[Brief discussion on the characteristics of meridian sinew theory at the early era].

The characteristics of meridian sinew theory at the early era have been collected. It is believed that the running courses and indications of twelve meridian sinew regions in Lingshu (Miraculous Pivot) are closely associated with Zubi Shiyimai Jiujing (Moxibustion Therapy on the Eleven Meridians of Legs and Arms) and Yinyang Shiyimai Jiujing (Moxibustion Therapy on the Eleven Meridians of Yin and Yang). Due to the attachment of twelve regular meridians, the development of its own theory is blocked. Meridian sinew theory guides the diagnosis and treatment of many dominant disorders (e.g. pain disorder and bi syndrome) with acupuncture and moxibustion. The defensive qi is circulated among meridian sinews, which is the core of meridian sinew theory. The acupoint selection relies on the meridian sinew theory at the early era, such as "consolidating muscles when they involved in disorders, using painful sites as acupoints to treat diseases" "interaction of the associated muscles" and "conducting meridian qi along with the running courses of meridians". The crack needling (one of the nine needling techniques exerted between two muscles to treat muscular pain) is adopted generally to mobilize the defensive qi so as to resist pathogens, relieve the compression in foci and promote qi and blood circulation in meridians. The rational understanding of meridian sinew theory may improve the accuracy of diagnosis and treatment of meridian sinew disorders, "reduce the pressure" on meridian theory and contribute to the enrichment of the theoretical framework of acupuncture and moxibustion.

[Analysis of the divergent meridians of twelve meridians].

This paper analyzes the problems existing in the current theory of divergent meridian ("Jingbie"), such as the unclear route of divergent meridian, the controversy in the "li-he-chu-ru" and the lack of in-depth research on the theory of "liuhe", clarifies the source and privides insights. The author analyzed the word "Jingbie" by means of the four proofreading methods combined with philology method to explore the origin of "Jingbie ". The divergent meridians is the remnant of the original meridians system in the bamboo and silk documents, which was put into the meridians system after being sorted out by doctors. The twelve meridians are combined in two, forming the "liuhe" point, which is located in the neck, and has a great influence on the blood circulation of the head and neck. "liuhe" point and theory can guide the differentiation of acupuncture and moxibustion, and has an important guiding significance for the treatment of empirical, emergency and head and face diseases.

[Acupuncture combined with opioid drugs on moderate and severe cancer pain: a randomized controlled trial].

OBJECTIVE: To explore the clinical therapeutic effect of acupuncture combined with opioid drugs on moderate and severe cancer pain. METHODS: A total of 60 patients with cancer were randomized into an observation group and a control group, 30 cases in each group. Oxycodonehydrochloride prolonged-release tablet was taken orally in the control group. On the basis of the control group, acupuncture was applied at Hegu (LI 4), Neiguan (PC 6), Zusanli (ST 36), Sanyinjiao (SP 6), etc. Corresponding back-shu points, xi-cleft points and ashi points were selected additionally according to primary viscera and pain sites in the observation group. The treatment was given once a day for 2 weeks. Symptomatic and supportive treatment were implanted, and no other antalgic measures were given during the trial. The daily dosage of opioid drug and the adverse reactions were recorded in both groups. Karnofsky performance status (KPS) and quality of life (QOL) scale scores were compared before and after treatment. Numerical rating scale (NRS) score was calculated to evaluate the clinical therapeutic effect. RESULTS: Compared before treatment, the daily dosage of opioid drugs after treatment was obviously reduced in the observation group (P<0.01), and was obviously increased in the control group (P<0.05). The dosage of opioid drugs after treatment in the observation group was much less than the control group (P<0.01). After treatment, the KPS and QOL scores were increased in both groups (P<0.01), and the scores in the observation group were superior to the control group (P<0.01, P<0.05). The analgesic effective rate was 90.0% (27/30) in the observation group, which was superior to 76.7% (23/30) in the control group (P<0.05). The adverse reactions rate in the observation group was lower than the control group (P<0.01). CONCLUSION: Acupuncture combined with opioid drugs can effectively relieve the cancer pain, improve the performance status and quality of life in cancer patients, reduce the dosage of opioid drugs and adverse reactions rate.

[Analysis of the academic features of the moxibustion of Xin'an physicians].

Xin'an acupuncture and moxibustion physicians have a lot of talented people. Their academic theories promote the development of moxibustion theory. WANG Guo-rui used acupuncture and moxibustion together in clinic, and emphasized reinforcing and reducing method. Moxibustion was performed with unique matching acupoint according to different cases. WANG Ji proposed the theory "moxibustion can cure sores, and has reinforcing and reducing method""scars block the movement of qi and do not use moxibustion when there is no disease". XU Chun-fu elaborated on the theory of moxibustion, which involved a wide range of ideas and advocated the idea of combining acupuncture with drugs. WU Qian put forward the theory "moxibustion is mostly used at acupoints on the back, and can cure multiple syndromes" "focus on the use of miraculous acupoints for the treatment of emergency diseases" "moxibustion must be treated with enough moxibustion to cure the disease". WU Yi-ding thonght that only by carefully identifying the types of diseases and using corresponding acupoints could have a very good curative effect; moxibustion had indications and contraindications, so be careful when used it; moxibustion was divided into yin and yang, also divided into reinforcing and reducing methods; sores were suitable for moxibustion and heat syndrome could also be used by moxibustion. He also believed that moxibustion was as important as acupuncture with the complementary relationship. Hence, the valuable significance of moxibustion in clinical practice is explored through the collection of the academic thoughts of WANG Guo-rui, WANG Ji, XU Chun-fu, WU Qian and WU Yi-ding.

