-β1 and PDGF levels in the fluid of knee joint.

Consideration on development of the national standard: Pure Moxa Stick / 中国针灸

The paper gives a consideration on the development of the national standard, Pure Moxa Stick. It is proposed that the principle and requirements for the development of product standard should be adhered to, while focusing on the applicability and safety of pure moxa stick. In terms of quality, the specific requirements should be developed on the ratio of moxa floss, wrapping paper and adhesives. Regarding the specifications, either the market demands or the resource waste prevention should be considered. In safety, the combustion temperature and moxa smoke control are the key issues.

Investigating the influence of moxibustion on colonic mucosal barrier in rats with dextran sulfate sodium-induced ulcerative colitis / 针灸推拿医学（英文版）

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.

Observation on therapeutic efficacy of thunder-fire moxibustion for hypomenorrhea after induced abortion / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of thunder-fire moxibustion for hypomenorrhea after induced abortion. Methods: A total of 74 patients with hypomenorrhea after induced abortion were randomized into two groups, with 37 cases in each group. The control group was treated with conventional hormone sequential therapy, and the observation group was treated with thunder-fire moxibustion. The course of treatment was 3 menstrual cycles. The traditional Chinese medicine (TCM) symptom scores, menstrual volume, endometrial thickness and the sex hormone levels were observed before and after treatment. The clinical efficacy was compared after treatment. Results: The total effective rate in the observation group and the control group was 91.4％ and 73.5％, respectively, and the difference between the two groups was statistically significant (P<0.05). After treatment, the TCM symptom scores in both groups decreased significantly (all P<0.05), and the scores in the observation group were lower than those in the control group (P<0.05). The menstrual volume, endometrial thickness and each sex hormone level of the patients in both groups were significantly improved after treatment (all P<0.05), and the improvements in the observation group were more significant than those in the control group (all P<0.05). Conclusion: Thunder-fire moxibustion can significantly improve the clinical symptoms of patients with hypomenorrhea after induced abortion; it can increase menstrual volume and endometrial thickness, and regulate the sex hormone levels, producing a better curative effect than the conventional hormone sequential therapy.

Clinical observation on the time-effect relationship of moxibustion for primary dysmenorrhea due to stagnation and congelation of cold-damp / 针灸推拿医学（英文版）

Objective: To observe the time-effect relationship of moxibustion for primary dysmenorrhea (PD) due to stagnation and congelation of cold-damp, thus explore the optimal choice of moxibustion duration, and provide evidence for achieving satisfactory efficacy in moxibustion treatment. Methods: A total of 90 patients with PD due to stagnatin and congelation of cold-damp were divided into three groups by the random number table method, with 30 cases in each group. All the patients in the three groups were given moxibustion treatment at Guanyuan (CV 4), 20 min in group A, 40 min in group B and 60 min in group C. The changes in the pain measurement score in the three groups were observed after treatment. Results: After treatment, there were significant differences in the clinical efficacy among the three groups (P<0.05); the clinical efficacy was better in group B and group C than that in group A (P<0.05), and that in group B was better than that in group C (P<0.05). Besides, the pain measurement score changed significantly after treatment in the three groups (all P<0.05), and the between-group differences were also statistically significant (P<0.05); the pain measurement scores in group B and group C were lower than that in group A (P<0.05), and that in group B was lower than that in group C (P<0.05). Conclusion: Given the same stimulating frequency and intervention time of moxibustion, 40-minute duration demonstrates relatively better efficacy for PD due to stagnation and congelation of cold-damp.

