[Effects of different acupuncture and moxibustion methods on articular cartilage morphology and NF-κB p65/NLRP3 pathway in rats with knee osteoarthritis].

OBJECTIVE: To compare the effects of filiform needling, electroacupuncture (EA) and moxibustion on articular cartilage morphology and nuclear transcription factor-κB (NF-κB) p65/ Nod-like receptor protein 3 (NLRP3) pathway in rats with knee osteoarthritis (KOA). METHODS: Wistar rats were randomly divided into blank control， model, filiform needling, EA and moxibustion groups, with 8 rats in each group. The KOA model was established by injecting sodium iodoacetate into the right knee cavity. Filiform needling, EA and moxibustion groups were treated with the right side of "Dubi" (ST35) and "Neixiyan" (EX-LE5), and were given filiform needling, EA and mild moxibustion therapies for 15 min respectively, once every other day, for a total of 4 weeks. The diameter of the right knee joint was observed. The ultrastructure of knee chondrocytes was observed by transmission electron microscope. The contents of serum tumor necrosis factor-α (TNF-α), interleukin (IL)-1ß and IL-18 were determined by ELISA. The expression levels of NF-κB p65, NLRP3, apoptosis-related speckle like protein (ASC) and TNF-α in knee cartilage were dectected by Western blot. RESULTS: Compared with the blank control group, the right knee joint cavity was narrowed, chondrocytes were constricted significantly, mitochondria were moderately swollen, the diameter of the right knee was increased, and the contents of serum TNF-α, IL-1ß and IL-18 were increased (P<0.01), the expressions of NF-κB p65, NLRP3 and TNF-α in knee cartilage were increased (P<0.01) while the expression of ASC was decreased (P<0.01) in the model group.Compared with model group, the narrowed knee joint cavity and chondrocyte injury were improved， knee diameter decreased (P<0.01, P<0.05), and the content of serum TNF-α and the expression of NLRP3 in knee cartilage were decreased (P<0.05, P<0.01) in 3 treatment groups; the contents of serum IL-1ß and IL-18, and the expression of TNF-α in knee cartilage were decreased (P<0.01, P<0.05), while the expression of ASC in knee cartilage was increased (P<0.01) in EA and moxibustion groups; the expression of NF-κB p65 in knee cartilage was decreased (P<0.01) in moxibustion group. Compared with EA group, the content of serum IL-18 was decreased (P<0.05) in moxibustion group. CONCLUSION: Filiform needling, EA and moxibustion can all reduce the formation of knee osteophytosis in KOA rats, alleviate joint cavity narrowing, improve the ultrastructure of articular cartilage, reduce the level of inflammatory factors, regulate the NF-κB p65/NLRP3 pathway. Moxibustion has the most obvious regulatory effect among the 3 treatment methods.

Effects of different courses of moxibustion treatment on intestinal flora and inflammation of a rat model of knee osteoarthritis.

OBJECTIVE: This study was done to determine the effects of different courses of moxibustion on a rat knee osteoarthritis (KOA) model, and explore the dose-effect relationship of moxibustion on KOA from the perspectives of intestinal flora and inflammatory factors. METHODS: Wistar rats were randomly divided into five groups: normal, model, moxibustion for 2 weeks, moxibustion for 4 weeks and moxibustion for 6 weeks groups (n = 5 each group). A KOA rat model was induced by monosodium iodoacetate, and moxibustion intervention was performed at the acupoints "Dubi" (ST35) and "Zusanli" (ST36), once every other day. Pathologic changes in the cartilage of rat knee joints were assessed after intervention, and fecal samples were subjected to 16S rRNA high-throughput sequencing for microbial diversity analysis. RESULTS: Damage to the knee articular cartilage was obvious in the model group, which also had increased levels of pro-inflammatory factors, decreased levels of anti-inflammatory factors, and intestinal flora disorders with decreased diversity. The degree of cartilage damage in the 4 and 6 weeks of moxibustion groups was significantly improved compared with the model group. The 4 and 6 weeks of moxibustion groups also demonstrated reduced levels of interleukin-1ß and tumor necrosis factor-α and increased levels of interleukin-10 (P < 0.05). Both the abundance and diversity of the intestinal flora were increased, approaching those of the normal group. Abundances of probiotics Eubacterium coprostanoligenes group and Ruminococcaceae UCG-014 increased, while that of the pathogenic bacteria Lachnospiraceae NK4A136 group decreased (P < 0.05). Although the abundance of Lachnospiraceae NK4A136 group decreased in the 2 weeks of moxibustion group compared with the model group (P < 0.05), there was no statistically significant difference in serum inflammatory factors, flora species diversity or degree of pathological damage compared with the model group. CONCLUSION: Moxibustion treatment led to significant improvements in the intestinal flora and inflammatory factors of rats with KOA. Moxibustion treatment of 4 and 6 weeks led to better outcomes than the 2-week course. Moxibustion for 4 and 6 weeks can regulate intestinal flora dysfunction with increased probiotics and reduced pathogenic bacteria, reduce pro-inflammatory factors and increase anti-inflammatory factors. No significant differences were seen between the effects of moxibustion for 4 weeks and 6 weeks.

