| Objective:The theoretical study of the subject through the study of ancient and modern literature, investigate that the moxibustion temperature is a key factor to the efficiency of moxibustion, that suitable temperature of the moxibustion is an important prerequisite to obtain the best moxibustion effective, which provide a theoretical basis for the next step moxibustion Warming effect mechanism; Clinical trials through the observation the impact of different moxibustion temperature on the content of lipids and Ox-LDL, ET-1, NO in serum of patients with hyperlipidemia, explore the warming and promoting effect mechanism of moxibustion, to see whether it can be reflect by different aspects of the pathology, including adjusting blood lipid components, antioxidant, protecting vascular endothelial improving vasomotor function, preventing AS and so on.The animal experiments observed the impact of temperature sensors TRPV1agonist capsaicin and antagonist capsazepine on the blood lipids and TRPV1mRNA expression of dorsal root ganglion in C57BL/6mice with hyperlipidemia. it is confirmed that TRPV1mediated mechanism of moxibustion regulating blood lipids and clearing the blood by negative control study and positive control study.Method:Theory research:search related ancient and modern literature, including temperature, feeling, effection, mechanism of moxibustion, hyperlipidemia, TRPV1and then summarize, analysis the correlation between the above information and the this topic.Method:Clinical trials:part one:test Li4of20healthy volunteers with laser doppler temperature probe to observe their sense of different temperature; part two:42patients with primary hyperlipidemia were randomly divided into45℃group and38℃, using different temperature moxibustion on CV8and ST36,10minutes for each acupoint one time, every other day at a time, after12weeks of treatment, draw elbow vein blood to observe the changes of index before and after treatment and the curative effect of the differences between groups. Animal experiment:part one:32SPF level healthy adult male C57BL/6mice were randomly divided into4groups:the normal group, the model group, the46℃group as well as the38℃group, eight for each group. Use selfmade75%egg yolk emulsion as25ml/kg by intraperitoneal injection at one time to foster acute hyperlipidemia model.on9p.m. of the first day, take food away and water left, the next day at13p.m to build mold, after the success of model making, start treatment at the third day. Draw materials immediately on the fourth day after treatment, then detect serum lipids with automatic biochemical analyzer and detect TRPV1mRNA expression amount of dorsal root ganglion by quantitative PCR. part two:40SPF level healthy adult male C57BL/6mice were randomly divided into5groups:46℃group, normal group, model group,46+CPZ group,46+soluble enzyme group, eight for each group.model making and treatment is the same as the part one,46+CPZ group with capsazepine daubed on the acupoints before treatment,46+enzyme group daub soluble enzyme agent before treatment, Draw materials immediately on the fourth day after treatment, then detect serum lipids with automatic biochemical analyzer and detect TRPV1mRNA expression amount of dorsal root ganglion by quantitative PCR; part three,68SPF level healthy adult C57BL/6male mice were randomly divided into6groups, the normal group, model group, the46℃group, the38℃group, the CAP group and the soluble enzyme group, each group of eight mice. Model making and treatment is the same as the part one. The CAP group daub capsaicin without other treatment, as well as the enzyme group. Draw materials immediately on the fourth day after treatment to detect, and then detect serum lipids in mice with automatic biochemical analyzer and detect TRPV1mRNA expression amount of dorsal root ganglion by quantitative PCR.Result:Clinical Research:1there are four moxibustion sense:warm, hot, burning, pain, they have different temperature range, the temperature range of warm is about32.8℃-35.8℃; the temperature range of heat is about36.8℃-39.9℃; the temperature range of hot is about40.9℃-43.5℃; the temperature range of pain is probably greater than or equal to44.5℃。2Comparison between the two groups after treatment, the45℃group reduce the content of TC, TG, Ox-LDL and ET-1/NO the ratio in the serum of patients with hyperlipidemia, significantly better than the38℃group (P<0.05or P<0.001). In the same time, the45℃group increased the content of NO in the serum of patients with hyperlipidemia, which is significantly better than the38℃group (P<0.05).3moxibustion stimulate of45℃and38℃can significantly reduce the levels of Ox-LDL in the serum, but the38℃group had no significant impact on the content of NO, ET-1, ET-1/NO, while45℃group had obvious impact. That indicate that moxibustion stimulate of38℃also has a therapeutic effect, but its pathway may be different from45℃moxibustion stimulate.Experimental Research:4Compared with the model group, the group of46℃decreased the content of TC significantly(P<0.05); Compared with