[Hunyuan moxibustion for diarrhea-predominant irritable bowel syndrome of spleen and kidney yang deficiency: a randomized controlled trial].

OBJECTIVE: To compare the therapeutic effect between Hunyuan moxibustion and oral western medication on diarrhea-predominant irritable bowel syndrome（IBS-D）of spleen and kidney yang deficiency. METHODS: Sixty patients with IBS-D of spleen and kidney yang deficiency were randomly divided into a Hunyuan moxibustion group and a western medication group, 30 cases each group. The Hunyuan moxibustion group was treated with Hunyuan moxibustion at Guanyuan（CV 4），40 min each time, once a day; in the western medication group，loperamide hydrochloride capsules (2 mg each time, 3 times a day) and bacillus licheniformis live capsules (0.5 g each time, 3 times a day) were given orally.Both groups were treated for 20 days. The scores of irritable bowel syndrome（IBS）symptom severity scale（IBS-SSS）, IBS quality of life scale (IBS-QOL) and TCM symptom grading quantitative were observed before and after treatment, and the clinical efficacy and safety were evaluated in the two groups. RESULTS: After treatment，each item scores and total scores of IBS-SSS in the two groups were lower than those before treatment（P<0.05）, and the total scores of IBS-QOL were higher than those before treatment (P<0.05)；each item score and total score of IBS-SSS in the Hunyuan moxibustion group were lower than those in the western medication group (P<0.05), and the total score of IBS-QOL in the Hunyuan moxibustion group was higher than that in the western medication group (P<0.05).After treatment, each item score and total score of TCM symptom grading quantitative in the Hunyuan moxibustion group were lower than those before treatment (P<0.05), the abdominal pain, diarrhea, lack of appetite scores and total score in the western medication group were lower than those before treatment (P<0.05)；and the abdominal pain, soreness and weakness of waist and knees, fear to cold and cold limbs scores and total score in the Hunyuan moxibustion group were lower than those in the western medication group (P<0.05).The total effective rate was 90.0%（27/30）in the Hunyuan moxibustion group, which was higher than 73.3%（22/30）in the western medication group (P<0.05). No adverse reactions occurred in both groups during treatment. CONCLUSION: Hunyuan moxibustion can effectively improve the symptom severity and quality of life in patients with IBS-D of spleen and kidney yang deficiency, especially in improving the symptoms of abdominal pain, soreness and weakness of waist and knees, fear to cold and cold limbs.Its therapeutic effect is superior to western medication.

[Design and application of a new type of long snake moxibustion box].

Long snake moxibustion, a kind of indirect moxibustion therapy for stimulating the midline part of the back of the patient's body after playing a layer of ginger or garlic mud, is frequently used to treat spine disorders and deficiency-cold type syndromes. In the present paper, we introduced our newly made moxibustion box for applying long snake moxibustion which is safe and easy to operate and can be freely moved at any time in the treatment of vertebral diseases, and conveniently makes the ignited-moxa close to the locus. This newly-designed moxibustion box is made of two lines of paralleled flexible connection side plates hinged ends to ends and two U-like connection plates at the opposite two ends to construct a rectangular frame device. The hinged design makes the long snake moxibustion box conform to the physiological curvature of human body and its length can be adjusted according to the height of patients. When used in clinical practice, it can enhance the patients' safety and reduce the operator's working intensity, and may be helpful to the popularization and development of long snake moxibustion therapy.

[A correlation study of moxibustion time and moxibustion effect of long snake moxibustion in intervention of recurrent exopathogenic diseases in patients with yang-deficiency constitution].

OBJECTIVE: To explore the time-effect relationship of long snake moxibustion in intervening recurrent exopathogenic diseases of patients with yang-deficiency constitution in different moxibustion periods and provide a scientific basis for the selection of long snake moxibustion in preventing and treating recurrent exopathogenic diseases of patients with yang-deficiency constitution. METHODS: Ninety patients with yang-deficiency constitution who met the inclusion criteria of recurrent exopathogenic diseases were randomly divided into a 30 min group, a 60 min group, and a 90 min group, with 30 cases in each group. Long snake moxibustion was applied once a week from Dazhui (GV14) to Yaoshu (GV2) for different periods (30, 60, and 90 min), 12 times (12 weeks) in total. The scores of yang-deficiency constitution quality scale and Fatigue Severity Scale (FSS) before treatment, after treatment, and six months after treatment, as well as attack times of exopathogenic diseases within one year before treatment and after treatment in the three groups, were observed and recorded. RESULTS: After treatment and 6 months after treatment, the yang-deficiency quality scale scores and FSS scores of the three groups were lower than those before treatment (P<0.01), which decreased in the sequence of the 30 min group, the 90 min group, and the 60 min group (P<0.05). Within one year after treatment, the attack times of exopathogenic diseases in the three groups was lower than that within one year before treatment (P<0.01), which decreased in the sequence of the 30 min group, the 90 min group, and the 60 min group (P<0.05). CONCLUSION: The optimal moxibustion time of long snake moxibustion on the recurrent exopathogenic diseases of patients with yang-deficiency constitution is 60 min.

