The Xiaogu San Attenuates Pain and Cartilage Damage in Rats with Monosodium Iodoacetate Induced Osteoarthritis.

BACKGROUND: Osteoarthritis (OA) is a degenerative joint disease with an increasing incidence associated with increased life expectancy. The application of traditional Chinese medicine in the treatment of OA has become a research hotspot. OBJECTIVE: This study investigated the effects of XGS externally applied to osteoarthritic joints and analyze its effect on pain in monosodium iodoacetate (MIA)-induced OA rats. This study also evaluates potential mechanisms behind the anti-osteoarthritic effects of XGS. METHODS: A total of 24 Sprague Dawley rats were evenly and randomly divided into three separate groups, including the normal control (NC), OA and XGS groups. MIA (50 µL, 10 mg/mL) was injected into the left knee joints of the rats to induce OA. After 7 days, The rats of XGS group were given XGS (0.45 g) that was externally applied to the left knee joint, were fixed with gauze, and continuously administered XGS for 28 days. Morphological changes in tissues and organs were examined using H&E staining. Biochemical indicators were measured using an automatic biochemical analyzer. Inflammatory cytokines were detected using ELISA kits and immunohistochemistry. RNA-based high-throughput sequencing (RNA-seq) was performed to detect differential expression of mRNAs in normal and MIA-induced OA rats. RESULTS: Stride of the left leg was extended in rats, matrix increased on cartilage tissue surfaces, and inflammatory cytokines were reduced when treated with XGS. RNA-seq results revealed that the PI3K-Akt signaling pathway is activated in the OA model. The qRT-PCR showed that the expression levels of Tnn, Col6a6, Igf1 and Lamb1 were up-regulated by XGS. CONCLUSION: Altogether, this work demonstrated the potential therapeutic effects of XGS in rats with OA induced by MIA. The XGS may be considered an alternative therapy to manage OA.

[Effect of acupuncture on pain and cerebral hemodynamics in patients with migraine: a randomized controlled trial].

OBJECTIVE: To observe the therapeutic effect between acupuncture combined with medication and simple medication on migraine and cerebral hemodynamics. METHODS: A total of 120 patients with migraine were randomized into an acupuncture plus medication group (60 cases, 3 cases dropped off) and a medication group (60 cases, 6 cases dropped off). In the medication group, flunarizine hydrochloride capsule was given orally before sleep, 10 mg a day. On the basis of the treatment in the medication group, acupuncture was applied at Sizhukong (TE 23), Shuaigu (GB 8), Taiyang (EX-HN 5), Fengchi (GB 20) and etc. in the acupuncture plus medication group, 30 min each time, once a day. Treatment for 4 weeks was required in both groups. Before and after treatment, the visual analogue scale (VAS) score, indexes of cerebral hemodynamic [blood flow velocity of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), vertebral artery (VA) and basilar artery (BA)] and total TCM syndrome score were observed, and the clinical therapeutic effect and the incidence of the adverse events were evaluated in both groups. RESULTS: Compared before treatment, the VAS scores, the blood flow velocity of ACA, MCA, PCA, VA, BA and the total TCM syndrome scores were decreased in both groups (P<0.05). After treatment, the VAS score, the blood flow velocity of ACA, MCA, PCA, VA, BA and the total TCM syndrome score in the acupuncture plus medication group were lower than those in the medication group (P<0.05). The total effective rate was 96.5% (55/57) in the acupuncture plus medication group, which was superior to 90.7% (49/54) in the medication group (P<0.05). There was no statistical difference in the incidence of adverse events between the two groups (P>0.05). CONCLUSION: Acupuncture combined with flunarizine hydrochloride capsule can effectively relieve the pain in patients with migraine, reduce the cerebral blood flow velocity, the efficacy is superior to simple flunarizine hydrochloride capsule.

[Clinical effect of thunder-fire moxibustion combined with electroacupuncture in the treatment of cold-dampness knee osteoarthritis: a randomized controlled trial].

