[Standardizing the manipulation procedure of acupuncture-moxibustion, reinforcing the training of' clinical skill: learning experience of Acupuncture-moxibustion Clinical Skills Training: Chapter of Commonly Used Needling and Moxibustion Techniques]

The book Acupuncture-moxibustion Clinical Skills Training is one of "Twelfth Five-Year Plan" in novative teaching materials, which is published by People's Medical Publishing House. Through learning the first half of the book commonly used needling and moxibustion techniques, it is realized that the selection of book content is reasonable and much attention is paid to needling and moxibustion techniques; the chapter arrangement is well-organized, and the form is novel, which is concise and intuitive; for every technique, great attention is paid to standardize the manipulation procedure and clarify the technique key, simultaneously the safety of acupuncture and moxibustion is also emphasized. The characteristics of the book, including innovativeness, practicability, are highlighted, and it greatly helps to improve students' clinical skills and examination ability.

[Development and application of new temperature control moxibustion device]

To develop a new temperature control moxibustion device so as to improve the clinical therapeutic effect of moxibustion. According to the thermal effect of moxibustion, with the designs such as the modern electronic equipment (temperature control system) adopted and in combination of smoke filtration device and oxygen mask device, a new temperature control moxibustion device was developed. The new temperature control moxibustion device may achieve the automatic regulation of temperature and distance and avoid the pollution and irritation of smoke and flavor, etc. As a result, the traditional moxibustion therapy can better play its efficacy and display its safety and convenience in practice.

[Professor ZHENG Kuishan's experience in the clinical treatment of bi syndrome with acupuncture and moxibustion]

Professor ZHENG Kuishan has been engaged in the education and clinical practice of acupuncture and moxibustion for over 60 years. Professor ZHENG is strict in scholarly research and exquisite in medical techniques and he is good at treatment of bi syndrome induced by invasion of wind, cold and damp with warming and, promoting therapy. He emphasizes on syndrome differentiation and acupoint combination and selects the accurate manipulations. Not only are the symptoms relieved apparently, but also the body state is improved. As a result, the primary and secondary are treated simultaneously. In the paper, professor ZHENG's experience is introduced in the treatment of bi syndrome in the aspects of theory, method, formula, acupoint and technique. And his clinical therapeutic approaches have been deeply analyzed.

[Current situation and problems in school study of acupuncture and moxibustion]

By taking the evaluations made by scholars such as Wang Yongyan, et al. on status of TCM academic research as the introduction, various influencing factors in acupuncture school development are separately discussed, and the overall trend and existential state are described in modern acupuncture academic area. By displaying the opinions of acupuncture schools in recent years, the relationship among specific therapy, school and schools is analyzed to explain the similarities and differences of school and schools as well as their respective characteristics. It is proposed that the obstacles that lay before acupuncture school researchers are not the rights and wrongs of school and schools, but the evaluation criterion and development patterns that is appropriate for acupuncture research and development.

[Zhu Lian's characteristics and experiences in clinical practice of acupuncture and moxibustion]

This paper aims at discussing the clinical characteristics and experiences of ZHU Lian, the renowned contemporary acupuncture master from the following three aspects: "characteristics of clinical manipulations and techniques", "thoughts on diagnosis and treatment" and "examples of clinical cases". The study has shown that ZHU Lian invented the slow insertion technique by rotating needle and the embedding needle technique, improved moxibustion technique with moxa roll and proposed the three keys on the treatment with acupuncture and moxibustion, as well as discovered new acupoints for treatment. The pioneering and distinguished achievements she con tributed play the great demonstrating and driving role in the development of clinical study and practice of acupuncture and moxibustion.