[Comparision of therapertic effect of different acupuncture methods for knee osteoarthritis].

OBJECTIVE: To compare the clinical efficacy of acupuncture, electroacupuncture (EA) and moxibustion in the treatment of knee osteoarthritis (KOA). METHODS: A total of eight-four patients with KOA were randomly and equally divided into acupuncture group, EA group and moxibustion group. Neixiyan (EX-LE40), Dubi (ST35), Heding (EX-LE2), Liangqiu (ST34), Xuehai (SP10), Zusanli (ST36) and Ashi-point on the affected side of the body were punctured with filiform needles or EA (2 Hz/100 Hz) for 30 min. In the moxibustion group, moxibustion was applied to the surrounding area of the affected joint for 60 min. The treatment was conducted once every other day for 4 weeks. The pain degree was assessed by using numerical rating scale (NRS) and the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scale (0－240 points) was used to evaluate the severity of KOA. The "Minimal Clinically Important Improvement (MCII)" was used to assess the therapeutic effect after the treatment. RESULTS: After the treatment, the scores of NRS, and the pain, stiffness, motor function and total scores of WOMAC were significantly decreased in the three groups compared with their own pre-treatment (P<0.05), and were obviously lower in the EA and moxibustion groups than in the acupuncture group (P<0.05), and those of the moxibustion group was notably lower than those of the acupuncture group (P<0.05). Of the 28 cases in the acupuncture, EA and moxibustion groups, 11, 17 and 22 were effective, with the effective rate being 39.29%, 60.71% and 78.57%, respectively. The comprehensive therapeutic effect of the moxibustion group was significantly superior to that of the acupuncture and EA groups (P<0.05). CONCLUSION: All the three different kinds of acupuncture and moxibustion methods have positively regulatory effect on KOA, and moxibustion is the best for reducing the joint pain and stiffness, and improving the motor function.

[Effect of moxibustion on inflammatory factors and oxidative stress factors in patients with knee osteoarthritis: a randomized controlled trial].

OBJECTIVE: To compare the clinical efficacy between moxibustion and acupuncture for knee osteoarthritis (KOA), and to observe the effect on serum tumor necrosis factor-α(TNF-α), interleukin-1ß(IL-1ß), superoxide dismutase (SOD) and malondialdehyde (MDA). METHODS: A total of 60 patients with KOA were randomized into a moxibustion group (30 cases, 2 cases dropped off) and an acupuncture group (30 cases, 2 cases dropped off). In the aucpuncture group, acupuncture was applied at Neixiyan (EX-LE 4), Dubi (ST 35), Heding (EX-LE 2), Xuehai (SP 10), Liangqiu (ST 34), Zusanli (ST 36) and ashi point on the affected side for 30 min.In the moxibustion group, moxibustion was adopted at knee for 60 min. The treatment was given once every two days for 4 weeks, totally 14 times. Before and after treatment, the western ontario and McMaster universities osteoarthritis index (WOMAC) score was compared, and the therapeutic effect was evaluated in the two groups. The contents of serum TNF-αand IL-1ß, the activity of serum SOD and the serum level of MDA were detected in the two groups. RESULTS: Compared before treatment, the WOMAC scores and the contents of serum TNF-α, IL-1ß and MDA after treatment were reduced (P<0.05), the activity of serum SOD was increased (P<0.05) in the two groups. In the moxibustion group, the WOMAC score and the contents of serum TNF-α, IL-1ß and MDA after treatment were lower than the acupuncture group (P<0.05), the activity of serum SOD was higher than the acupuncture group (P<0.05). The total effective rate was 89.3% (25/28) in the moxibustion group, which was superior to 42.9% (12/28) in the acupuncture group (P<0.05). CONCLUSION: Moxibustion and acupuncture can relieve KOA symptoms, and the therapeutic effect of moxibustion is superior to acupuncture. The mechanism may be related to the reduction of serum inflammatory factor and oxidative stress factor.

