Journal of Acupuncture and Tuina Science

To observe the therapeutic efficacy of warm needling moxibustion plus intra-articular injection of sodium hyaluronate in treating chondromalacia patellae and its effect on inflammatory factors in knee joint fluid. Sixty-eight patients with chondromalacia patellae were randomized into a control group and an observation group, with 34 cases in each group. The control group was treated with intra-articular injection of sodium hyaluronate, while the observation group was given additional warm needling moxibustion treatment. Before and after treatment, the two groups were scored using Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and visual analog scale (VAS), examined by magnetic resonance imaging (MRI) and determined for the levels of nuclear factor-KB (NF-kB), tumor necrosis factor (TNF)-α and interleukin (IL)-1β in knee joint fluid. Clinical efficacy was estimated after treatment. The effective rate was higher in the observation group than in the control group (P<0.05). After treatment, the scores of pain, stiffness and daily activities, as well as the general score of WOMAC declined significantly in both groups (all P<0.05), and were lower in the observation group than in the control group (all P<0.05); the time cost for climbing up and down one staircase and VAS score decreased markedly in both groups (all P<0.05), and were shorter or lower in the observation group than in the control group (both P<0.05); the MRI grading showed no significant change in the control group after intervention (P>0.05), while the grading in the observation group showed notable improvement (P<0.05), and was better than that in the control group (P<0.05); the levels of NF-kB and IL-1β in knee joint fluid dropped significantly in the control group after treatment (both P<0.05), while the levels of NF-kB, TNF-α and IL-1β in knee joint fluid all decreased significantly in the observation group (all P<0.05) and were lower than those in the control group (all P<0.05). Warm needling moxibustion plus intra-articular injection of sodium hyaluronate can produce definite efficacy in treating chondromalacia patellae; it can mitigate the clinical symptoms, improve the lesion extent of chondromalacia and down-regulate the levels of NF-kB, TNF-α and IL-1β in knee joint fluid.

To observe the effects of different moxibustion time on cartilage morphology, tumor necrosis factor (TNF)-α and interleukin (IL)-10 of the knee joint in rats with knee osteoarthritis (KOA), and to explore the best treatment time of moxibustion for KOA. Healthy male Wistar rats were randomly divided into a blank group, a model group, a 15-minute-moxibustion group, a 30-minute-moxibustion group, and a 60-minute-moxibustion group, with 10 rats in each group. Except for the blank group, the KOA model was established in all groups by injecting sodium iodoacetate solution into the knee joint cavity of rats. Rats in the 15-minute-moxibustion group, the 30-minute-moxibustion group, and the 60-minute-moxibustion group were all treated with mild moxibustion intervention for 15 min, 30 min, and 60 min, respectively at Neixiyan (EX-LE4) and Dubi (ST35) points near the patella, 3 times a week for 4 weeks, 12 times in total. Rats in the blank group and the model group were fixed for 30 min without moxibustion intervention. Macroscopic observation for the smoothness of knee cartilage surface was performed after the intervention. Hematoxylin-eosin staining, toluidine blue staining, and Mankin score were used to evaluate the pathological changes in the cartilage. The expression levels of TNF-α and IL-10 in the serum were detected by enzyme-linked immunosorbent assay. Compared with the blank group, the articular cartilage surface in the model group was rough, the chondrocyte arrangement was irregular, the Mankin score and the serum TNF-α expression were significantly increased (P<0.05), while the expression of serum IL-10 was significantly decreased (P<0.05). Compared with the model group, the articular cartilage surface was smoother, the chondrocytes were arranged neatly, the Mankin score and serum TNF-α expression level were significantly lower in the three moxibustion intervention groups (P<0.05); the serum IL-10 level in the 30-minute-moxibustion group and the 60-minute-moxibustion group was increased significantly (P<0.05). Compared with the 15-minute-moxibustion group, the articular cartilage surface in the 30-minute-moxibustion group and the 60-minute-moxibustion group was smoother, the chondrocyte arrangement was more regular, the Mankin score and the serum TNF-α level were decreased significantly (P<0.05), and the serum IL-10 level was increased (P<0.05). There was no significant difference in the serum TNF-α or IL-10 level between the 30-minute-moxibustion group and the 60-minute-moxibustion group (P>0.05). Moxibustion can obviously improve the morphology and structure of KOA articular cartilage, protect articular cartilage, inhibit cartilage inflammation, and delay KOA cartilage degeneration. Moxibustion’s effect is closely related to moxibustion time; the therapeutic effect of the 30-minute-moxibustion and the 60-minute- moxibustion is better than that of the 15-minute-moxibustion.