Clinical observation of heat-sensitive moxibustion for acute ischemic stroke / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of heat-sensitive moxibustion in intervening acute ischemic stroke. Methods: A total of 112 patients were divided into a control group and an observation group by the random number table method, with 56 cases in each group. The control group was treated with conventional treatment, and the observation group was treated with heat-sensitive moxibustion on the basis of the treatment in the control group. The National Institute of Health stroke scale (NIHSS) and modified Barthel index (MBI) were evaluated, and the intracranial hemodynamic indicators including mean velocity (Vm), pulsatility index (PI) and resistance index (RI) were recorded, and the serum levels of superoxide dismutase (SOD) and homocysteine (HCY) were measured before and after treatment. Clinical efficacy was evaluated after treatment. Results: The total effective rate of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the NIHSS scores in both groups decreased significantly (both P<0.05), and the MBI scores increased significantly (both P<0.05). The improvements of NIHSS and MBI scores in the observation group were superior to those in the control group (both P<0.05). Vm in both groups increased significantly (both P<0.05), PI and RI decreased (all P<0.05), and Vm, PI and RI in the observation group were superior to those in the control group (all P<0.05). The serum levels of SOD and HCY in the observation group were significantly improved, and were statistically different from those in the control group (both P<0.05). Conclusion: Conventional treatment plus heat-sensitive moxibustion is effective in intervening acute ischemic stroke. It can promote the recovery of neurological function, improve daily activities, and improve intracranial blood flow, which may be related to the regulation of serum SOD and HCY levels.

Effect of mild moxibustion on cancer-related fatigue, serum ghrelin and adiponectin in patients undergoing chemotherapy after colorectal cancer surgery / 针灸推拿医学（英文版）

Objective: To observe the effect of mild moxibustion on cancer-related fatigue, serum ghrelin and adiponectin in patients undergoing chemotherapy after colorectal cancer surgery. Methods: Seventy patients were divided into a control group and an observation group according to the random number table method, with 35 cases in each group. Patients in both groups were treated with conventional FOLFOX4 chemotherapy regimen. Patients in the control group also received routine treatments such as symptomatic treatment of complications, health education, nutritional support, and exercise intervention. Patients in the observation group received mild moxibustion on the basis of interventions used in the control group. The Piper fatigue scale-revision (PFS-R), Karnofsky performance status (KPS) and spleen and kidney yang deficiency syndrome were scored, and serum ghrelin and adiponectin levels were measured before and after treatment. Results: After treatment, total score of PFS-R in the control group did not change significantly (P>0.05), while in the observation group it was significantly reduced (P<0.05) and lower than that in the control group (P<0.05); KPS scores in both groups were increased (both P<0.05), and it was significantly higher in the observation group than in the control group (P<0.05); total score of spleen and kidney yang deficiency syndrome in the control group did not change significantly (P>0.05), while it was significantly reduced in the observation group (P<0.05) and lower than that in the control group (P<0.05); serum ghrelin and adiponectin levels in the control group had no significant changes (both P>0.05), but the levels were significantly increased in the observation group (both P<0.05) and higher than those in the control group (both P<0.05). Conclusion: Based on the routine treatments, mild moxibustion can relieve fatigue, improve quality of life, and improve the symptoms of spleen and kidney yang deficiency in patients undergoing chemotherapy after colorectal cancer surgery, which may be related to the regulation of serum ghrelin and adiponectin levels.

Regulatory effect of mild moxibustion on P2X3 receptors in spinal cord, anterior cingulate cortex and thalamic ventral posterolateral nucleus of rats with IBS visceral hyperalgesia / 针灸推拿医学（英文版）

Objective: To observe the therapeutic effect of mild moxibustion on irritable bowel syndrome (IBS) visceral hyperalgesiamodel rats and its regulatory effect on P2X3 receptors in the spinal cord, anterior cingutate cortex (ACC) and thalamic ventral posterolateral nucleus (VPL). Methods: Thirty 8-day-old newborn rats were randomly divided into a normal group (n=6) and a modeling group (n=24) according to the completely random number table method. Rats in the normal group were bred routinely, and those in the modeling group were subjected to preparing IBS chronic visceral hyperalgesia model using colorectal distention (CRD) in stimulation method. Rats successfully modelled were re-divided into a model group, a mild moxibustion group, a P2X3 receptor antagonist group, and a normal saline group according to the completely random number table method with 6 rats in each group. Rats in each group received corresponding interventions from the 37-day old, once a day for 7 consecutive days. Immunohistochemistry and Western blot assays were used to detect P2X3 protein expressions in the spinal cord, ACC and VPL of rats. Results: Under different intensities of CRD stimulation, the abdominal withdrawal reflex (AWR) scores of the model group were significantly increased versus the normal group (all P<0.05); the AWR scores of the mild moxibustion group and the P2X3 receptor antagonist group were significantly reduced versus the model group (all P<0.01). The P2X3 protein expressions in rat spinal cord, ACC and VPL tissues of the model group were significantly increased versus the normal group (all P<0.01); the P2X3 protein expressions in rat spinal cord, ACC and VPL tissues of the mild moxibustion group and the P2X3 receptor antagonist group were significantly reduced versus the model group (all P<0.01). Conclusion: Mild moxibustion can inhibit the P2X3 receptor expressions in the spinal cord, ACC, and VPL tissues of IBS visceral hyperalgesia model rats, which may be the mechanism of mild moxibustion in relieving the central sensitization of rats with IBS visceral hyperalgesia.

