| Background:Rheumatoid arthritis(RA)is a chronic autoimmune disease characterized by joint synovitis,mainly involving the small joints of hands and feet.The pathogenesis is complex and has not yet been fully elucidated.Its pathology is characterized by synovial hyperplasia of persistent and the destruction of the cartilage and bone.Moxibustion has been used to treat RA to suppress arthritis,for relief pain and improve a person's ability to perform activities associated with daily living.By statistical analysis the best time of moxibustion treatment can be found in every disease,that is the best quantity of moxibustion.Therefore,our trial aims is to evaluate the effect of different moxibustion durations on RA and find the appropriate quantity of moxibustion treatment the CIA(collagen-induced arthritis)rats.Through the standardization of moxibustion research,simplify the clinical procedures,reduce the error and improve the curative effect of moxibustion treatment of rheumatoid arthritis.Objective:The aim of this study was to detect the influence of different moxibustion durations in CIA rats,find the best amount of moxibustion for treatment of RA and elucidate the effect of moxibustion dose-effect relationship.Promote the development of the standardization of the moxibustion treatment and the continuous improvement of the moxibustion operation.Methods:(1)The 40 rats were randomly selected 8 rats as normal group.The other 32 rats was created by CIA animal model.After the success of the modeling,then the 32 rats were randomly 'divided into a model group,moxibustion 20min group,moxibustion 40min group and moxibustion 60min group with 8 rats in each group.In moxibustion 20min group,moxibustion 40min group and moxibustion 60min group,moxibustion treatment was given at Shenshu(BL 23)and Zusanli(ST 36)for 20min?40min and 60min respectively.Intervention for 6 days,rest one day,7 days a course of treatment,a total of three courses.(2)Baseline comparison:Compare the weight of rats and the toe volume in each group.(3)Comparison of rats before modeling,three weeks moxibustion in general.(4)Compared the changes of body weight of rats in each group before and after moxibustion for three weeks.(5)Compared the changes of toe volume of rats in each group before and after moxibustion for 3 weeks.(6)Compared the changes of AI score of rats in each group before and after moxibustion for 3 weeks,blank control group not this points.(7)Three weeks after moxibustion,heart blood,centrifugal separation,enzyme-linked immunosorbent assay(ELISA),compare serum IL-1? and TNF-? levels in rats.(8)Three weeks after moxibustion,collected anatomical pathology of each group of ankle joint pathologic histology was evaluated.(9)Using the one-way ANOVA to obtain the optimal duration of moxibustion treatment.Results:(1)Before modeling,there was no significant difference in the weight and volume toe of the rats in each group,P>0.05.(2)Before modeling the rats generally in good condition;after modeling,model group and moxibustion group rats were all joint swelling.Moxibustion for three weeks,the symptoms of the model group continued to increase,joint swelling significantly,limp and activity decreased;Moxibustion 20 minutes group and moxibustion 60 minutes group rats activity general,joint swelling has improved,but the joint swelling is still obvious,slightly limp;Moxibustion 40 minutes group rats joint swelling significantly improve,swollen joints reduce and the activity is better;the control control group showed normal,no joint swelling.(3)Weight comparison:Before moxibustion,the body weight of rats in each group was not statistically significant,P>0.05,not comparable.Moxibustion for 3 weeks,the model group,moxibustion 20 minutes group,moxibustion 40 minutes group and moxibustion 60 minutes group were compared with the control group weight.The body weight of rats increased significantly in the control group and the body weight of model group and all of the moxibustion groups was significantly lower than that of the control group(P<0.05),the difference was statistically significant.Compared with the model group,the body weight of the rats in the model group was lower than that in the moxibustion groups(P<0.05),the difference was statistically significant.The body weight of each Moxibustion group,P>0.05,no statistically significant.