Effect Of Electroacupuncture On Clinic And Cytokines In Peripheral Blood Of Rheumatoid Arthritis

Objective: to observe the clinical effects of electroacupuncture in the treatment of Rheumatoid Arthritis (RA) and its influence on Interleukin-1(IL-1),Interleukin-4(IL-4),Interleukin-6(IL-6),Interleukin-10(IL-10),Tumor Necrosis Factor-α(TNF-α);Investigate the mechanism of the effects of electroacupuncture against the inflammation of RA. To investigate the precise effect of the acupuncture method for clinical and to provide ideas about acupuncture treating other dieases.Methods:Clinical research: The diagnostic standards of RA and evaluation standards of illness state from American College of Rheumatology(ACR)were used in this study This study of 28 cases of electroacupuncture treatment effect observed in patients with RA and with the regular needle acupuncture group 27 cases of RA patients with control .Points of Fengchi,Quchi,Ganshu,Shenshu,Pishu,Sanyinjiao,Zusanli,Yanglingquan and Xuanzhong, along with the actual points of pain on the body, were used. Acupuncture treatment was applied every other day for a total of 30 days with a 2 days intermission after the 10th treatment. The two groups were observed before and after treatment the number of painful joints, swollen joints ,number of pain assessment of patients, doctors and patients with the disease activity of the comprehensive evaluation, the patient assessment of physical function, morning stiffness time,CRP,ESR,etc. At the same time to observe the levels of cytokine including IL-1,IL-4,IL-6,IL-10,TNF-αin peripheral blood.Empirical study: 60 Wistar male rats with body weights from 230g to 270g were divided into four groups as follow: normal control(20rats), Collagen-induced arthritis(CIA)withouttreatment(20rats),CIA with eletroacupuncture treatment(10rats) ,CIA with regular acupuncture treatment(10rats). Acupuncture treatment was performed every day 21 days after modeled ,points of Yanglinquan,Huantiao,Bafeng,Shenshu of both sides were choiced. After pulling the needles into the two sides of Yanglingquan connected with electronic acupuncture equipment. The treatmen lasted 20 minutes each time for 20 times with 2 days intermission after the 10th treatment.The four groups were observed before and after model and treatment the general situation in rats,foot circumference,arthritis index (AI),levels of cytokine including IL-1,IL-4,IL-6,IL-10,TNF-αin peripheral blood.Results : Clinical research1. Electroacupuncture was more effective on RA patients although both of electroacupuncture and regular acupunctures worked. Electroacupuncture improved ACR-20 of 71.43% patients and improved ACR-50 of 21.43% of patients.This was significantly different from the effects that were achieved byregular acupuncture, which improved ACR-20 of 48.15%patients and ACR-50 of 14.81% patients(P<0.05);2.Electroacupuncture was more effective in reducing the numbers of painful joints,swollen joints,number of pain assessment of patients, doctors and patients with the disease activity of the comprehensive evaluation, the patient assessment of physical function, morning stiffness time(P<0.01), and both the two groups were woked(P<0.05); 3. After treatment the levels of CRP,ESR in two groups of patients's serum were significantly decreased, but there was no difference between the two groups(P>0.05);4. The two groups were significantly decreased the levels of IL-1,IL-6,TNF-αin RA patiens's peripheral blood(P<0.01), while electroacupuncture was more effective than regular acupuncture(P<0.05).The two groups were significantly increased the levels of IL-4,IL-10 in RA patiens's peripheral blood(P<0.01),without siginificant difference in this two groups(P>0.05);Empirical study: 1 .Electroacupuncture can significantly reduce the degree of joint swelling in rats and the arthritis index;2. Electroacupuncture treatment adjusted the balance among Th1/Th2 cytokines and modified immunity by decreasing serum IL-1,IL-6,TNF-αand increasing serum IL-4,IL-10.Conclusions : Those results indicated that electroacupuncture treatment had effects on RA patients, reduce the clinical symptoms, improve quality of life of patients and improve immune function,and the electroacupuncture was more effective than the regular acupuncture. Electroacupuncture can adjusted the balance among Thl/Th2 cytokines and modified immunity by decreasing serum proinflammatory factors IL-1,IL-6,TNF-αand increasing serum suppressing inflammatory cytokinesIL-4,IL-10 and it was the one of the important mechanism on acupuncture treating RA. This therapy for the treatment of rheumatoid arthritis has well clinical application and further research value.