Effect of moxibustion at Shenque (CV 8) on myocardial remodeling and function in exercise-induced fatigue rats / 针灸推拿医学（英文版）

Objective: To explore the effect of moxibustion at Shenque (CV 8) on myocardial structure and function in exercise-induced fatigue rats. Methods: A 12-week treadmill running training was performed to create an exercise-induced fatigue rat model. Sixty eligible male specific-pathogen-free grade Sprague-Dawley rats were randomly divided into a blank group, a control group, a model group, a non-meridian non-acupoint group, a Zusanli (ST 36) group and a Shenque (CV 8) group, with 10 rats in each group. Rats in the blank group did not receive treadmill running training or moxibustion. Rats in the control group did not receive treadmill running training but received mild moxibustion at Shenque (CV 8). Rats in the model group received treadmill running training but no moxibustion. Rats in the non-meridian non-acupoint group, the Zusanli (ST 36) group and the Shenque (CV 8) group received moxibustion at the non-meridian non-acupoint points, Zusanli (ST 36) or Shenque (CV 8) immediately after each treadmill running training, 15 min each time, once a day for 5 consecutive days a week at a 2-day interval, 60 times of moxibustion in total. Left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVESd), left ventricular diastolic volume (LVDv), left ventricular systolic volume (LVSv), ejection fraction (EF), stroke volume (SV), early diastolic peak flow velocity of mitral valve (E) and late diastolic peak flow velocity of mitral valve (A) of each group before and after the last treadmill running training were measured. Blood was collected 6 h after the last treadmill running training, and serum C-reactive protein (CRP), myoglobin (Mb), creatine kinase-myocardial band (CK-MB), cardiac troponin I (cTnI) and cardiac troponin T (cTnT) levels were detected. Finally, the heart was separated, the heart mass (HM) was measured, the cTnT level of the myocardial tissue was detected, the ultrastructural changes of the left ventricular myocardium were observed by transmission electron microscope, the left ventricular fraction shortening (LVFS), E/A and heart mass index (HMI) were calculated. Results: Compared with the same group before treatment, the rat cardiac LVEDd, LVESd, LVDv, LVSv, SV, E and A were significantly increased (all P<0.01), and the rat LVFS, E/A and EF were significantly decreased (all P<0.01) in the model group and the non-meridian non-acupoint group after treatment; the rat cardiac SV, LVDv, LVSv, E and A were all increased (all P<0.01), while E/A and EF were decreased (all P<0.01) in the Zusanli (ST 36) group after treatment; the rat cardiac LVDv, E and A were significantly increased (P<0.01 or P<0.05), and E/A was significantly decreased (P<0.01) in the Shenque (CV 8) group after treatment. After treatment, compared with the blank group, the rat cardiac LVEDd, LVESd, SV, LVDv, LVSv, E, A, the serum CRP, Mb, CK-MB, cTnI, cTnT and HMI, and the myocardial cTnT were increased (all P<0.01), and the LVFS, E/A and EF were all reduced (all P<0.01) in the model group; compared with the model group and the non-meridian non-acupoint group, rats in the Zusanli (ST 36) group and the Shenque (CV 8) group showed decreased LVEDd, LVESd, SV, LVDv, LVSv, E, A, serum CRP, Mb, CK-MB, cTnI, cTnT and HMI, and myocardial cTnT (P<0.01 or P<0.05), along with increased LVFS, E/A and EF (all P<0.01); compared with the Zusanli (ST 36) group, Mb and A of the Shenque (CV 8) group were decreased (both P<0.01), while both E/A and EF were increased (P<0.01, P<0.05). Transmission electron microscopy examination showed that myofibrils in the blank group and the control group were neatly arranged with clear light and dark bands; the model group and the non-meridian non-acupoint group showed different degrees of myofibril disintegration and breakage, increased and aggregated mitochondria of different sizes, and increased electron density. The myofibrils in the Shenque (CV 8) group and Zusanli (ST 36) group were arranged neatly with clear light and dark bands, and compensatory hyperplasia of mitochondria. Conclusion: Moxibustion at Shenque (CV 8) and Zusanli (ST 36) both can effectively improve the occurrence of myocardial remodeling in exercise-induced fatigue rats, and the effect of moxibustion at Shenque (CV 8) is better in improving cardiac function.

