| Background:Rheumatoid arthritis is characterised by persistent synovitis,systemic inflammation,and autoantibodies(particularly to rheumatoid factor and citrullinated peptide).Rheumatoid arthritis causes joint damage,disability,decreased quality of life,and cardiovascular and other comorbidities.Disease-modifying antirheumatic drugs(DMARDs),the key therapeutic agents,reduce synovitis and systemic inflammation and improve function.Biological agents are used when arthritis is uncontrolled or toxic effects arise with DMARDs.Infections and high costs restrict prescription of biological agents.Moxibustion is an important method of treating the disease by traditional Chinese medicine.It is through the function of warming and warming and the action of the leaves,and after the meridian regulation,it plays the role of yin and yang,the purpose of treatment of rheumatoid arthritis.Moxibustion can warm through the meridians,blood circulation,not only on the inflammatory response to local anti-inflammatory regulation of the role,but also through the regulation of nerve-endocrine network system and the regulation of the entire body.However,most of the moxibustion operation by virtue of experience,clinical lack of standards,moxibustion distance to become an important factor affecting the efficacy of moxibustion Objective:By comparing the effect of different moxibustion distance on the curative effect of rheumatoid arthritis,the optimal distance of moxibustion treatment of RA was discussed in order to get the best treatment distance of moxibustion For the clinical operation of moxibustion to provide the basis for promoting the standardization of Chinese medicine development,and promote its promotion and application in clinical.Methods:(1)Eight randomly selected from 40 male Sprague-Dawley rats were as controls,and the remaining 32 used for modeling.The collagen type ?-induced ankle arthritis models were established,and then given the moxibustion at Shenshu(BL23),and Zusanli(ST36)at 1,2 and 3 cm of distance,respectively,once daily,each point for 10 minutes,each course of 6 days for three courses,and 1 day of course interval.(2)Baseline comparison:body weight and toe volume of rats in each group before modeling.(3)The general situation of the rats before modeling,before the intervention and after 3 weeks of moxibustion were observed,including the color of hair,the feeding situation and the activities of limbs.(4)The changes of body weight of rats in each group before and after treatment for 3 weeks were compared.(5)The changes of the toes volume of moxibustion at 3 weeks were compared before intervention.(6)The levels of arthritis index(AI)were measured before and after moxibustion at 3 weeks.The normal control group had no score.(7)After 3 weeks of moxibustion,the levels of serum tumor necrosis factor(TNF-?)and interleukin 1?(IL-1?)were measured by enzyme-linked immune sorbent assay(ELISA)Level for comparison.(8)After 3 weeks of moxibustion,the histopathological observation of the anatomical tissues of the rats in each group was collected.Results:(1)Baseline comparison:There was no significant difference in body mass and toe volume between the two groups(P>0.05).(2)Before modeling,rats in each group were generally in good condition.After modeling,the model group,moxibustion 1,2,3cm group rats were joint swelling,some rats were injected with focal skin ulcers.After 3 weeks of moxibustion,the symptoms of the rats in the model group continued to increase,the joint swelling was obvious,and the activity was limited.The activity of the moxibustion group was improved,but the joint swelling was still improved;the control group was normal.Normal control group showed normal.(3)Comparison of body weight:Before treatment,the body weight of each group,the difference was not statistically significant,P>0.05,comparable.After moxibustion for 3 weeks,moxibustion group 1,2,3cm group and model group were compared with the normal control group,the body weight of the normal control group increased significantly,moxibustion group,the model group was significantly lower than the normal control Group,P<0.05,the difference was statistically significant.There was significant difference between the model group and the control group and the moxibustion group(2 cm)(P<0.01).There was significant difference between the moxibustion group and the model group(P<0.05).(4)Before and after the intervention,moxibustion 1,2,3 cm group,model group conpared with the normal control group,the toe volume increased significantly,P<0.05,the difference was statistically significant;moxibustion 1,2,3 cm group and the model group toes Volume,P>0.05,the difference was not statistically significant,comparable.Moxibustion 3 weeks later,moxibustion 1,2,3 cm group,the model group compared with the normal control group,the toe volume was significantly greater than the normal control group,P<0.05,the difference was statistically significant.Compared with the model of the moxibustion group,the volume of the toes in the moxibustion group decreased,while the volume of the toes in the model group continued to increase,and the difference was statistically significant(P<0.05).Moxibustion 1,2 cm group was superior to moxibustion 3 cm group(P<0.05)in reducing the toe volume.(5)Before the intervention,the scores of AI scores in the model group and moxibustion group were all higher than 4 points,and the model was successful.The difference was not statistically significant(P>0.05).Moxibustion three weeks later,moxibustion group compared with the model group,moxibustion group score was less than the model group,P<0.05 the difference was statistically significant.There was no significant difference in the scores of arthritis between the moxibustion groups(P>0.05).(6)IL-1? level:moxibustion 3 weeks later,mxibustion 1,2,3 cm group compared with the model group,IL-1? levels were significantly decreased,P<0.05,the difference was statistically significant.The level of interleukin-1? in moxibustion group 1,2 cm was significantly lower than that in moxibustion group 3 cm(P<0.01).(7)TNF-a level:moxibustion 3 weeks later,moxibustion 1,2,3 cm group compared with the model group,TNF-? levels were significantly decreased,P<0.05,the difference was statistically significant.The level of TNF-a in moxibustion group 1,2 cm was significantly lower than that in moxibustion group 3 cm(P<0.01).(8)Pathological HE staining:Normal control group of rats with pathological HE staining normal In the model group,the articular cavity was narrowed,and the inflammatory cells were seen in the joint cavity.The inflammatory cells were infiltrated;the pannus was formed.The synovial cells were cluttered,the synovial swelling and hyperplasia were obvious.Moxibustion group showed moderate inflammatory cell infiltration;synovial thinning,synovial cells slightly hyperplasia,moderate swelling;compared with the model group,less pannus,indicating a signifcant improvement.Conclusions(1)After 3 weeks of moxibustion treatment,moxibustion 1,2,3 cm group compared with the model group,the general situation improved,relatively soft toe swelling,pathological staining showed thinning of the synovium,inflammatory cells mild infiltration.Serum EL-1? level and TNF-a level were lower than those in model group.Moxibustion in the improvement of joint function,regulate immunity has a certain role,but the rat toe swelling is difficult to improve in the short term.(2)Moxibustion treatment of CIA rats,moxibustion distance of 1?2cm,moxibustion treatment better.(3)From the aspects of tolerance,acceptance,efficacy and other aspects of comprehensive consideration,moxibustion 2 cm group for moxibustion treatment of rheumatoid arthritis rats the best distance.The results of this study provide an important reference value for clinical standardized moxibustion treatment of RA. |
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