Investigating The Effect Of Moxibustion On Serum Levels Of LTB4/MMP-9 In Patients With Rheumatoid Arthritis(RA)

Objective:To observe the effect of moxibustion on serum levels of leukotriene B4(LTB4),interleukin-17(IL-17),tumor necrosis factor-α(TNF-α)and matrix metalloproteinase-9(MMP-9)in patients with rheumatoid arthritis(RA),to find the target of moxibustion in treating RA and to explore the mechanism of moxibustion in treating RA.Methods:74 RA participants are from the Department of Rheumatic Immunology,Sichuan Hospital of traditional Chinese Medicine,they were randomly divided into treatment group(n = 37)or control group(n = 37)by using the random number table method.The control group was treated with conventional western medicine,the specific drugs and dosage were: methotrexate tablet(2.5mg,3-6 piece/every time,qw)combined with folic acid tablet(5mg,2 piece/every time,qw)or leflunomide(10mg,1 piece/every time,qd).The treatment group was treated with moxibustion and conventional western medicine,selecting ST36,Ashi and BL23 acupoints for moxibustion,three times a week for 5 weeks.The clinical symptoms,clinical routine test indexes and the contents of LTB4,IL-17,TNF-α and MMP-9 in serum of the two groups of RA participants were compared before and after treatment.SPSS26.0 statistical software was used to analyze the data of the two groups of participants.Results:1.Baseline results:The data related to the disease,clinical symptoms,clinical routine test indexes,and the contents of LTB4,IL-17,TNF-α and MMP-9 in the serum of both RA participants was consistent and comparable(P > 0.05).2.Effect of moxibustion on clinical symptoms and clinical routine test indexes of RA participants:(1)Intra-group comparison: After treatment,the improvement of the clinical symptoms of RA participants in both groups was statistically significant(P<0.05),the decrease of RF,CRP,and ESR in the treatment group was statistically significant(P<0.01);the decrease of RF in the control group was statistically significant(P<0.05),but the decrease of CRP and ESR was not statistically significant(P>0.05).(2)Comparison between groups: After treatment,there was a statistically significant difference in the improvement of the clinical symptoms between the two groups(P<0.05);however,there was no statistically significant difference in the comparison of clinical routine test indexes between the groups(P>0.05).3.Effect of moxibustion on the contents of LTB4,IL-17,TNF-α and MMP-9 in serum of RA participants:(1)Intra-group comparison: After treatment,the contents of LTB4,IL-17,TNF-αand MMP-9 in serum of RA participants in treatment group were decreased(P < 0.05);Serum levels of LTB4,IL-17,TNF-α and MMP-9 in RA participants in the control group were not significantly decreased after treatment(P > 0.05).(2)Comparison between groups: After treatment,the contents of LTB4,IL-17 and MMP-9 in the serum of RA participants in the treatment group decreased more significantly than those in the control group,but there was no significant difference in the content of TNF-α in serum between the treatment group and the control group(P >0.05).4.Correlation analysis of LTB4,IL-17,TNF-α and MMP-9:There was a positive correlation between serum levels of LTB4,IL-17,TNF-α and MMP-9 before and after treatment in the treatment group(P < 0.05,r >1).5.Correlation analysis between improvement of clinical symptoms and improvement of LTB4,IL-17,TNF-α and MMP-9:The improvement of VAS score,morning stiffness,number of joint tenderness,number of joint swelling and DAS28 score in treatment group after treatment was correlated with the improvement of serum LTB4,IL-17,TNF-α and MMP-9,and the correlation was positive(Lift >1).Conclusion:1.Moxibustion combined with conventional western medicine can significantly improve the VAS score,joints tenderness and swelling,morning stiffness and other symptoms,and reduce the disease activity of RA participants.2.The improvement of moxibustion on the clinical symptoms of RA participants may be related to the fact that moxibustion could enhance the function of conventional western medicine on the contents of LTB4,IL-17 and MMP-9 in serum of RA participants.3.The potential mechanism of moxibustion on the bone protection of RA participants may be related to the fact that moxibustion regulating LTB4,inhibiting the production of IL-17 inflammatory factors,reducing the production of MMP-9,and thus weakens the ability of MMP-9 to degrade bone matrix.