Efficacy and effect on serum VEGF-C of mild moxibustion plus functional exercise for upper-limb lymphedema after breast cancer surgery / 针灸推拿医学（英文版）

Objective: To observe the efficacy of mild moxibustion combined with functional exercise in the treatment of upper-limb lymphedema after breast cancer surgery and its effect on serum vascular endothelial growth factor C (VEGF-C). Methods: Seventy-eight patients were divided into a control group and an observation group by the random number table method, with 39 cases in each group. The control group received functional exercise and the observation group received mild moxibustion plus functional exercise. The differences in circumference between the two upper limbs, the lymphatic flow of the affected upper limb, the disability of arm, shoulder and hand (DASH) score, the functional assessment of cancer therapy-breast (FACT-B) score and serum VEGF-C level between the two groups were compared before and after treatment. Efficacy was evaluated after treatment. Results: The total effective rate was significantly higher in the observation group than in the control group (P<0.05). The difference in circumference between the two upper limbs of the two groups decreased significantly after treatment (both P<0.05), but it was significantly lower in the observation group than in the control group (P<0.05). The lymphatic flow of the affected upper limb of the two groups increased significantly after treatment (both P<0.05), but it was significantly greater in the observation group than in the control group (P<0.05). The DASH scores of the two groups decreased significantly after treatment (both P<0.05), but it was significantly lower in the observation group than in the control group (P<0.05). The FACT-B scores of the two groups increased significantly after treatment (both P<0.05), but it was significantly higher in the observation group than in the control group (P<0.05). After treatment, the serum VEGF-C level increased significantly in the observation group (P<0.05), whereas the control group did not show significant change (P>0.05). The post-treatment serum VEGF-C level was significantly higher in the observation group than in the control group (P<0.05). Conclusion: The efficacy of mild moxibustion combined with functional exercise for upper-limb lymphedema after breast cancer surgery is certain, which can reduce the difference in circumference between the two upper limbs, increase the lymphatic flow of the affected upper limb, improve the limb function and the quality of life, and regulate the serum VEGF-C level.

Mild moxibustion plus loratadine tablets for children with allergic rhinitis: a randomized controlled trial / 针灸推拿医学（英文版）

Objective: To explore the efficacy of mild moxibustion plus loratadine tablets for children with allergic rhinitis (AR).Methods: A total of 80 children were randomized into a control group and an observation group, with 40 cases in each group. The control group was treated with loratadine tablets, and the observation group was treated with mild moxibustion plus loratadine tablets. Before and after treatment, the total nasal symptom score (TNSS) was evaluated, and the serum eosinophils (EOS) count, and the interleukin (IL)-27 and macrophage migration inhibitory factor (MIF) levels were measured. Clinical efficacy was evaluated after treatment. Results: The total effective rate of the observation group was higher than that of the control group (P<0.05). After treatment, the TNSS in both groups decreased (P<0.05), and the TNSS in the observation group was lower than that in the control group (P<0.05); the serum EOS count in both groups decreased (P<0.05), and the serum EOS count in the observation group was lower than that in the control group (P<0.05). The serum IL-27 level in the control group had no statistical difference compared with the same group before treatment (P>0.05), and the serum MIF level decreased after treatment (P<0.05). The serum IL-27 level in the observation group increased after treatment (P<0.05), and the serum MIF level decreased after treatment (P<0.05), and were both statistically different from those in the control group (P<0.05). Conclusion: Mild moxibustion plus loratadine tablets is effective in treating children with AR. It can significantly improve the nasal symptoms and reduce the serum EOS count, which may be related to the regulation of the serum IL-27 and MIF levels.