OBJECTIVE: To investigate the clinical effect of thunder-fire moxibustion combined with electroacupuncture in the treatment of cold-dampness knee osteoarthritis. METHODS: A total of 72 patients with cold-dampness knee osteoarthritis were randomly divided into observation group and control group according to the random numbers generated by computer software, with 36 patients in each group. For the observation group, electroacupuncture was performed at the main acupoints of Dubi (ST35), Neixiyan (EX-LE4), Zusanli (ST36), Yanglingquan (GB34), Yinlingquan (SP9), Xuehai (SP10), Liangqiu (ST34), and Heding (EX-LE2) once a day, with a needle retaining time of 30 min, and thunder-fire moxibustion was performed at Shenque (CV8) and Guanyuan (CV4) in the form of suspended moxibustion once a day, with 30 min each time. The patients in the control group were given oral administration of diclofenac sodium double-release enteric-coated capsules, 75 mg each time, once a day, and Fugui Gutong capsules, 6 capsules a time and 3 times a day. Each course of treatment was 14 days, and both groups were treated for 2 courses, with an interval of 2 days between the two courses. Visual Analogue Scale (VAS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and Lequesne index were observed before the treatment, immediately after the treatment, and at 4 months after the treatment, and the outcome of traditional Chinese medicine (TCM) syndrome was compared between the two groups after treatment. RESULTS: Both groups had significant reductions in VAS score, WOMAC score, and Lequesne index immediately and at 4 months after the treatment (P<0.05). Compared with the control group, the observation group had significant reductions in VAS score, Lequesne index, and WOMAC score (scores of pain, function and total score) immediately and at 4 months after the treatment (P<0.05). The effective rate was 97.1% (34/35) in the observation group, and was 78.8% (26/33) in the control group. The effective rate of the observation group was obviously higher than that of the control group (P<0.05). CONCLUSION: Thunder-fire moxibustion combined with electroacupuncture has a better, more durable clinical effect and fewer adverse reactions than the drugs in the treatment of cold-dampness knee osteoarthritis.

[Effect of hysteretic acupuncture on joint function and related cytokines in articular fluid in patients with knee osteoarthritis].

OBJECTIVE: To observe the difference of therapeutic effect between hysteretic acupuncture and Celecoxib capsules for knee osteoarthritis(KOA), and to investigate their effects on levels of interleukin 6(IL-6) and tumor necrosis factor α(TNF-α) in articular fluid. METHODS: Seventy-two patients with KOA were randomly divided into hysteretic acupuncture and me-dication groups, with 36 cases in each group. The patients of the hysteretic acupuncture group received hysteretic acupuncture stimulation at Dubi (ST35), Neixiyan (EX-LE4), Zusanli (ST36), Yanglingquan (GB34), Yinlingquan (SP9), Xuehai (SP10), Liangqiu (ST34) and Heding (EX-LE2) as the main acupoints for 30 min once daily. The patients of the medication group received oral administration of Celecoxib capsules(200 mg) once daily. Both of the two groups were treated with 14 days as a course of treatment, with a 2-day rest between each course of treatment, and the treatments were conducted for 2 courses. The visual analogue scale(VAS) score of pain, Lequesne index score, IL-6 and TNF-α level in joint fluid and the change of traditional Chinese medicine(TCM) syndrome score were observed before and after treatment. RESULTS: Compared with pre-treatment, the VAS score, Lequesne index score, IL-6 and TNF-α level, and total TCM syndrome score decreased significantly after treatment in both of the two groups (P<0.05). Hysteretic acupuncture was more effective in reducing VAS score, Lequesne index score, IL-6 and TNF-α level than Celecoxib capsules (P<0.05), and there was no significant difference in total TCM syndrome score and total effective rate between the two groups(P>0.05). No adverse events occurred in both groups during the treatment. CONCLUSION: Hysteretic acupuncture can effectively relieve pain symptoms and improve joint function in KOA patients. Its effect is comparable to that of oral administration of Celecoxib capsules.

[Clinical observation on the therapeutic effect of drugs-paste separated moxibustion combined with electroacupunture for knee osteoarthritis patients of cold-damp type].