[Effects of Moxibustion on Ventricular Mass Index and Expression of Apoptosis Related Proteins in Myocardium of Rats with Chronic Heart Failure].

OBJECTIVE: To observe the effect of moxibustion on cardiac function and the expression of B-cell lymphoma-2 (Bcl-2), Bcl-2 associated X (Bax), Fas, Fas ligand (FasL) in cardiomyocytes of chronic heart failure (CHF) rats, so as to explore its underlying mechanisms in preventing and treating CHF. METHODS: SD rats were randomly divided into normal control, model, moxibustion, Captopril and moxibustion ＋ Captopril (M＋C) groups (n＝12 rats/group). The CHF model was established by intraperitoneal injection of Adriamycin (ADR, from 1 to 4 mg/kg, once every other day for 15 days). Mild moxibustion was applied to bilateral"Feishu"(BL 13) and "Xinshu"(BL 15). Rats of the Captopril group was treated by gavage of Captopril suspension (5 mg/mL, 25 mL/kg), and those of the M＋C group treated by the combined two methods. All the treatments were given once a day for 3 weeks. The general conditions and behaviors of rats were observed. The left ventricular mass index (LVMI) and right ventricular mass index (RVMI) were detected for assessing the cardiac performance. Morphological changes of myocardium were observed by HE staining. Enzyme linked immunosorbent assay (ELISA) was used to detect the concentrations of B-type natriuretic peptide (BNP) and precursor N-terminal pro-brain natriuretic peptide (NT-pro BNP) in the serum. The expression levels of Bcl-2, Bax, Fas and FasL of the left ventricle of heart were detected by Western blot. RESULTS: After modeling, the pathological changes of myocardium (as myocardial cell swelling with vacuoles, myocardial fibre breakage, etc.) were obvious, the LVMI, RVMI, serum BNP and NT-pro BNP concentrations, and myocardial Bax, Fas and FasL protein expression levels were significantly increased in the model group compared with the normal group (P<0.01), while the expression level of Bcl-2 was significantly down-regulated (P<0.01). Following the interventions, the myocardial injury was reduced, both LVMI and RVMI, serum BNP concentration and Bax, Fas and FasL expression levels in the three treatment groups, and serum NT-pro BNP concentration in the moxibustion and M＋C groups were significantly decreased (P<0.05, P<0.01), while the myocardial Bcl-2 protein levels in the three treatment groups were significantly increased relevant to the model group (P<0.01). Comparison among the three treatment groups showed that the effects of moxibustion ＋ Captopril were significantly superior to those of simple moxibustion and simple Captopril in suppressing CHF-induced increased expression of myocardial Bax, Fas and FasL, and in lessening CHF-induced decrease of Bcl-2 level (P<0.05, P<0.01). No significant differences were found among the three treatment groups in down-regulating LVMI and RVMI, and serum BNP content (P>0.05)．. CONCLUSION: Moxibustion can reduce myocardial injury and improve cardiac function in CHF rats, which may be related to its effects in down-regulating the expression of myocardial Bax, Fas and FasL proteins, and up-regulating the expression of Bcl-2 protein to inhibit cardiomyocyte apoptosis.

[Effect of Moxibustion Stimulation of "Feishu" (BL 13) and "Xinshu" (BL 15) on Expression of Myocardial MyD 88 Protein and Caspase 3 mRNA in Chronic Heart Failure Rats].

OBJECTIVE: To observe the effect of moxibustion stimulation of "Feishu" (BL 13) and "Xinshu" (BL 15) on pathological changes of myocardium and the expression of myocardial myeloid differentiation factor 88 (MyD 88) protein and Caspase 3 mRNA in chronic heart failure (CHF) rats, so as to explore its mechanism underlying improvement of CHF. METHODS: SD male rats were randomly divided into normal (n=9), model (n=8), moxibustion (n=8), medication (n=8) and moxibustion + medication (n=8) groups. In addition, the other 6 rats (3/normal and 3/model groups) were used for measuring cardiac ventricle weight and H.E. stain. The CHF model was made by intraperitoneal injection of Adriamycin (ADR, from 1 to 4 mg/kg, once every other day for 15 days). Mild moxibustion was applied to bilateral BL13 and BL15 for 15 min, once daily for 3 weeks. Rats of the medication group were treated by Captopril (gavage) for 3 weeks. The expression of myocardial Caspase 3 mRNA and MyD 88 protein of the left ventricle was determined by quantitative real time-PCR and Western blot, respectively. RESULTS: In comparison with the normal group, the myocardial damage (cell swelling, cytoplasma vaculation, and disordered arrangement, rupture and lysis of some cardiac muscle fibers), and the expression levels of myocardial MyD 88 protein and Caspase 3 mRNA were obviously increased in the model group(P<0.01). After the interventions, the myocardial damage was relatively milder, and the expression of myocardial MyD 88 protein and Caspase 3 mRNA were significantly down-regulated in the moxibustion, me-dication and moxibustion+medication groups in comparison with the model group(P<0.05). No significant differences were found among the 3 treatment groups in the expression levels of MyD 88 protein and Caspase 3 mRNA(P>0.05). CONCLUSIONS: Moxibustion intervention can suppress CHF induced up-regulation of expression of myocardial MyD 88 protein and Caspase 3 mRNA in rats, which may contribute to its effect in relieving myocardial injury.