To observe the impact of herb-partitioned moxibustion and electroacupuncture on hyaluronic acid (HA), procollagen III (PC III) and collagen IV (C IV) of intestinal fibrosis in rats with Crohn’s disease (CD), and discuss the effect and the mechanism of acupuncture on treating intestinal fibrosis of rats. SD rats were randomly divided into control group, model group, herb-partitioned moxibustion group, electroacupuncture group and medicine group. The model of CD was developed by trinitrobenzene sulfonic acid. Masson stain was used to observe the collagen fibers hyperplasia in colon and radioimmunoassay was adopted to detect the content of HA, PC III and C IV in serum. Compared with the control group, the proliferation of colonic collagen fibers, as well as the HA, PC III and C IV in serum increased in the model group. Compared with the model group, the expression of collagen fibers, serum HA, PC III and C IV decreased in the herb-partitioned moxibustion group, electroacupuncture group and medicine group. The expression of collagen fibers serum HA, PC III and C IV in the herb-partitioned moxibustion group were lower than in the electroacupuncture group and medicine group. Herb-partitioned moxibustion and electroacupuncture effectively improved the pathological state of intestinal fibrosis in rats with CD and reduced the content of HA, PC III and C IV in serum.

To observe the efficacy of knee-balancing manipulation plus heat-sensitive moxibustion in treating knee osteoarthritis (KOA) and its impact on the expression of C-telopeptide of type I collagen (CTX- I), tartrate-resistant acid phosphatase 5b (TRACP-5b), A disintegrin and metalloproteinase with thrombospondin motifs 4 (ADAMTS-4), and matrix metalloproteinase 3 (MMP-3). A total of 134 unilateral KOA patients were randomized into a knee-balancing group, a heat-sensitive moxibustion group, and a joint intervention group. The knee-balancing group received knee-balancing Tuina (Chinese therapeutic massage) manipulation for treatment. The heat-sensitive moxibustion group received heat-sensitive moxibustion treatment. The joint intervention group received the heat-sensitive moxibustion in addition to the knee-balancing manipulation. The intervention period lasted for four weeks. After the treatment, and at the 2-week and 6-week follow-ups, the three groups were assessed using the visual analog scale (VAS) for knee joint pain and Western Ontario and McMaster Universities arthritis index (WOMAC), and clinical efficacy was also evaluated. The enzyme-linked immunosorbent assay was adopted to detect the expression levels of serum CTX-I, TRACP-5b, ADAMTS-4, and MMP-3. The knee-balancing group had 44 participants, but one dropped out; there was no dropout case among the 44 participants in the heat-sensitive moxibustion group; among the 46 participants in the joint intervention group, two cases dropped out. After the treatment, and at the 2-week and 6-week follow-ups, the total effective rate was found higher in the joint intervention group than in the knee-balancing and heat-sensitive moxibustion groups (P<0.05). Compared with the baseline, the VAS and WOMAC scores and the serum levels of CTX- I, TRACP-5b, ADAMTS-4, and MMP-3 decreased significantly in all three groups after treatment and at the 2-week and 6-week follow-ups (P<0.05). At the same three time points, the VAS and WOMAC scores and serum levels of CTX- I, TRACP-5b, ADAMTS-4, and MMP-3 were lower in the joint intervention group than in the knee-balancing and heat-sensitive moxibustion groups (P<0.001). Either used alone or combined, the knee-balancing manipulation and heat-sensitive moxibustion therapy can improve the symptoms and down-regulate the serum levels of CTX- I, TRACP-5b, ADAMTS-4, and MMP-3 in KOA patients, producing durable efficacy; nevertheless, a more significant efficacy can be achieved by combining the two methods.

