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Title: [Effect of different suspension moxibustion methods on syndrome characteristics of rats with rheumatoid arthritis of heat bi syndrome based on "moxibustion can be used for heat syndrome"].
Author: Zhao ZT, Zhao YK, Chen JL, Zhu TT, Yan XK, Zhang YF.
Journal: Zhongguo Zhen Jiu; 2023 Sep 12; 43(9):1062-9. PubMed ID: 37697883.
Abstract:
OBJECTIVE: To observe the effects of different suspension moxibustion methods on the syndrome characteristics and inflammatory factors of rats with rheumatoid arthritis (RA) of heat bi syndrome and to prove the concept of "moxibustion can be used for heat syndrome". METHODS: Among seventy Wistar rats, 12 rats were randomly selected as a normal group, and the remaining rats were induced by collagen combined with wind, dampness, and heat environmental stimulation to establish the RA model of heat bi syndrome. Forty-eight rats with successful model establishment were further randomly divided into a model group and three moxibustion groups (mild moxibustion group, rotating moxibustion group and sparrow-pecking moxibustion group), with 12 rats in each group. The acupoints "Quchi" (LI 11), "Dazhui" (GV 14) and ashi point were used in all moxibustion groups, with mild moxibustion, rotating moxibustion, and sparrow-pecking moxibustion intervention given respectively, each acupoint was treated with moxibustion for 10 min a day, and 6 days were considered one course of treatment, with a total of three courses. After the intervention, the arthritis index (AI), the Evans blue (EB) extravasated volume in the soft tissue of the right hind paw, and the levels of tumor necrosis factor (TNF)-α and interleukin (IL)-10 in the serum were measured by ELISA in each group. The volume of the bilateral hind paw was measured; the infrared thermal imaging was collected to analyze the temperature of the plantar area of the bilateral foot pads, and the reaction time of plantar heat pain was calculated before and after modeling, as well as after the 1st, 2nd and 3rd courses of interrention. The ankle dorsiflexion angle of the right hind foot was also measured before and after modeling, as well as after the intervention. RESULTS: After modeling, compared with the normal group, the rats in the model group had more high-temperature areas in the bilateral hind limbs, abnormal AI score, abnormal bilateral hind paw volume, abnormal temperature of the plantar area of the bilateral foot pads, abnormal foot pain response time, abnormal right hind ankle dorsiflexion angle, abnormal right hind paw soft tissue EB extravasation, and abnormal serum TNF-α and IL-10 levels (P<0.01, P<0.05). After the intervention, compared with the model group, the rats in each moxibustion group had decreased or disappeared high-temperature areas in the bilateral hind limbs, EB extravasated volume in the soft tissue of the right hind paw was reduced (P<0.05), and the right ankle dorsiflexion angle was increased (P<0.05), serum level of TNF-α was reduced, and level of IL-10 increased (P<0.05); the AI scores in the mild moxibustion group and the sparrow-pecking moxibustion group was decreased (P<0.01, P<0.05). After the 1st, 2nd and 3rd courses of intervention, compared with the model group, the bilateral hind paw volume of rats in each moxibustion group was decreased (P<0.05, P<0.01), and plantar heat pain reaction time was increased (P<0.05). After the 2nd course and the 3rd course of intervention, the temperature of the right hind paw pad area was decreased in each moribustion group (P<0.05); after the 3rd courses of intervention, the temperature of the left hind paw pad area was decreased in the mild moxibustion group (P<0.05). CONCLUSION: Suspension moxibustion could adjust the serum levels of TNF-α and IL-10 to improve the syndrome characteristics of RA rats of heat bi syndrome, such as joint redness, swelling, heat, pain and activity restriction. The effect of mild moxibustion is the most prominent. The findings could provide scientific basis for "moxibustion can be used for heat syndrome". 目的：观察不同悬灸法对热痹型类风湿关节炎（RA）大鼠证候特征和炎性因子的影响，初步探明“热证可灸”。方法：将70只Wistar大鼠随机取12只作为正常组，剩余大鼠以胶原诱导联合风、湿、热环境刺激复制热痹型RA模型，造模成功的48只大鼠再随机分为模型组和3个悬灸组（即温和灸组、回旋灸组、雀啄灸组），每组12只。3个悬灸组大鼠均取“曲池”“大椎”“阿是穴”，并分别给予温和灸、回旋灸、雀啄灸干预，每穴每日施灸10 min，6 d为一疗程，共3个疗程。干预后观察各组大鼠关节炎指数（AI）评分，测定右侧后足垫软组织依文思蓝（EB）漏出量和血清肿瘤坏死因子（TNF）-α、白细胞介素（IL）-10含量；于造模前后及干预1、2、3个疗程后测量各组大鼠双侧后足足跖容积，采集红外热成像图并分析双侧足垫区温度，计算足底热痛反应时间；于造模前后及干预后测量右侧踝关节跖屈角度。结果：造模后，与正常组比较，模型组大鼠双侧后肢高温区增多，AI评分、双侧后足足跖容积、双侧后足足垫区温度、足底热痛反应时间、右后侧踝关节跖屈角度、右侧后足垫软组织EB漏出量、血清TNF-α与IL-10含量均出现异常（P<0.01，P<0.05）。干预后，与模型组比较，各悬灸组大鼠双侧后肢高温区缩小或消失，右后侧踝关节跖屈角度增大（P<0.05），右侧后足垫软组织EB漏出量减少（P<0.05），血清TNF-α含量降低、IL-10含量升高（P<0.05）；温和灸组、雀啄灸组大鼠AI评分降低（P<0.01，P<0.05）。干预1、2、3个疗程后，与模型组比较，各悬灸组大鼠双侧后足足跖容积减小（P<0.05，P<0.01），足底热痛反应时间增加（P<0.05）；各悬灸组大鼠干预2、3个疗程后右侧后足足垫区温度及温和灸组大鼠干预3个疗程后左侧后足足垫区温度降低（P<0.05）。结论：悬灸可调节血清TNF-α、IL-10含量使关节红、肿、热、痛和活动受限等热痹型RA证候特征改善，以温和灸效应最突出，可为“热证可灸”提供科学依据。.

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