Comparison of Therapeutic Effects Between Thermosensitive Moxibustion and Medication in the Treatment of Insomnia of Liver-Qi Stagnation Pattern / 针刺研究

OBJECTIVE: To compare the therapeutic effect of thermosensitive moxibustion (TSM) and medication in the treatment of insomnia patients with the syndrome of stagnation of liver-qi. METHODS: A total of 60 insomnia patients with the syndrome of liver-qi stagnation were randomly divided into TSM group and medication group (n ＝ 30 in each). Mild moxibustion was applied to bilateral Taichong (LR 3) and Qiuxu (GB 40) alternatively till the patient experienced an intense warmth (diathermic, heat transmission, etc.) feeling in the local region. The treatment was conducted once daily for 15 d. Patients of the medication group were ordered to take Estazolam tablets (1 mg/d) 1 h before sleeping, once daily for successive 15 days. The sleep quality (sleeping quality, falling asleep time, sleep duration, sleep efficiency, sleep disorders, hyponotic and day time dysfunction, 0－21 points) was evaluated by using Pittsburgh Sleep Quality Index (PSQI). The therapeutic effect was assessed in accordance with the "Guide Principles for Clinical Trials on New Drugs of Chinese Materia Medica (1993)" and international united sleep efficiency value. RESULTS: Following the treatment, the PSQI of both groups were significantly decreased relevant to their own pre-treatment (P0.05). Of the two 30 cases in the medication and moxibustion groups, 12 (40.00%) and 20 (66.67%) had marked improvement, 7 (23.33%) and 6 (20.00%) were effective, and 11(36.67%) and 4 (13.33%) were invalid, with the effective rates being 63.33 % (19/30) and 86.67% (26/30), respectively. The effective rate of the TSM group was significantly higher than that of the medicine group (P <0.05). CONCLUSION: Thermosensitive moxibustion applied to the source points of the Liver and Gallbladder Meridians can improve the quality of sleep in insomnia patients with syndrome of liver-qi stagnation.

Thermosensitive Moxibustion Induces A Better Therapeutic Effect in the Treatment of Facial Paralysis Patients / 针刺研究

OBJECTIVE: To compare the effect difference between the thermosensitive moxibustion (TSM) and conventional mild moxibustion (CMM) at Yifeng (TE 17) plus acupuncture intervention in the treatment of facial paralysis patients. METHODS: The prospective cohort study design was used in the present study. A total of 183 patients were divided into a thermosensitive moxibustion (regional heat penetrating, heat extending, warmer in deep-tissue, etc.) group (n＝132) and a CMM group (n＝51) according to the patients' subjective feeling to moxibustion stimulation of TE 17. After propensity score matching (PSM, a statistical matching technique of observational data) processing by using SPSS 19. 0 software, outcomes of 33 cases in the TSM group and 33 cases in the CMM group were analyzed. In the 1st course (10 days) of treatment, TSM was applied to TE 17 till the thermosensitive feelings disappeared for patients in the TSM group, or CMM employed to TE 17 for 45 min for patients in the CMM group, followed by manual acupuncture stimulation of Cuanzhu (BL 2), Yangbai (GB 14), Sibai (ST 2), Quanliao (SI 18), Jiache (ST 6), etc. on the affected side (shallow needling, uniform reinforcing-reducing needle-manipulation) for 30 min, once daily. In the 2nd course (10 days), only manual acupuncture was performed, the same acupoints were stimulated with the same methods used in the 1st course, and in combination with bilateral Zusanli (ST 36) which was stimulated with reinforcing-needling technique. The interval between the 2 courses was 2 days. The modified Portmann scale (for movements of eyebrow raising, eye closing, cheek bulging, pouting, teeth showing and nostril widening, and symetry during resting state) was used to evaluate the severity of the facial palsy before and after the treatment. RESULTS: After the treatment, the Portmann scores were significantly higher than those of their own pre-treatment in each of the two groups (P < 0.01), being markedly higher in the TSM group than in the CMM group (P < 0.01), suggesting a better therapeutic effect of TSM. CONCLUSION: The thermosensitive moxibustion is considerably superior to the conventional mild moxibustion in improving the symptoms of facial paralysis patients.

Clinical therapeutic effects on rheumatoid arthritis treated with the assisted therapy of acupuncture at the points detected with thermosensitive moxibustion in medicine / 中国针灸