[Effect of long-snake moxibustion on nonspecific low back pain with symptom of cold and dampness].

OBJECTIVE: To compare the clinical therapeutic effect of long-snake moxibustion and ginger-partitioned moxibustion at ashi point on nonspecific low back pain (NLBP) with symptom of cold and dampness. METHODS: A total of 120 patients were randomized into a long-snake moxibustion group, an ashi point group and a waiting for treatment group, 40 cases in each one. Ginger-partitioned moxibustion was applied from Dazhui (GV 14) to Yaoshu (GV 2) of governor vessel in the long-snake moxibustion group, and was applied at ashi point of affected area in the ashi point group, 40 min each time, once every other day and totally 8 times were required. No intervention was adopted in the waiting for treatment group, and after the trial, long-snake moxibustion was applied. Before and after treatment, the visual analogue scale (VAS) scores of rest and activity, the Oswestry disability index (ODI) score and the score of cold and dampness symptom were observed in the 3 groups. RESULTS: Compared before treatment, the VAS scores of rest and activity, the ODI scores and the scores of cold and dampness symptom after treatment were decreased in the long-snake moxibustion group and the ashi point group (P<0.05). After treatment, the variations of the above indexes in the long-snake moxibustion group and the ashi point group were larger than those in the waiting for treatment group (P<0.05), and the variations of the above indexes in the long-snake moxibustion group were larger than those in the ashi point group (P<0.05). CONCLUSION: Long-snake moxibustion can effectively improve the pain, dysfunction and the symptom of cold and dampness in patients with nonspecific low back pain, and the improvement is superior to the ginger-partitioned moxibustion at ashi point.

[Clinical effect of long-snake moxibustion on lumbago of cold-dampness type].

OBJECTIVE: To observe the effect of long-snake moxibustion on pain, functional disorder and body constitution in the patients with lumbago of cold-dampness type. METHODS: A total of 90 patients with lumbago of cold-dampness type were randomized into long-snake moxibustion, acupuncture and medication groups, 30 cases in each group. In the long-snake moxibustion group, long-snake moxibustion was exerted on the spinal (between Dazhui[GV14] and Yaoshu[GV2]) with the self-prepared moxa powder formula combined with fresh ginger and moxa wool, once a week, for 4 weeks. Regular acupuncture was given to the acupuncture group, 30 min each time, once a day, 8 times as a treatment course, at the interval of 2 days between the courses. The duration of treatment was 1 month. In the medication group, Diclofenac Sodium was prescribed for oral administration, 25 mg each time, three times a day, and Mecobalamine tablets, 0.5 mg each time, 3 times a day. The duration of medication was 1 month. Before and after treatment, the differences were evaluated in the scores of visual analog scale (VAS), the present pain intensity(PPI), Oswestry disability index (ODI) and the scale of yang-deficiency body constitution among the 3 groups. RESULTS: After the treatment, VAS and PPI score and ODI were significantly reduced in the patients of the 3 groups as compared with those before treatment (all P<0.05). Compared with the medication group, ODI score was significantly reduced in the long-snake moxibustion group and the acupuncture group (P<0.05). After the treatment, the scores of the scale of yang-deficiency body constitution were significantly reduced in the long-snake moxibustion group and the acupuncture group (P<0.05) as compared with those before the treatment, but not statistically significant in the medication group in comparison before and after the treatment (P>0.05). The score of the scale of yang-deficiency body constitution in the long-snake moxibustion group was significantly lower than that in the acupuncture group and the medication group (P<0.05). Regarding the clinical effect, the effective rate was 93.33% (28/30) in the long-snake moxibustion group and it was 86.67% (26/30) in the acupuncture group and 73.33% (22/30) in the medication group after the treatment. The effective rate in the long-snake moxibustion group was significantly higher than those in the acupuncture group and the medication group (P<0.05). CONCLUSION: The long-snake moxibustion therapy can achieve significant effect on lumbago of cold-dampness type. This therapy can alleviate pain, relieve the functional disorders and improve the conditions of body constitution in the patients. Hence, it is applicable for the clinical promotion.

[Clinical effectiveness of "long snake moxibustion" for cold-dampness type chronic non-specific low back pain patients with negative emotions].