OBJECTIVE: To observe the curative effect of Chinese drugs-paste separated moxibustion combined with electroacupuncture (EA) for knee osteoarthritis (KOA). METHODS: A total of 124 cases of KOA patients were randomly and equally divided into moxibustion plus electroacupunture (M + EA) group and medication group by using a random table. Chinese drugs-paste separated moxibustion was applied to Shenque (CV 8) for 9 moxa-cones, combined with EA (4 Hz/20 Hz, 1-2 mA) of Liangqiu (ST 34), Heding (EX-LE 2), Neixiyan (EX-LE 4), etc. for 30 min, once daily, 5 sessions a week. Patients of medication group were treated by oral administration of Antine Capsule (diclofenac sodium, 50 mg, twice daily). After 4 weeks of treatment, the therapeutic effect was evaluated. RESULTS: Compared with pre-treatment, the knee-joint pain scores and the index of severity of osteoarthritis of both M + EA and medication groups decreased significantly after termination of the treatment and 10 weeks after the treatment (P < 0.01), and those of M + EA group were markedly lower than those of medication group (P < 0.05). After the treatment, of the two cases in medication and M + EA groups, 3 (4.8%) and 8 (12.9%) were under control in their symptoms, 16 (25.8%) and 21 (33.9%) had remarkable improvement, 31 (50.0%) and 27 (43.5%) were effective, 12 (19.4%) and 6 (9.7%) failed in the treatment, with the effective rates being 80.6% and 90.3% respectively. Ten weeks after the treatment, of the two 62 cases in medication and M + EA groups, 1 (1.6%) and 7 (11.3%) were under control, 10 (16.1%) and 19 (30.6%) had marked improvement, 31 (50.0%) and 28 (45.2%) were effective, 20 (32.3%) and 8 (12.9%) failed in the treatment, with the effective rates being 67.7% and 87.1%, respectively. The curative effect of M + EA group was significantly superior to that of medication group (P < 0.05, P < 0.01). CONCLUSION: Chinese drugs-paste-separated moxibustion combined with EA is effective in the treatment of KOA of cold-damp type.

[Efficacy observation of primary dysmenorrhea treated with isolated-herbal moxibustion on Shenque (CV 8)].

OBJECTIVE: To observe the clinical efficacy on primary dysmenorrhea treated with isolated herbal moxibustion on Shenque (CV 8). METHODS: One hundred and two cases were randomized into isolated herbal moxibustion group and western medication group, 51 cases in each one. In isolated herbal moxibustion group, the cases were treated with isolated herbal moxibustion on Shenque (CV 8), and in western medication group, analgesic was administered. RESULTS: In isolated herbal moxibustion group, 17 cases were cured, 21 cases effective markedly, 9 cases effective and 4 cases failed. The total effective rate was 92.2%. In western medication group, 7 cases were cured, 11 cases effective markedly, 21 cases effective and 12 cases failed. The total effective rate was 76.5%. The comparison of the total effective rates between two groups indicated significant difference in statistics (P < 0.01), in which, the result in isolated herbal moxibustion group was superior to that in western medication group. In comparison of dysmenorrhea score before and after treatment and side effects of two groups, the significant differences presented in statistics, in which, the results in isolated herbal moxibustion group were superior to those in western medication group (all P < 0.01). CONCLUSION: The isolated herbal moxibustion on Shenque (CV 8) is superior to oral medication of analgesic for primary dysmenorrhea and it deserves to be promoted due to its advantages on safety, less side effect and good compliance of patients.

Location of Yaotong point and the optimal time of its needling.

OBJECTIVE: To determine the location of Yaotong point and the optimal time of its needling in the treatment of acute lumbar sprain. METHOD: Thirty-five cases of acute lumbar sprain were retrospectively analyzed for the location of Yaotong point and the method of its needling according to their disease courses and effects. RESULTS: The optimal time of needling is 1-3 days after lumbar sprain, and the location of Yaotong points on both hands correspond to the location of sprain. CONCLUSION: This correspondence is useful in