Heat-Sensitive Moxibustion Therapy In Dubi Acupoint With Knee Osteoarthritis Patients Functional Brain Imaging Study

ObjectiveObservation of heat-sensitive moxibustion for treatment of knee osteoarthritis (KOA) clinical efficacy, using resting-state functional Magnetic Resonance Imaging (rfMRI) of KOA patients, heat-sensitive moxibustion left calf nose cavity and brain in the resting state functional changes, explore the new moxibustion method possible brain mechanisms.Methods1.60cases of KOA patients were randomly divided into heat-sensitive moxibustion first group and conventional moxibustion group, each of30cases, and then select bilateral ST35(Dubi) acupoints, bilateral GB34(Yanglingquan) acupoints, bilateral ST36(Zusanli) acupoints and EX-LE2(Heding) acupoints for treatment. The heat-sensitive moxibustion first group were cyclotron, pecking, round-trip, mild moxibustion, conventional moxibustion group alignment should be routine acupoint location distance skin2-3cm mild moxibustion. The use of internationally recognized and widely used Lysholm knee joint function score for efficacy evaluation index. Comparison of the two groups before and after treatment of joint pain, morning stiffness, joint swelling, walking ability score.2. Choice of left KOA in30cases for rfMRI study, in the heat-sensitive moxibustion respectively before and after resting state fMRI scanning, the ratio of the amplitude of fractional amplitude of low frequency fluctions (fALFF) and regional homogeneity (ReHo) analysis method for observing the brain in the resting state functional changes.Results1. The heat-sensitive moxibustion first group joint pain score was (1.12±0.62),(0.62±0.61) score of morning stiffness, joint swelling score of (0.89±0.76), walking ability score is (1.79±1.56). The conventional moxibustion group joint pain score was (1.97±0.66),(0.69±0.61) score of morning stiffness, joint swelling score of (0.93±0.74), walking ability score (2.75±1.61). The heat-sensitive group of the observed indicators compared with the conventional moxibustion group differences were significant all P<0.01), especially in joint pain relief and walking ability was remarkable (all P<0.01). The heat-sensitive moxibustion first group markedly effective rate was90%,73.33%in conventional moxibustion group, the heat-sensitive moxibustion first group was better than conventional group (P<0.01).2. After the heat-sensitive moxibustion therapy, patients with right brain, the outer core, left cerebellum, left brain, white matter areas of fALFF value was significantly increased before moxibustion, precentral gyrus, frontal lobe, occipital lobe fALFF levels before moxibustion significantly reduced (P<0.05, K>85). In patients with thalamic, outer core, parietal brain areas is significantly higher ReHo value before moxibustion, right brain, the left brain, frontal ReHo values before moxibustion significantly reduced (P<0.05, K>85).Conclusion1. The heat-sensitive moxibustion therapy is superior to the conventional overall efficacy of moxibustion therapy, it can better improve the symptoms and signs of patients with KOA. There is worthy of promotion and use.2. After heat-sensitive moxibustion effect of multiple brain regions of significant change is basically consistent with the somatic pain temperature conduction path, while the somatosensory system activation may be the meridian phenomenon of propagated sensation objective basis. Heat-Sensitive Moxibustion modulating brain function not by a single brain area but by multiple brain regions comprising the network to achieve.