P2X₇ receptor of rat dorsal root ganglia is involved in the effect of moxibustion on visceral hyperalgesia

Irritable bowel syndrome (IBS) and inflammatory bowel disease often display visceral hypersensitivity. Visceral nociceptors after inflammatory stimulation generate afferent nerve impulses through dorsal root ganglia (DRG) transmitting to the central nervous system. ATP and its activated-purinergic 2X7 (P2X7) receptor play an important role in the transmission of nociceptive signal. Purinergic signaling is involved in the sensory transmission of visceral pain. Moxibustion is a therapy applying ignited mugwort directly or indirectly at acupuncture points or other specific parts of the body to treat diseases. Heat-sensitive acupoints are the corresponding points extremely sensitive to moxa heat in disease conditions. In this study, we aimed to investigate the relationship between the analgesic effect of moxibustion on a heat-sensitive acupoint "Dachangshu" and the expression levels of P2X7 receptor in rat DRG after chronic inflammatory stimulation of colorectal distension. Heat-sensitive moxibustion at Dachangshu acupoint inhibited the nociceptive signal transmission by decreasing the upregulated expression levels of P2X7 mRNA and protein in DRG induced by visceral pain, and reversed the abnormal expression of glial fibrillary acidic protein (GFAP, a marker of satellite glial cells) in DRG. Consequently, abdominal withdrawal reflex (AWR) score in a visceral pain model was reduced, and the pain threshold was elevated. Therefore, heat-sensitive moxibustion at Dachangshu acupoint can produce a therapeutic effect on IBS via inhibiting the nociceptive transmission mediated by upregulated P2X7 receptor.

[Clinical effect of different schemes of mild moxibustion for treatment of knee osteoarthritis]

OBJECTIVE

To observe the therapeutic effect of different schemes of mild moxibustion for treatment of (yang-deficiency induced cold-accumulation type)knee osteoarthritis (KOA).

METHODS

Fifty-nine KOA patients were chosen and randomly divided into control group (n =30) and test group (n =29). Patients of the control group were treated by mild moxi- bustion of Neixiyan (EX-HE4) and Waixiyan (ST 35) for 30 min, once daily for 14 days (two courses), and those of the test group were treated by mild moxibustion of EX-HE 4 and ST 35 for 30 mini once daily for 7 days (the same to control group), followed by moxibustion of Yaoyangguan (GV 3) and Mingmen (GV 4) once daily for next 7 days more. In addition, patients of the two groups were also treated by routine acupuncture stimulation of EX-HE 4, ST 35, Yanglingquan (GB 34), Kunlun (BL 60), etc. The interval between two therapeutic courses was one day. The Lysholm Knee Score Scale (LKSS) was used to evaluate the therapeutic effect. Visual analogue scale (VAS) was employed to assess the patient's knee-joint pain severity (arthralgia), and scores of morning stiffness, arthrocele, and walking restraint degree of the knee-joint were also evaluated before and after the treatment.

RESULTS

After the treatment, the scores of VAS, morning stiffness, arthrocele and walking restraint degree of the knee-joint of both groups were significantly decreased (P<0. 05), and the scores of the test group were obviously lower than those of the con- trol group (P<0. 05). The effective rate of the test group was 89.66% (26/29)which was obviously higher than that (70.00%, 21/30) of the control group (P<0. 05).

CONCLUSION

Mild moxibustion of Neixiyan (EX-HE 4) and Waixiyan (ST 35, local acu- points), and Yaoyangguan (GV 3) and Mingmen (GV 4) has a better therapeutic effect for KOA patients than moxibustion of local acupoints only.

[Effect of medicinal-cake-separated moxibustion on functional activity of back-leg and plasma substance P level in patients with lumbar disc herniation]

OBJECTIVE

To observe the effect of medicinal-cake-separated moxibustion combined with acupuncture on back-leg activities and plasma substance P (SP) levels in patients with lumbar disc herniation, so as to reveal its mechanism underlying pain relief.

