| Part one Observation on the clinical effect of moxibustion on knee osteoarthritisObjective: To observe the clinical efficacy and safety of moxibustion in the treatment of knee osteoarthritis,and to reveal the effect of moxibustion.Methods: Patients of 90 with KOA were randomly divided into Acupuncture group,Electroacupuncture group and Moxibustion group in a ratio of 1:1:1.The NRS score,WOMAC score,serum concentrations of IL-1?and TNF-? in the three groups were observed before and 4 weeks after treatment,and the efficacy was evaluated after 4 weeks of treatment.Results:1.After treatment,the effective rates of Acupuncture group,Electroacupuncture group and Moxibustion group were 39.29%,60.71% and78.57%,respectively,with the best moxibustion effect.2.After treatment,NRS score and WOMAC score were decreased in each group;The decrease range of Moxibustion group was greater than that of Electroacupuncture group,and Electroacupuncture group was greater than that of Acupuncture group.3.After treatment,IL-1? and TNF-? concentrations were decreased in each group.The decrease range of Moxibustion group was greater than that of Electroacupuncture group,and Electroacupuncture group was greater than that of Acupuncture group.Summary: Moxibustion can improve pain,stiffness and joint function,which may be related to the reduction the levels of IL-1? and TNF-? in patients.Part two Effect of moxibustion on cartilage in rats with osteoarthritis of knee induced by sodium iodoacetateObjective: To observe the protective effect of moxibustion on cartilage damage induced by sodium iodoacetate in KOA rats,and to explore the scientific reason of "external collaterals in limb segments" of meridian.Methods: Thirty-six rats were randomly divided into Normal group,Model group,Moxibustion group and the Diclofenac Sodium group.Model group did not intervene,Moxibustion group with moxibustion treatment,Diclofenac Sodium group oral diclofenac sodium treatment.The morphological changes of cartilage were observed macroscopically after 4weeks of treatment.HE and Safranin O-fast green staining were used to observe the pathological tissue of rat cartilage,and Mankin's score was obtained.The expression of IL-1? and TNF-? in cartilage was detected by WB.Serum concentrations of IL-1? and TNF-? were determined by ELISA.Results:1.Macroscopic observation showed that the Model group had the most severe local defects;The injury of moxibustion group and Diclofenac Sodium group.was alleviated.2.HE staining and Saffron-O-fast green stain staining showed that the damage of cartilage structure,cell death and large loss of proteoglycan in the Model group were relatively heavy,and the Mankin's score was relatively high,while the damage in the Moxibustion group and the Diclofenac Sodium group was relatively light and the Mankin's score was reduced,and the Moxibustion group was similar to the Diclofenac Sodium group in the Mankin's score.3.ELISA results showed that the expression of IL-1?and TNF-? in serum of the Model group was higher than that of the Normal group.The expression of IL-1? and TNF-? in Moxibustion group and Diclofenac Sodium group decreased.WB results were consistent with ELISA results.Summary: Moxibustion has a protective effect on the cartilage of KOA rats,which may be related to the reduction of local and systemic inflammation.Part three Effect of moxibustion on intestinal flora of rats with knee osteoarthritisObjective: To study the effect of moxibustion on intestinal flora induced by sodium iodoacetate in rats,and to further explore the scientific connotation of "internal part of zang-fu organs" in meridian.Methods: The experimental method was the same as the above part.Fresh feces of rats were collected,and bacterial 16 S r DNA method was used for high-throughput sequencing and biological analysis.High Throughput Sequence were performed by Illumina Hi Seq2500 and to investigate its biological characteristics.Results:1.OTU analysis showed that the number of OTU in the Normal group,Model group,Moxibustion group and Diclofenac Sodium group was 468,509,517 and 452.2.In species annotation and taxonomic analysis,at the level of phylum and genus,lactobacillus of beneficial bacteria in the Model group was reduced,beneficial bacteria in the Moxibustion group were increased,while harmful bacteria in the Diclofenac Sodium group were also increased.3.The results of the diversity of mice showed that the diversity of Model group and Diclofenac Sodium group decreased,while that of Moxibustion group increased.4.LEf Se analysis of the samples between the groups showed that the dominant bacteria in the Modle group were the genus prevotellaceae and the genus koala,while the dominant bacteria in the moxibustion group was brauteria.The western medicine group for enterococcus and shigella bacteria.5.Bug Base function predicted that the moxibustion group increased the ratio of Gram-positive microbes to Gram-negative bacteria,reduced the formation of bacterial biofilm and potential pathogenicity.Summary: Moxibustion increased the diversity and abundance of beneficial bacteria in intestinal flora of KOA rats and decreased the abundance of pathogenic bacteria.Conclusions:1.In the clinical study,the effective rate of moxibustion group in pain,stiffness,joint function and other aspects is 78.57%,moxibustion has anti-inflammatory effect.2.Moxibustion has a protective effect on the articular cartilage induced by sodium iodoacetate in KOA rats,which may be related to the inhibition of local and systemic inflammation,and provides certain experimental parameters for the "external collaterals to limb segments" of the meridians.3.The therapeutic effect of moxibustion may be related to the regulation of the structure,diversity and function of intestinal flora,which provides certain experimental basis for the meridian "belonging to zang-fu". |
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