OBJECTIVE: To observe the clinical efficacy of long snake moxibustion and Ashi-point moxibustion in the treatment of cold-dampness type chronic non-specific low back pain (CNLBP) patients. METHODS: A total of 120 cold-dampness type CNLBP patients who signed the informed consent were randomly and equally divided into control, long snake moxibustion and Ashi-point moxibustion groups. Ginger-separated moxibustion was applied to the region between Dazhui (GV14) and Yaoshu (GV2) for patients of the long-snake moxibustion group, or to the tenderness spot of the waist for patients of the Ashi-point moxibustion group. The treatment was conducted for 40 min each time, once every other day for a total of 8 sessions. Patients of the control group did not receive any intervention. The visual analogue scale (VAS) was used to assess low back pain severity. The Oswestry Disability Index (ODI) was employed to assess ten aspects of patients' daily-life activities (pain intensity, personal care, lif-ting, walking, sitting, standing, sleeping, sex life, social life, and traveling). The cold-damp syndrome scores (pain property, symptoms, ranges of motion, waist palpation, tongue and pulse condition) were achieved by consulting the textbook "Differential Diagnostics of Traditional Chinese Medicine Syndromes". The Hospital Anxiety and Depression Scale (HADS, a self-made assessment instrument) was used to assess the patients' severity of emotional disorder.The plasma cortisol level was detected by ELISA. RESULTS: Before treatment, there were no significant differences among the three groups in the levels of all the indexes (P>0.05). After moxibustion, the VAS scores during rest and movement, ODI score, cold-damp syndrome score and anxiety score in both long snake moxibustion and Ashi-point moxibustion groups, and the HADS depression score and plasma cortisol content in the long snake moxibustion group were significantly reduced compared with their own pre-treatment (P<0.05). The difference values between pre and post-treatment of VAS scores during rest and movement, ODI score, cold-damp syndrome score, anxiety score, depression score and cortisol content were obviously higher in the long snake moxibustion and Ashi-point moxibustion groups than those in the control group. The difference values between pre- and post-treatment of VAS scores during rest and movement, ODI score, cold-damp syndrome score, anxiety score, depression score and cortisol content were obviously higher in the long snake moxibustion group than in the Ashi-point group (P<0.05). CONCLUSION: Both ginger-separated long snake moxibustion and Ashi-point moxibustion can relieve low back pain, daily-life activities, cold-damp syndrome, negative emotions, and reducing cortisol level in cold-dampness type CNLBP patients，and the therapeutic efficacy of long snake moxibustion is obviously better.

[Ginger-separated Snake Moxibustion Improves Yang Deficiency Constitution by Up-regulating Serum Adrenocorticotropic Hormone and Cortisol Levels in Yang Deficiency Constitution Volunteers].

OBJECTIVE: Yang deficiency constitution may bring with different types of illnesses in many people. The present study was designed to observe the effect of ginger-separated snake moxibustion on yang deficiency symptom, and serum adrenocorticotropic hormone (ACTH) and cortisol (CORT) contents in yang deficiency constitution subjects, so as to explore its mechanism underlying improvement of yang deficiency constitution. METHODS: Ninety subjects with yang deficiency type constitution were equally and randomly assigned to control A group (19 men and 26 women, 18－60 years in age) and moxibustion group (16 men and 29 women, 18－60 years in age) and 45 normal subjects with mild constitution (18 men and 27 women, 18－60 years in age) were assigned to control B group. An snake-like moxa-cone was placed at a moxa-holder covering the middle back of human body from Dazhui (GV 14) to Yaoshu (GV 2) after paving a layer (about 1 cm thick) of fresh ginger in the holder, and then ignited, followed by the next moxa-cone, 3 cones altogether every time for each participant. The treatment was conducted once a week, 12 times in total. The subjects' constitution was scored according to the "Classification and Evaluation of Constitution of Traditional Chinese Medicine" formulated by China Association of Chinese Medicine. The serum ACTH and CORT contents were measured by radioimmunoassay before and at the end of the treatment and 6 months after the treatment. RESULTS: The constitation scores of the moxibustion group and control A group were significantly higher than that of the control B group before treatment (P<0.01). At the end of the treatment, the constitution score was significantly decreased in the moxibustion group (P<0.01) rather than in the control A group relevant to its own pre-treatment (P>0.05). The serum CORT and ACTH contents were significantly decreased in both the moxibustion and control A groups in comparison to the control B group before treatment (P<0.01), and obviously increased at the end of treatment in the moxibustion group compared with its own pre-treatment (P<0.01). No significant differences were found among the three groups in the constitution score, and serum CORT and ACTH levels at the 6th month after the treatment compared with their own post-treatment (P>0.05)．. CONCLUSION: The ginger-separated snake moxibustion treatment may improve the constitution of yang deficiency participants by increasing the levels of serum ACTH and CORT, which may be helpful in resisting diseases.