[Feasibility analysis on acupuncture therapy for the treatment of Corona Virus Disease 2019 and the exploration on the application scheme].

The situation of Corona Virus Disease 2019 (COVID-19) is still severe at present. In order to better fight against the epidemic and give full play to the advantages of traditional Chinese medicine, we explored the feasibility of acupuncture therapy in the intervention of COVID-19 through analyzing the relevant literature in both ancient and modern time. Additionally, we analyzed the intervention scheme of acupuncture for COVID-19 developed by China Association of Acupuncture and Moxibustion and supplemented the protocol of the intervention with auricular acupuncture. It was proposed that the advantages of acupuncture and moxibustion should be fully displayed while Chinese herbal medications have been applied in the treatment of COVID-19. During treatment, acupuncture physicians should be rationally allocated to a certain proportion so as to adequately utilize comprehensive therapeutic approaches and guarantee people's safety to the greatest extent. Eventually, the clinical therapeutic effect may be improved, the national resources be economized on and the COVID-19 epidemic be conquered early.

[Clinical application characteristics of different acupuncture-moxibustion therapies for knee osteoarthritis in the past decade: an analysis based on data mining techniques].

OBJECTIVE: To investigate the application characteristics of different acupuncture-moxibusition (acu-moxi) therapies for knee osteoarthritis (KOA), and to provide a reference for clinical application. METHODS: Computer and data mining techniques were used to establish a database of acu-moxi therapies for KOA, and the articles on acu-moxi in the treatment of KOA in the past decade were collected, screened, entered, reviewed, and analyzed. Acu-moxi therapies for KOA were summarized in terms of treatment method, clinical effect, association between treatment method and acupoint selection, needle specifications, and depth of acupuncture. RESULTS: There are as many as 46 kinds of operation methods to treat knee osteoarthritis, among which moxibustion method has the highest frequency and the most operation methods. Traditional Chinese acupuncture and moxibustion technology has a significant effect on knee osteoarthritis, and the effective rate is more than 90%, among which the minimally invasive technique of traditional Chinese medicine has the highest cure rate and recovery rate. The relationship between traditional Chinese medicine operation and acupoint selection shows that the acupuncture and moxibustion therapy guided by traditional Chinese medicine theory pays more attention to acupoint selection based on syndrome differentiation, while the minimally invasive technique of traditional Chinese medicine is mostly proximal acupoint selection. The diameter of the needle with the highest usage frequency was 0.3 mm. The larger the diameter of the needle, the higher the specificity. The level of acupuncture was mostly tendon, followed by bone. The cure rate of acupuncture to bone is the highest. CONCLUSION: Acupuncture and moxibustion has a significant effect in the treatment of KOA, with a profound theoretical basis; treatment of KOA should emphasize overall conditioning, and acupuncture should reach the bone and the tendon, so as to achieve a better clinical effect.

[Regularities of clinical application of hand acupuncture therapy to treatment of various diseases based on data mining].

