Impact On Observation Moxibustion Treatment For Synovium Lesions Of Patients With Rheumatoid Arthritis Based On High Frequency Ultrasound

Objective: we observe the effects of moxibustion for synovitis/synovial lesions of patients with rheumatoid arthritis(RA)by high frequency ultrasound(US).and synovial lesions?serum vascular endothelial growth factor(VEGF)and interleukin-1?(IL-1?)of RA were correlation analyzed,in order to explore the mechanism action of moxibustion in RA patients clinical efficacy.Methods:This study participants included 40 patients with RA,which were randomly divided into treatment group and control group,20 cases in each group.The control group with methotrexate or leflunomide.the treatment group Attach moxibustion "zusanli","shen shu","gao huang shu","fei shu","ashixue",2 times a week,four weeks for a period of treatment,a total of three courses.Before and after treatment of RA patients,double hand joints with clinical symptoms were observed by high frequency ultrasound,We record the joints and ratings of synovial thickening,joint effusion,blood flow signal and Bone erosion.The Clinical symptoms,laboratory parameters were evaluated,and serum VEGF ?IL-1?content by enzyme-linked immunosorbent assay(ELISA)were measured in two groups before and after treatment.And Within the groups and Comparison between group and group were performed,the examination results of High frequency ultrasound?VEGF and IL-1?of RA were correlation analyzed,in order to explore the mechanism action of moxibustion in RA patients.Results: 1?The clinical efficacy evaluation results of two kinds of treatment of RA(1)Baseline results,the two groups have no significant different,comparable.(2)The influence of two kinds of treatment for Clinical symptoms,laboratory indexes in patients with RA: 1)the comparison within groups:before and after the treatment,moxibustion group can improve morning stiffness?VAS score,?DAS28 score?tenderness?swelling index ? symptom integral and ESR ? CRP ? RF.Control group can improve VAS score?DAS28 score?tenderness?swelling index?symptom integral and CRP?RF.2)the comparison between groups:The improvement of VAS score?DAS28 score?tenderness?swelling index?symptom integral and laboratory indexes in moxibustion group were better than the control group.2?The influence of two kinds of treatment for synovium lesions in patients with RA(1)comparison within groups :before and after the treatment,moxibustion group and the control group can reduce synovial thickness,joint effusion,blood flow signal and bony destruction in patients with RA.(2)the comparison between groups :The improvement of synovial thickness,joint effusion,and the improvement of blood flow signal Moxibustion group was better than that of control group.3?The influence of two kinds of treatment for content of serum VEGF,IL-1? in patients with RA(1)comparison within groups:before and after the treatment,moxibustion group and the control group can reduce the content of serum VEGF?IL-1?in patients with RA.(2)the comparison between groups:the content of serum VEGF,IL-1?in moxibustion group were improved more significantly than control group.4?The correlation analysis of US testing the result of the synovium lesions and content of serum VEGF,IL-1?(1)the improvement score of synovial thickness,joint effusion and blood flow signal and content of VEGF?IL-1?moxibustion group and control group have positive correlation,but the correlation of moxibustion group was better than control group,the improvement score of bone erosion and content of serum VEGF?IL-1?in two groups has no correlation.Conclusion: 1?Moxibustion can enhance the conventional western medicine for the influence of synovialthickness,blood flow signals,joint effusion,and the content of VEGF?IL-1 ? in patients with RA.That moxibustion treatment mechanism effectively for RA may be related to affect the thickness of the synovial membrane,blood flow signals,joint effusion.2?Improvement of synovial thickening,blood flow signal and joint effusion score in patients with RA has significant correlation with the content of serum VEGF,IL-1?,and As synovium lesions in RA patients with the content of serum VEGF?IL-1 ? change and change,to some extent,explain synovium lesions are associated with inflammatory pathways of serum VEGF?IL-1?,which may be one of the important mechanisms of moxibustion treatment effectively for RA.3?High frequency ultrasound detection in patients with RA synovial pathological changes,to a certain extent,can be used as the the important indicators of RA synovial thickening and pannus formation.