Depressive disorder seriously affects people’s physical and mental health. Acupuncture is a safe and effective treatment for depression, yet, its mechanism is unclear. Therefore, acupuncture’s action mechanism in intervening depression was summarized from several perspectives, including morphology and ultrastructure of neurons in depression-related brain areas, function and structure of glial cells, brain functional and structural connectivity, and neuroelectrophysiology. It’s discovered that acupuncture can repair the morphological and ultrastructural damage of neurons in the hippocampus and prefrontal lobe, mitigate the functional and structural injuries of glial cells in the hippocampus and prefrontal lobe, strengthen functional connectivity and heal structural connection, and promote neuroelectrophysiological activities, which possibly are the principal mechanisms of how acupuncture works in intervening depressive disorder.

To observe the clinical efficacy of tuina plus heat-sensitive moxibustion in treating temporomandibular disorders (TMD). Fifty patients with TMD were randomized into a treatment group and a control group, 25 cases in each group. The treatment group was intervened by tuina plus heat-sensitive moxibustion, while the control group was by medication. The Fricton-Shiffman craniomandibular index (CMI) was observed before and after intervention, and the clinical efficacies of the two groups were also evaluated. There was no significant difference in comparing the CMI score between the two groups before intervention (P>0.05). After a treatment course, there were significant improvements in evaluating the CMI score in both groups (P<0.01), and the improvement was more significant in the treatment group than that in the control group (P<0.01). The total effective rate of the treatment group was significantly higher than that of the control group (P<0.01). Tuina plus heat-sensitive moxibustion is effective in treating TMD, and it’s safe, without adverse reactions, thus worth promoting in clinic.

To observe the efficacy of acupoint sticking with Jianpi Tongjing Zhitong ointment in the treatment of functional dyspepsia due to liver-qi stagnation and spleen deficiency and its effect on serum 5-hydroxytryptamine (5-HT) and ghrelin contents. One hundred patients with functional dyspepsia due to liver-qi stagnation and spleen deficiency were divided into a treatment group and a control group by the random number table method, with 50 cases in each group. The treatment group received acupoint sticking with Jianpi Tongjing Zhitong ointment and the control group was treated with mosapride citrate orally. Patients were treated for 4 weeks as a course. The therapeutic efficacy was compared after one-course treatment and the differences in gastric emptying rate, and serum 5-HT and ghrelin contents between groups were compared before and after treatment. The total effective rate was 79.6% in the control group and 89.4% in the treatment group, showing significantly different between groups (P<0.05). After treatment, the gastric emptying rate and serum ghrelin content of the two groups increased significantly, and the serum 5-HT content decreased significantly, the intra-group differences were significant (all P<0.01). After treatment, the gastric emptying rate and serum ghrelin content were significantly higher in the treatment group than those in the control group, while the serum 5-HT was significant lower in the treatment group, the inter-group differences were significant (all P<0.05). A negative correlation (r=−0.59) was observed between serum 5-HT content and gastric emptying rate, and a positive correlation (r=0.64) was observed between serum ghrelin content and gastric emptying rate, showing statistical significance (all P<0.01). Acupoint sticking with Jianpi Tongjing Zhitong ointment has a remarkable clinical efficacy in treating patients with functional dyspepsia due to liver-qi stagnation and spleen deficiency and is able to influence the secretion of serum 5-HT and ghrelin. Improving the gastrointestinal motility through the regulation of related brain-gut peptides is suggested as an underlying mechanism for this therapy.

Medical acupuncture is a term given to a pragmatic treatment approach used within the public health services in North Western Europe and other Western countries. Its rationale and methods are derived from, but distinct from, classical traditional Chinese medicine as it is practiced in China and in Europe. The article summarizes 9 principles of the medical acupuncture modality, offers an explanatory model, and reviews international research during 2005 to 2012.