(4)Comparison of toe volume:Before moxibustion treatment,the toe volume of model group and moxibustion groups were significantly increased than those in the control group(P<0.05),the difference was statistically significant;moxibustion groups compared with model group of toe volume,P>0.05,there was no statistically significant difference.After moxibustion 3 weeks,compared with the model group,moxibustion groups significantly decreased the toe volume(P<0.01),moxibustion 40 minutes groups almost reaching the level of the control group.There is no significant difference between moxibustion 40 minutes group and the control group in the statistically(P>0.05).There is a significant difference in the toe vollume between moxibustion 40 minutes group with moxibustion 20 minutes group and moxibustion 60 minutes group,however moxibustion 20 minutes and moxibustion 60 minutes no statistically significant difference(P>0.05).This study suggesting that moxibustion 40 minutes gruop is superior to moxibustion 20minutes group and moxibustion 60 minutes group in the decrease of the toe volume(P<0.01).(5)Compared the changes of AI score:Before moxibustion treatment,the scores of AI scores in the model group and the three moxibustion groups were all higher than 4 points,that is,the model was successful,there was no statistically significant difference between the four groups in terms of the arthritis score.After three courses moxibustion treatment,moxibustion groups significantly decreased the AI scores of the CIA rats(P<0.01).There was a significant difference in the arthritis scores between moxibustion 40 minutes group and moxibustion 20 minutes group?moxibustion 60 minutes group(P<0.01),however moxibustion 20 minutes group and moxibustion 60 minutes group no statistically significant difference,suggesting that moxibustion 40min is superior to moxibustion 20min and moxibustion 60min in the lighten arthritis scores.(6)Inflammatory factors IL-1? and TNF-? levels:Moxibustion for three weeks,compared with the control group,serum IL-1? and TNF-? levels significantly increased in the model group(P<0.01).Compared with the model group,moxibustion could significantly decrease serum IL-1? and TNF-? levels(P<0.05).There were also significant differences between moxibustion 20min.moxibustion 40min and moxibustion 60min(P<0.05).The effect of moxibustion 40min was superior to that of moxibustion 20min and moxibustion 60min in mitigate serum IL-1? and TNF-? levels.There is no statistically significant difference in moxibustion 20min and moxibustion 60min in change of serum IL-1? and TNF-? levels.So the effect of moxibustion 40 minutes group is better than that of moxibustion 20 minutes group and moxibustion 60 minutes group.Moxibustion 40 minutes can be effective in reducing serum IL-1? and TNF-? level.(7)Pathological HE staining:The synovial inflammation In the control group showed that the articular surface was covered with transparent cartilage,the joint capsule was smooth and the synovial cells of the joint were smooth and the structure was clear.No synovial swelling,necrosis and inflammatory cell infiltration were observed.In the model group,synovial inflammation in the model group showed severe congestive edema,severe synovial swelling,severe inflammatory cell infiltration and moderate tissue necrosis.Moxibustion 20 minutes group synovial inflammation pathology visible mild synovial swelling,mild congestion and edema,synovial cell mild hyperplasia and visible a small amount of inflammatory cell infiltration.Moxibustion 40 minutes group synovial inflammation pathology visible joint synovial cells continuous formation,the structure level is clear,no tissue necrosis,inflammatory cell infiltration,joint synovium visible mild congestion and edema.Moxibustion 60 minutes group synovial inflammation pathology visible synovial mild hyperemia edema,synovial cells mild hyperplasia,mild synovial swelling.Moxibustion 20 minutes group,moxibustion 40 minutes group and moxibustion 60 minutes group of synovial inflammation pathological synovial inflammation pathological improvement than the model group and moxibustion 40 minutes group synovial inflammation pathology improved significantly.Conclusions:(1)After three weeks of moxibustion,moxibustion groups compared with the model group,the general situation of rats were improved,the toe volume decreased and the serum IL-1? level and TNF-? level were lower than those in model group,synovial thickening and inflammation slightly lighter.It is proved that moxibustion has effect in improving joint swelling and regulating immunity.(2)The effect of moxibustion for the treatment of CIA rats 40min is better than that of moxibustion 20min and moxibustion 60min.(3)Different duration of moxibustion treatment of CIA rats have a significant effect,but the effect of moxibustion 40 minutes is the most significant effect.The results of this experiment provide important reference value for clinical standardization of moxibustion treatment of RA duration. |
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