Study on the differences between moxibustion at different points in the effects on the anti-fatigue ability of rats undergoing one-time exhaustive swimming / 针灸推拿医学（英文版）

Objective: To observe the effects of moxibustion at Shenshu (BL 23), Zusanli (ST 36) and Shenque (CV 8) on the energy metabolism and endocrine metabolism indicators of rats undergoing one-time exhaustive swimming, and to explore the differences between moxibustion at different points in the effects on anti-exercise fatigue. Methods: Forty-eight male SPF rats were randomly divided into a blank group, a model group, a non-meridian and non-acupoint group, a Shenshu (BL 23) group, a Zusanli (ST 36) group, and a Shenque (CV 8) group using random number table method, with eight rats in each group. Except for the blank group, rats in the other groups were subjected to replicating the one-time exhaustive model using the weight-bearing swimming experiment. Except for the model group, the other model rats received mild moxibustion immediately after swimming. Rats in the non-meridian and non-acupoint group received mild moxibustion at bilateral subcostal non-meridian and non-acupoint points, those in the Shenshu (BL 23) group received mild moxibustion at bilateral Shenshu (BL 23), those in the Zusanli (ST 36) group received mild moxibustion at bilateral Zusanli (ST 36), and those in the Shenque (CV 8) group received mild moxibustion at Shenque (CV 8) for 15 min. Four hours after the exhaustive swimming, femoral artery blood was collected to detect blood lactate (BLA), lactate dehydrogenase (LDH), creatine kinase (CK), creatinine (CRE), blood urea nitrogen (BUN), cortisol (C) and testosterone (T) levels, and calculate the T/C ratio. Results: Compared with the blank group, rat's serum levels of BLA, LDH, CK, BUN and C in the model group and the non-meridian and non-acupoint group were increased, and serum levels of CRE and T, and T/C ratios were decreased (P<0.01 or P<0.05); compared with the model group and the non-meridian and non-acupoint group, the serum levels of BLA, LDH, CK, BUN and C in the Shenshu (BL 23) group, Zusanli (ST 36) group and Shenque (CV 8) group were decreased, and the serum CRE and T levels, and the T/C ratios were increased (all P<0.01); compared with the Shenshu (BL 23) group, the serum CK level was decreased in the Shenque (CV 8) group (P<0.01), the serum levels of T and C were decreased in the Zusanli (ST 36) group and Shenque (CV 8) group (P<0.01 or P<0.05), and the T/C ratio was increased in the Shenque (CV 8) group (P<0.01); compared with the Zusanli (ST 36) group, the serum CK and BUN levels were decreased (P<0.01, P<0.05), and the T/C ratio was increased in the Shenque (CV 8) group (P<0.05). Conclusion: Moxibustion at Shenshu (BL 23), Zusanli (ST 36) and Shenque (CV 8) shows different anti-fatigue effects by regulating the energy metabolism and endocrine metabolism in rats undergoing one-time exhaustive swimming. Moxibustion at Shenshu (BL 23) is better in promoting energy synthesis. Moxibustion at Shenque (CV 8) is more effective in regulating synthesis and decomposition of the skeletal muscle proteins.