OBJECTIVE: To explore the regularities of clinical application of hand acupuncture therapy to the treatment of diseases of different departments by using data mining technique, so as to provide a reference for clinical practice. METHODS: We searched papers, academic dissertations and case reports (published in journals from Jan 1, 1953 to December 31, 2017) from databases of China National Knowledge Internet (CNKI), VIP, and Wanfang, and also searched papers from medical books about hand acupuncture treatment of different diseases/illness by using keywords of "hand acupuncture" and "hand acupoints"， followed by constructing a database after sorting, screening, recording, extracting, and statistical analysis by using a computer. Then, the data mining was conducted for summarizing the characteristics and rules of the hand acupuncture therapy in clinical application. RESULTS: The hand acupuncture therapy in Chinese medical journals was found to be applied to various clinical departments, with the frequency from high to low successively being 16 types of diseases (37.21%) in the surgery, 15 diseases (34.88%) in the internal medicine, 2 diseases (4.65%) in the pediatrics, 8 diseases (18.60%) in the ophthalmology-otorhinolaryngology, 1 disease (2.33%) in the genecology and 1 disease (2.33%) in the dermatology. In the treatment of diseases, the cure plus markedly effective rate of hand acupuncture was found to be highest for diseases of the pediatrics (90.65%), and was 88.45% surgery, 78.06% internal medicine, 89.96% ophthalmology-otorhinolaryngology, 60.61% gynecology, and 67.73% dermatology, respectively. When hand acupuncture used, the acupoints of the hand region on both sides, healthy side and affected side were often selected, and movement exercise was often used in combination, particularly for problems of the surgery. In the collected medical records and 6 acupuncture books, the hand acupuncture was employed for treatment of 34 and 123 kinds of diseases or problems, respectively, with the tissue injury, lumbocrural pain being most frequently seen in the records, and abdominal pain, lumbocrural, chest obstruction, etc. most frequently seen in the acupuncture books. CONCLUSION: Hand acupuncture therapy is widely used in the treatment of many clinical problems of different departments, such as tissue injury, leg pain, etc. of the surgery; abdominal pain, asthma, etc. of the internal medicine; infantile enuresis, diarrhea, etc. of the pediatrics. Acupoints of the hand on the unilateral side are frequently employed and may have a better therapeutic effect.

[Data Mining-revealed Characteristics of Clinical Application of Scalp Acupuncture].

OBJECTIVE: To explore the regularity and characteristics of clinical application of scalp acupuncture therapy for different types of clinical conditions so as to provide a reference for clinical practice. METHODS: In the present study, "head acupuncture" and"scalp acupuncture" were used as the keywords to search papers and academic dissertations having definite standards for diagnosis and therapeutic effect assessment and published in journals and academic conferences collected in database China National Knowledge Internet(CNKI) from January 1 of 1959 to December 31 of 2016, followed by constructing a database after sorting, screening, recording, extracting, and statistical analysis by using a computer. Then, the data mining was conducted for summarizing the indications of disease categories, involved medical departments, needle-insertion methods, needle manipulation techniques, academic schools, and clinical efficacy of scalp acupuncture therapy. RESULTS: As a result, a total of 587 papers met our including criteria were analyzed. The scalp acupuncture therapy was widely employed in the treatment of various clinical conditions of different departments, with the application frequency being the internal medicine (438 times), surgery (75 times), pediatrics (44 times), etc. Of the indicated 102 types of clinical problems, 55 belong to the internal medicine, constituting of 53.92%, particularly the cerebral apoplexy and its sequelae with the top application frequency being 102 and 115 times, respectively. In terms of needle inserting methods mentioned in partial papers (most papers do not mention), fingernail-pressing-aided needle insertion, needle-twirling insertion, fingers-squeezed-needle insertion, particularly the swiftly rotating needle insertion and rapid needle-propelling insertion were most commonly used.Regarding the needle manipulation method, rapid needle twirling technique was frequently employed, usually at a frequency of approximately 200 times per min. In regard to the academic schools, JIAO Shun-fa's scalp acupuncture system was most frequently used, followed by the international standardized scalp acupuncture. The therapeutic effect of scalp acupuncture is effective in the treatment of different conditions of various departments, especially those of the dermatology and gynecology. CONCLUSION: Scalp acupuncture has superiority in the treatment disorders of the internal medicine and has been demonstrated to have positive effects for many types of problems, particularly for apoplexy and its sequelae. Rapid needle-propelling insertion and rapid needle-twirling technique are often employed.

[Research of Characteristics of Stimulation Methods and Application of Acupoint in Auricular Needle Therapy Based on Data Mining].

In the present paper, using data mining technology,the authors downloaded information from databases on auricular needle therapy, and obtained data samples from journals and academic dissertations involving the application of auricular needle therapy to treat diseases, and then screened, audited, and extracted the data and performed a statistical analysis. The authors extracted data on the application of auricular needle therapy in the stimulation methods of medicine (needling instrument), selection of the side of ear to treat disease and the number of times the ear was pressed per day and the compression time. In the stimulation methods, the needling instrument varied, the seeds of cowherb Semen Vaccariae were applied in 60.89% of the total stimulation methods. The number of times the ear was pressed per day and the compression time in the clinic were optional. The main points in auricular needle therapy were the contralateral side; there was no significant difference in the effect of a single side or both sides of the ear to treat disease.