<p><b>OBJECTIVE</b>To evaluate the clinical therapeutic effects and safety on rheumatoid arthritis (RA) treated with acupuncture at the points detected with thermosensitive moxibustion in medicine combined with western medication.</p><p><b>METHODS</b>A total of 168 RA patients in compliance with the inclusive criteria were collected and randomized into an observation group and a control group, 84 cases in each one. In the control group, in reference to the updated guideline of new drugs by the European League Against Rheumatism (EULAR) in 2013, the medication scheme was formulated for oral administration, methotrexate tablet 7.5 mg, once a week; salazosulfapyridine enteric-coated tablets, 100 mg, twice a day; hydroxychloroquine sulfate tablets, 20 mg, twice a day; and meloxicam tablets, 15 mg, once a day. In the observation group, besides the treatment as the control group, the acupuncture therapy at the points detected with thermosensitive moxibustion in medicine was given. The mild moxibustion was applied near to the affected joint with the moxa material of herbal medicine to detect the sensitization points. Afterwards, the acupuncture technique of medicine was given on those points, without any manipulation applied. The needles were retained for 30 min, once daily. The treatment for 2 weeks was as one course, continuously for 2 courses. The indexes were observed before and after treatment in the two groups including gripping power, the time of morning stiffness, the swollen joint count 28 (SJC 28), the tender joint count 28 (TJC 28), the disease activity score 28 (DAS 28), the score of patient global assessment of disease activity (PtGA) and the score of provider global assessment of disease activity (PhGA), as well as rheumatoid factors (RF), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and anti-cyclic peptide containing citrulline (A-CCP). The clinical therapeutic effects were evaluated in the two groups.</p><p><b>RESULTS</b>After 4-week treatment, a total of 163 patients accomplished the clinical trial, 81 cases in the observation group and 82 cases in the control group. The results of gripping power, the time of morning stiffness, SJC 28, TJC 28, PtGA, PhGA, DAS 28, RF, CRP, ESR and A-CCP were all improved as compared with those before treatment (all <0.05). In 4 weeks of treatment, the results of gripping power, the time of morning stiffness, SJC 28, TJC 28, PtGA, PhGA, DAS 28, as well as CRP and ESR in the observation group were better than those in the control group (all <0.05). The results of RF and A-CCP were not different significantly between the two groups (both >0.05). The total effective rate was 85.19% (69/81) in the observation group, higher than 70.73% (58/82) in the control group (<0.05).</p><p><b>CONCLUSION</b>The acupuncture therapy at the points detected with thermosensitive moxibustion in medicine achieves the satisfactory clinical effects with few adverse effects.</p>

Mechanism of thermosensitive moxibustion on knee osteoarthritis in rabbit models / 中国针灸

<p><b>OBJECTIVE</b>To observe the impacts of thermosensitive moxibustion (TSM) on the expressions of nitric oxide (NO), typeⅠdisintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4), typeⅡcollagen and proteoglycan (PG) in the rabbit models of knee osteoarthritis (KOA) and explore the mechanism of TSM on KOA.</p><p><b>METHODS</b>A total of 42 Japanese long-eared male rabbits were divided into a blank group (6 rabbits), a model group (6 rabbits), a moxibustion group (24 rabbits) and a sham-operation group (6 rabbits) according to the random number table. In the blank group, the rabbits were fed normally. In the model and moxibustion groups, the papain injection was given to establish KOA models. The rabbits in the sham-operation group were treated with the intracavity injection of 0.9% NaCl solution. The rabbits were forced to move for 30 min every day, continuously for 15 days during modeling. At the end of modeling, in the moxibustion group, moxibusiton was applied at "Dubi" (ST 35), once a day, 40 min each time, for 14 days totally. According to the temperature changes during moxibustion, the rabbits were divided into a TSM group and a non-TSM group. 6 rabbits were collected randomly from the two groups. The usual feeding was given in the blank group, the model group and the sham-operation group, without any intervention. The body mass and behavioristics changes were observed in each group. At the end of treatment, the nitrate reduction method was adopted to determine NO expression in the serum. The real-time PCR was adopted to determine the expressions of ADAMTS-4, typeⅡcollagen and PG in the cartilage.</p><p><b>RESULTS</b>① After modeling, compared with the blank group, the body mass was all reduced and the Lequesne MG score was increased in the model group, TSM group, non-TSM group and sham-operation group (<0.05, <0.01). After intervention, compared with the blank group, the body mass was decreased and the Lequesne MG score was increased in the model and sham-operation groups (<0.05, <0.01). Compared with the model group, the body mass was increased and the lequesne MG score was decreased in the TSM, non-TSM, and sham-operation groups (<0.05, <0.01). Compared with the non-TSM group, the body mass in the TSM group was increased remarkably (<0.05), but the difference in Lequesne MG score was not statistically significant (>0.05). ② After intervention, compared with the blank group, the expressions of NO and ADAMTS-4 were all increased and the expressions of typeⅡcollagen and PG were decreased in the model group, TSM group, non-TSM group and sham-operation group (<0.05, <0.01). Compared with the model group, the expressions of NO and ADAMTS-4 were all remarkably lower and the expressions of typeⅡcollagen and PG were increased in the TSM group, non-TSM group and sham-operation group (<0.05, <0.01). Compared with the non-TSM group, the expressions of NO and ADAMTS-4 were all remarkably lower and the expressions of typeⅡcollagen and PG were increased in the TSM group after intervention (all <0.05).</p><p><b>CONCLUSION</b>The thermosensitive moxibustion alleviates the inflammatory reactions and protects the joint cartilage through inhibiting the expressions of NO and ADAMTS-4 to achieve the effects in the treatment of KOA.</p>