Electronic moxibustion apparatus and traditional moxibustion in treating knee osteoarthritis: a randomized controlled trial / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of DZWJY-1 type electronic moxibustion apparatus and traditional moxibustion in treating knee osteoarthritis (KOA). Methods: A total of 76 eligible patients were randomized into an electronic moxibustion apparatus group and a traditional moxibustion group, with 38 cases in each group. The electronic moxibustion apparatus group was intervened by DZWJY-1 type electronic moxibustion apparatus, and the traditional moxibustion group received moxa stick moxibustion for treatment. Neixiyan (EX-LE 4), Dubi (ST 35), Xuehai (SP 10) and Liangqiu (ST 34) were selected for both groups and the treatment was conducted 3 times a week for a total of 12 times. The visual analog scale (VAS) and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores were observed before treatment and after 6 and 12 sessions of treatment, respectively. Results: There were 4 dropout cases in the traditional moxibustion group. Therefore, this trial had 72 valid cases, including 38 cases in the electronic moxibustion apparatus group and 34 cases in the traditional moxibustion group, the differences in the baseline data between the two groups were statistically insignificant (P>0.05). After 6 and 12 sessions of treatment, the VAS scores decreased significantly with the increase of treatment sessions in both groups (all P<0.01), and the betweengroup differences were statistically insignificant at the same time points (both P>0.05). The pain intensity was evaluated using the weighted value of VAS score. The markedly effective rate was 47.4％ and the total effective rate was 89.5％ in the electronic moxibustion apparatus group, versus 50.0％ and 94.1％ in the traditional moxibustion group, and the betweengroup differences were statistically insignificant (both P>0.05). After 6 and 12 sessions of treatment, the total score and the component scores including pain, stiffness and difficulty moving in the WOMAC decreased significantly with the increase of treatment sessions in both groups (all P<0.01), and the between-group differences were statistically insignificant (all P>0.05). Conclusion: Electronic moxibustion apparatus and traditional moxibustion both are effective in reducing joint pain and improving joint function in KOA patients, and they are equivalent comparing the clinical efficacy.

Therapeutic efficacy observation on moxibustion with moxa of different storage years for moderate-to-severe primary knee osteoarthritis / 针灸推拿医学（英文版）

Objective: By observing the differences in Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and visual analog scale (VAS) scores in moxibustion treatment for moderate-to-severe primary knee osteoarthritis (KOA) with moxa of different storage years (3-year moxa and 1-year moxa from Qichun, Huanggang City, Hubei Province, China) through a randomized clinical trial, to objectively evaluate the differences in therapeutic efficacy of moxibustion with moxa of different storage years. Methods: A total of 63 patients with moderate-to-severe KOA who met the inclusion criteria were randomized into moxibustion group 1 and moxibustion group 2 by central randomization method, with 32 cases in moxibustion group 1 and 31 cases in moxibustion group 2. Moxibustion group 1 was treated with moxa stored for 3 years, and moxibustion group 2 was treated with moxa stored for 1 year. Dubi (ST 35), Neixiyan (EX-LE 4) and Heding (EX-LE 2) were selected in both groups, and the treatment lasted 20 min per time, 3 times a week. The immediate efficacy was compared after 6 times of treatment, and long-term efficacy was compared at follow-up 4 weeks after the end of treatment. Results: During the treatment, there were 2 dropouts in moxibustion group 1, and 1 dropout in moxibustion group 2. The total effective rate in the two groups was 83.3％ and 60.0％, respectively. Followed up at 4 weeks after the end of treatment, the total effective rate in the two groups was 80.0％ and 66.7％, respectively. There were no statistical differences between the two groups (both P>0.05). After treatment and 4 weeks after the end of treatment, the WOMAC and VAS scores in both groups decreased significantly compared with those before treatment (all P<0.01); the scores of stiffness item of WOMAC in moxibustion group 1 were lower than those in moxibustion group 2 (both P<0.05); there were no statistical differences in the scores of pain item and dysfunction item of WOMAC, and VAS scores between the two groups (all P>0.05). Conclusion: Moxibustion with moxa of different storage years (stored for 3 years and 1 year) both can improve the pain, stiffness and motor function in patients with moderate-to-severe KOA. While moxa stored for 3 years has a better therapeutic efficacy in improving stiffness of the knee joint than that stored for 1 year.

Effect of moxibustion at sensitized-acupoints on quality of life in patients with chronic superficial gastritis / 针灸推拿医学（英文版）

