RESUMO
OBJECTIVE: To systematically evaluate the efficacy and safety of conventional therapy combined with moxibustion in the treatment of chronic obstructive pulmonary disease (COPD) in stable phase based on Meta-analysis medicine. METHODS: The randomized controlled trials (RCTs) of moxibustion as adjuvant therapy for COPD were retrieved from the databases of CNKI, Wanfang, SinoMed, PubMed, Web of Science, Cochrane Library and Ebsco. RevMan5.3 software was used for Meta analysis, and the quality of evidence was evaluated according to GRADE standards. RESULTS: A total of 16 RCTs were included, involving 1425 patients. The results of Meta-analysis showed that: compared with the conventional treatment, â the adjuvant therapy with moxibustion had advantages in reducing the number of acute exacerbations [MD=-0.31, 95%CI:-0.49--0.13, P=0.0006]; â¡the adjuvant therapy with moxibustion improved lung function significantly [FEV1% (MD=4.00, 95%CI:2.63-5.37, P<0.000 01) and FEV1/FVC (MD=3.56, 95%CI:1.69-5.43, P=0.000 2)]; â¢the adjuvant therapy with moxibustion could extend the 6 min walking distance (6WMD) (MD=35.00, 95%CI:18.02-51.99, P<0.000 1); â£the adjuvant therapy with moxibustion could improve the modified British Medical Research Council breathing questionnaire (mMRC) classification significantly (MD=-0.62, 95%CI:-1.18--0.05, P=0.03); â¤no adverse reaction was reported in the included literature. CONCLUSION: The efficacy of moxibustion as adjuvant therapy for COPD in stable phase is better than that of simple conventional therapy. Due to insufficient clinical evidence and the limitations of this study, clinical safety is unclear and further evidence is needed to support the results.
Assuntos
Moxibustão , Doença Pulmonar Obstrutiva Crônica , Humanos , Pulmão , Doença Pulmonar Obstrutiva Crônica/terapia , Resultado do TratamentoRESUMO
Protein kinase Cε (PKCε) is a transforming oncogene and plays an important role in many cellular processing. In the present paper, we review the development of experimental researches on the acute-chronic pain transformation. Results indicated that prostaglandin E2 (PGE2) / EP1 receptor-Gq-PKCε is an important signaling pathway to modulate chronic pain in peripheral dorsal root ganglion (DRG) neurons, and also plays a role in the later stage of hyperalgesia during transformation from acute to chronic pain. PKCε in DRG neurons induces mechanical and thermal hypersensitivity respectively by over expression of transient receptor potential vanilloid 1 (TRPV1) and TRP ankyrin-1 (TRPA1), further mediating the transformation from acute to chronic pain. Whereas, PGE2-evoked activation of EP1-Gq-PKCε signaling may be the key link in initiating the pain translation process through regulating downstream TRPA1 and TRPV1. Electroacupuncture (EA) has been used to effectively relieving various types of acute and chronic pain for decades, and can significantly inhibit the expression of PKCε and its upstream and downstream molecules. Therefore, it can be inferred that there exists a possibility of EA interventions in interfering the transformation from acute to chronic pain by regulating peripheral PKCε signaling pathway.
Assuntos
Dor Crônica , Eletroacupuntura , Animais , Humanos , Hiperalgesia , Proteína Quinase C-épsilon , Ratos , Ratos Sprague-Dawley , Canais de Cátion TRPVRESUMO
OBJECTIVE: To observe the effect of electroacupuncture (EA)on mechanical pain transition and content of protein kinase C epsilon(PKCε)in dorsal root ganglia (DRG) in inflammatory articular pain ratsï¼so as to explore its peripheral mechanism underlying relieving transition from acute to chronic pain. METHODS: 1)In the first part of the present studyï¼male SD rats were equally randomized into blank controlï¼sham hyperalgesic priming(HP), and real HP groups(nï¼6 in each). The HP model was established by subcutaneous injection of 1% carrageenan (100 µL) into the left hind paw (the first injection)ï¼followed by injection of PGE 2 (100 ng/25 µL, the second injection) into the dorsum pedis of the same hind paw 7 days after the first injection. The mechanical withdrawal threshold (MWT) of the ipsilateral paw was detected before and 4, 24, 48, 72 h, and 7 d after the first injectionï¼and 1, 4, 24 and 48 h after the second injection. 2) In the second partï¼SD rats were randomly divided into sham-HPï¼real HPï¼sham-EA and EA groups(nï¼6 in each). The sham-HP and HP models were made in the same way as those in the first part. Bilateral "Zusanli"(ST 36)and "Kunlun"(BL 60)were punctured with filiform needles and also stimulated with electrical currentï¼2 Hz/100 Hzï¼0.5ï¼1.5 mA(0.5 mA increase per 10 min)for 30 minï¼1 time/d from the 1st carrageenan injection on till the end of the experiments. PKCε protein expression in the L 4ï¼L 6 DRGs was assayed by Western blot 48 h after the second injection. RESULTS: 1)In the first part of the studyï¼compared with the sham-HP groupï¼the MWT at 4, 24ã48 h after carrageenan injection and 4, 24 and 48 h after PGE 2 injection were significantly decreased in the HP model group(P<0.01). 2)In the second partï¼compared with the HP groupï¼the MWT at 24ã48 and 72 h after carrageenan injection, and 24 and 48 h after PGE 2 injection were significantly up-regulated in the EA group(P<0.05ï¼P<0.01). 3)The relative content of PKCε in the DRGs(L 4ï¼L 6)was significantly higher in the HP group than in the sham-HP group(P<0.01)ï¼but considerably lower in the EA group than in the HP group (P<0.01)ï¼. CONCLUSION: EA has a good effect on pain conversion in inflammatory joint pain ratsï¼which may be related to its effect in down-regulating the PKCε level in the ipsilateral lumbar DRGs.