[Influence of Heat-reinforcing Needling on Expression of Plasma Atp 5 O mRNA and Atp 6 V 1 B 2 mRNA in Patients with Rheumatoid Arthritis of Wind-cold-damp Retention Type].

OBJECTIVE: To observe influences of heat-reinforcing needling (HRN) on scores of traditional Chinese medicine (TCM) symptoms and expression of plasma ATP synthase subunit O (Atp 5 O) mRNA and lysosomal V 1 subunit B 2 (Atp 6 V 1 B 2) mRNA in patients with wind-cold-damp retention type rheumatoid arthritis (RA), so as to investigate its biological mechanisms in "heat production". METHODS: Sixty wind-cold-damp retention type RA patients were randomly allocated to HRN group (n=30) and control group (n=30). Guanyuan (CV 4), Qihai (CV 6), bilateral Zusanli (ST 36), and local acupoints near the knee-joint were selected for needling stimulation. Patients of the HRN group were treated by manipulating the acupuncture needle with HRN, and those of the control group treated by manipulating the needle with uniform reinforcing-reducing method. The treatments were performed once daily, 5 days a week, and two weeks altogether. The other 30 healthy volunteers were recruited as the normal control group. The TCM symptom scoring system (0-31 points, 11 items as the severities of pain, swelling and tenderness of the knee-joint) was used to evaluate the status of RA, and quantitative real-time PCR (RT-PCR) was used to detect the expression of plasma Atp 5 O mRNA and Atp 6 V 1 B 2 mRNA following removal of red blood cells. RESULTS: After the treatment, the TCM scores of both the HRN and control groups were significantly decreased (P<0.05), and that of the HRN group was significantly lower than that of the control group (P<0.05). Before the treatment, the expression levels of plasma Atp 5 O mRNA and Atp 6 V 1 B 2 mRNA in RA patients were significantly lower than those of the normal group (P<0.05), and after the treatment, the expression levels of plasma Atp 5 O mRNA and Atp 6 V 1 B 2 mRNA were significantly increased in both HRN and control groups compared to pre-treatment in the same one group (P<0.05), and the up-regulated Atp 5 O mRNA and Atp 6 V 1 B 2 mRNA levels were remarkably higher in the control group than in the HRN group (P<0.05). CONCLUSIONS: Both heat-producing needling and uniform reinforcing-reducing needling can improve RA patients' clinical symptoms, which may be associated with their actions in up-regulating expressions of plasma Atp 5 O mRNA and Atp 6 V 1 B 2 mRNA.

[Clinical observation on idiopathic sudden hearing loss treated by warming-promoting needling technique].

OBJECTIVE: To explore the effective therapeutic method in the treatment of idiopathic sudden hearing loss (ISHL). METHODS: One hundred and eighty-eight cases of ISHL were randomized into a warming-promoting needling group (74 cases), a conventional acupuncture group (56 cases) and a medication group (58 cases). In the conventional acupuncture group, the conventional needling technique was applied to Baihui (GV 20), Fengchi (GB 20), Yifeng (TE 17), Tinggong (SI 19), Touqiaoyin (GB 11) and Zhigou (TE 6) on the affected side. The treatment was given 5 times each week. Totally, the treatment of 6 weeks was required. In the warming-promoting needling group, on the basic treatment as the conventional acupuncture group, the warming-promoting needling technique was applied to Fengchi (GB 20). In the medication group, the intravenous drop with salvia injectio and mecobalamin was prescribed, once per day, for 10 days totally. Meanwhile, Erlong Zuoci Wan was prescribed for oral administration, 8 pills each time, three times a day for 30 days continuously. RESULTS: All of the three therapeutic methods achieved the effect on ISHL. The total effective rate was 89.2% (66/74) in the warming-promoting needling group, which was better than 62.5% (35/56) in the conventional acupuncture group and 53.4% (31/58) in the medication group (both P<0.01). CONCLUSION: The warming-promoting needling techinque achieves the significant efficacy on ISHL. The hearing improvement is superior to that treated with either the conventional needling technique or medication.

[Observation on the analgesic effect of heat-reinforcing needling manipulation for acute arthritis and the concomitant changes of beta-EP and PGE2 contents in the local joint tissue in rabbits].

OBJECTIVE: To observe the analgesic effect of heat-reinforcing needling manipulation for acute inflammatory arthritis and its underlying mechanism in experimental rheumatoid arthritis rabbits. METHODS: A total of 60 rabbits were randomized into control (n=6), model (n=6), needle-twirling (n=24) and heat-reinforcing (n=24) groups, and the later 2 groups were further divided into 0 h, 0.5 h, 1 h and 2 h subgroups,with 6 cases in each. Rheumatoid arthritis model was established by injecting mixed solution of egg-albumin (4 mg/ml) and equal volume of complete Freund's adjuvant (CFA) into the subcutaneous tissue (6 points around the shoulder, 0.2 ml/point). Fourteen days later,the injection was repeated once again,and another 6 days later, egg-albumin (0.4 ml, 20 mg/ml) solution was injected into the bilateral knee-joints. "Zusanli" (ST 36) and "Hegu" (LI 4) were punctured and stimulated by needle-twirling or by heat-reinforcing needling technique for 1 min, with the needle retained for 30 min. The pain threshold of the paw was detected with K+ import stimulation method. beta-EP and PGE2 contents of the joint tissue were assayed with radioimmunoassay. RESULTS: Compared with model group, the pain threshold of needle-twirling group and heat-reinforcing group at each time-point increased significantly (P<0.01, P<0.05). Compared with needle-twirling group, the pain threshold of heat-reinforcing group at 0.5 h, 1 h and 2 h subgroups increased significantly (P<0.05, P<0.01). Both beta-EP and PGE2 contents of model group were significantly higher than those of control group (P<0.01, P<0.05). In comparison with model group, beta-EP contents of needle-twirling group and heat-reinforcing group at each time-point increased significantly (P<0.01, P<0.05), and PGE2 contents of needle-twirling group and heat-reinforcing group at each time-point decreased significantly (P<0.01, P<0.05). The beta-EP content of heat-reinforcing group was significantly higher than that of needle-twirling group at 2 h (P<0.05), while PGE2 content of the former group was significantly lower than that of needle-twirling group at 0 h (P<0.01). CONCLUSION: Both needle-twirling and heat-reinforcing needling can effectively raise the pain threshold in acute arthritis rabbits, which my be closely associated with their effects in upregulating beta-EP content and lowering PGE2 level in the local joint tissue. The analgesic effect of heat-reinforcing needling manipulation is superior to that of needle-twirling.