Objective: To compare the efficacy difference between moxibustion at sensitized-acupoints and non-sensitized- acupoints using the same group of acupoints. Methods: A total of 139 patients with chronic superficial gastritis were divided into a sensitized acupoint group (102 cases) and a non-sensitized acupoint group (37 cases) based on whether acupoint sensitization occurred. The SPSS version 19.0 statistical software propensity score matching function was used to balance the baseline data between the groups. Finally, 29 pairs of matched patients were included, namely 29 cases in the sensitized acupoint group and 29 cases in the non-sensitized acupoint group. Both groups were treated with moxibustion therapy. The treatment lasted for 30 min per time, and was performed every other day for 8 weeks. Changes in the traditional Chinese medicine (TCM) symptom score and the short-form 36-item health survey (SF-36) score in both groups were observed before and after treatment, as well as the clinical efficacy. Results: The covariates of age, course of disease, TCM symptom score and SF-36 score in the two groups were balanced after matching (all P>0.05). After treatment, the total effective rate was 100.0％ in the sensitized acupoint group and 79.3％ in the non-sensitized acupoint group. The difference in the total effective rate between the two groups was statistically significant (P<0.01). After treatment and at the 4-week follow-up, the TCM symptom scores in the sensitized acupoint group were significantly lower than those in the non-sensitized acupoint group (all P<0.01); the SF-36 scores in the sensitized acupoint group were significantly higher than those in the non-sensitized acupoint group (all P<0.01). Conclusion: With the same group of acupoints, the sensitized acupoints have a better therapeutic effect and long-term efficacy than the non-sensitized acupoints in the treatment of chronic superficial gastritis.

Observation on therapeutic efficacy of heat-sensitive moxibustion plus Western medicine for diabetic peripheral neuropathy / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of heat-sensitive moxibustion plus Western medicine in treating patients with diabetic peripheral neuropathy (DPN). Methods: A total of 70 patients with DPN were divided into an observation group and a control group by sealed envelope method combined with the random number table method, with 35 cases in each group. The control group was treated with routine medicine, and the observation group was treated with heat-sensitive moxibustion on the basis of the treatment in the control group. After 2 courses of treatment, the scores of Toronto clinical scoring system (TCSS) and vibration perception threshold (VPT) in both groups were observed, and the clinical efficacy was compared. Results: During treatment, 3 cases dropped out in the control group and 4 cases in the observation group. After treatment, the total effective rate in the observation group was higher than that in the control group (P<0.05). The scores of TCSS and VPT in both groups decreased after treatment, and the intra-group comparison showed statistical significance (both P<0.05). The scores of TCSS and VPT in the observation group were lower than those in the control group, and the differences were statistically significant (both P<0.05). Conclusion: Heat-sensitive moxibustion plus Western medicine can improve the symptoms in patients with DPN, and has a better curative effect than the Western medicine alone.

Therapeutic efficacy and mechanism of heat-sensitive moxibustion for adjuvant treatment of depression in Parkinson disease / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of heat-sensitive moxibustion for adjuvant treatment of depression in Parkinson disease and explore its mechanism. Methods: A total of 80 patients with Parkinson disease coupled with depression were randomized into an observation group and a control group, with 40 cases in each group. The control group was treated with levodopa and benserazide hydrochloride tablets and paroxetine tablets, while the observation group was treated with heat-sensitive moxibustion on the basis of the medications in the control group. The treatment course was 2 months. The Hamilton depression scale-17 (HAMD-17), unified Parkinson's disease rating scale (UPDRS) and Parkinson's disease quality of life questionnaire-39 (PDQ-39) were scored before and after the treatment, and the efficacy was evaluated after treatment. Levels of patients' serum dopamine (DA), 5-hydroxytryptamine (5-HT), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected before and after the treatment. Results: After treatment, the total effective rate of the observation group was higher than that of the control group (P<0.05). The HAMD-17 scores in the two groups decreased significantly after treatment (both P<0.05), and the score in the observation group was obviously lower than that in the control group (P<0.05). The component scores and total scores of UPDRS in both groups decreased significantly (all P<0.05), and the scores in the observation group were lower than those in the control group (all P<0.05). The score of PDQ-39 in the observation group decreased significantly (P<0.05), and was lower than that in the control group (P<0.05). After treatment, the serum DA and 5-HT levels in the observation group increased significantly (both P<0.05) and the TNF-α and IL-6 levels decreased significantly (both P<0.05), which were statistically different from those in the control group (all P<0.05). Conclusion: Heat-sensitive moxibustion has certain auxiliary effect in treating depression in Parkinson disease, significantly improving clinical symptoms and the quality of life, which may be related to the up-regulation of DA and 5-HT levels and down-regulation of TNF-α and IL-6 levels.