the46℃group, the content of TC in38℃group is significantly more higher (P<0.05); expression of TRPV1mRNA in the46℃group is2.62times of the model group, the expression of TRPV1mRNA in the38℃group was1.78times of the model group, the amount is38℃group at46℃TRPV1mRNA expression, expression of TRPV1mRNA in the46℃group is1.47times of the38℃group.5Compared with the46℃group, the content of TC in46+CPZ group is significantly more higher (P<0.05), which indicate that capsazepine antagonized the lipid-lowering effect of46℃group moxibustion. The expression of TRPV1mRNA in the46℃group was2.62times of the model group, The expression of TRPV1mRNA in the46+CPZ group was1.59times of the model groupd, The expression of TRPV1mRNA in the46+CPZ group was1.64times of the46℃groupd, The expression of TRPV1mRNA in the46+soluble enzyme group was2.49times of the model groupd.6Compared with the model group, the content of TC in46℃group and CAP group was significantly reduced(P<0.05); the CAP group and46℃group statistically speaking had no differences in lowering effect of TC. The expression of TRPV1mRNA in the46℃group was2.62times of the model group. The expression of TRPV1mRNA in the CAP group was2.62times of the model group, the expression of TRPV1mRNA in the38℃group was1.78times of the model group, The expression of TRPV1mRNA in the soluble enzyme group was1.68times of the model groupd.Theoretical research:7The moxibustion sense is key in moxibustion onset; warm, hot, burning, pain feeling were the main manifestations of the moxibustion sense; suitable amount of moxibustion was the important condition to get moxibustion sense and the moxibustion efficiency; Moxibustion temperature was comprehensive moxibustion amount of different moxibustion strength, and the suitable moxibustion temperature is an important prerequisite to obtain the best moxibustion effective; moxibustion mechanism is associated with many physical and chemical factors during the action of burning, such as the acupoint local receptors, heat shock proteins, mast cell degranulation, etc, and these factors are affected by temperature and produce biological changes.Conclusion:Clinical research:1warm, hot, buring, pain corespound to four kind of different sense of moxibustion for different temperature range, which is32.8℃to35.8℃,35.8℃to39.9℃,40.9℃to43.5℃, and more than44.5℃. Sense of moxibustion is closely related with temperature.245℃moxibustion stimulating can regulate the lipid metablison,, reduce the serum TC, TG, ApoB, LDL-c content in different degrees, significantly increase the content of HDL-C;45℃moxibustion stimulation greately reduces the Ox-LDL content in serum of hyperlipidemia patients, proved to have antioxidant effects;45℃moxibustion stimulation can reduce ET-1in serum content, increase NO content and lower ratio of ET-1by NO, hyperlipidemia patients. Thus45℃moxibustion stimulation can protect the vascular endothelial function.338℃moxibustion stimulation has less effect in regulating the lipid levels;38℃moxibustion stimulation can largely reduce the content of Ox-LDL in serum of hyperlipemia patients, exert antioxidant effects;38℃moxibustion stimulation has little impact on the content of NO and ET-1, ratio of ET-1by NO,which means it can not protect the vascular endothelial function obivosly.4By contrast,45℃group ofmoxibustion shows better impact on regulating lipid index, exerting antioxidant effect and protecting the vascular endothelial function; moxibustion has the function of warming and promoting to regulate lipid,"warm" is one condition, and it need to reach a certain temperature,45℃is better than38℃,"tong" is the effect of moxibustion stimulation,Only when reaching the certain condition,will it exert better effect of regulating the lipid and unblocking the meridiansAnimal studies:146℃moxibustion stimulation reduced the content of TC, while significantly increase the expression level of TRPV1mRNA, which in different from38℃.2The local application capsazepine competition antagonised lipid metabolism function of the46℃the moxibustion thermal stimulation, as well as suppress of TRPV1mRNA in the mice dorsal root ganglion induced by moxibustion heat stimuli.3The same as Capsaicin,46℃moxibustion stimulus can activate TRPV1, and produce the same role in regulate lipid.4TRPV1mediates moxibustion warming and promoting effect mechanism, and a suitable amount of moxibustion is necessary to activate TRPV1amount. The suitable temperature can enable the patient tolerate and can also activate enough amounts of TRPV1.which is43℃-45℃.Theoretical studies:1A moxibustion sense moxibustion onset.2warm, hot, burning, pain feeling were the main manifestations of the moxibustion sense3suitable amount of moxibustion was the important condition to get moxibustion sense and the moxibustion efficiency.4Moxibustion temperature was comprehensive moxibustion amount of different moxibustion strength, and the suitable moxibustion temperature is an important prerequisite to obtain the best moxibustion effective... |
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