METHODS

A total of 114 patients with lumbar disc herniation were randomly divided into control group (n=56) and treatment group (n=58) according to a random digits table. Patients of the control group were treated by manual acupuncture stimulation of main acupoints Jiaji (EX-B 2), Huantiao (GB 30, affected side), Chengshan (BL 57, affected side), Kunlun (BL 60, affected side), and supplemented acupoints Yanglingquan (GB 34), Weizhong (BL 40) and Zusanli (ST 36) in combination with wheat-flour-cake separated moxibustion at the main acupoints, and patients of the treatment group were treated by medicinal-cake [Chuanwu (Radix Aconiti), Caowu (Radix Aconiti Kusnezoffii), Ruxiang (Olibanum), etc. ]-separated moxibustion in combination with manual acupuncture stimulation of the same acupoints mentioned above. Acupuncture treatment was conducted for 30 min, followed by moxibustion for 15 min. The treatment was given once daily for 10 days. The patients' back-leg functional activity ability was assessed using straight-leg raising test, and the pain state assessed using visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) scores, respectively. The therapeutic effect was evaluated by using "Crite- ria for Diagnosis and Outcome Evaluation of Clinical Disorders or Syndromes of Chinese Medicine" issued in 1994 and plasma SP content was detected by radioimmunoassay.

RESULTS

After the therapy, the back-leg activity score and JOA score of both groups were significantly higher than those of pre-treatment in the same one group (P<0. 05, P<0. 01), and those of the treatment group were significantly higher than those of the control group (P<0.05). The VAS score of the treatment group was re- markably lower than that of the control group (P<0. 01). After the treatment, the plasma SP content was markedly lower in the treatment group than in the control group (.P<0O. 05 ) .

CONCLUSION

Medicinal-cake-separated moxibustion therapy can ame- liorate pain severity and functional activity of the back-leg pain patients with lumbar disc hernia, which may be related to its effect in reducing blood SP level.

[Research progress on Huang Fu-mi's A-B classic of acupuncture and moxibustion]

In order to understand the research status of HUANG Fu-mi's A-B Classic of Acupuncture and Moxibustion, 83 pieces of literature that have been publically published since 1978 were analyzed. A summary was performed according to 7 aspects including version origin, emendation, arrangement and summary, theory discussion, clinical research, value evaluation, the rest questions, etc. It is believed that deep research work has been done on explanations, emendation and translation regarding A-B Classic of Acupuncture and Moxibustion. However, the exploration work on the theory and application is far from enough. Therefore, beginning from historical and cultural background, we should analyze the humanistic spirit of HUANG Fu-mi combined with A-B Classic of Acupuncture and Moxibustion to perform a deep exploration, so we could have a thorough and comprehensive research on HUANG Fu-mi's academic thoughts.

[Development idea and practice of Qiu Mao-liang's acupuncture diagnosis and treatment]

Professor Qiu Mao-liang is considered as one of the representatives in the renaissance and development of acupuncture and moxibustion in the 20th century, whose academic characteristics could be summarized as "sticking to tradition and absorbing new knowledge". The practice ideas, methods and influence factors that were presented in acupuncture clinical practice are analyzed in this paper, from which development tendency and practice pattern of modern acupuncture clinical practice are discussed.

[Diseases treated by moxibustion and fire needling in clinical practice based on data mining: a comparison study]

OBJECTIVE

To discuss the specificity of diseases treated by moxibustion and fire needling in clinical practice, so as to provide references for clinical treatment.

METHODS

With data mining of modern computer technique, journal and literature databases regarding moxibustion and fire needling were established, respectively. Literature regarding moxibustion and fire needling for the past 60 years has been collected, screened, included, reviewed and abstracted. The utility rate of moxibustion and fire needling in each department was calculated, frequency of diseases in clinical practice was summarized, and diseases which had differences in clinical practice in each department were screened; also the advantages of disease categories and clinical practice between two kinds of therapies in each department were compared.

RESULTS

(1) The utility rate of moxibustion was highest in department of internal medicine and surgery, which were 43.6% and 28.1%, respectively; the utility rate of fire needling was highest in surgery and dermatological department, which were 53.7% and 23.8%, respectively. (2) According to the comparison and analysis on diseases treated by two therapies in clinic, among 26 kinds of gynecology diseases that were treated by moxibustion, 20 kinds were not involved with fire needling; among 22 kinds of pediatrics diseases that were treated by moxibustion, 20 kinds were not involved with fire needling. It was certain that the difference of the two therapies in clinical application was more significant in gynecology and pediatrics than that in the rest four departments. (3) Among the diseases which had differences in clinical practice in each department, the ones involved with moxibustion alone were insomnia, distention and fullness, consumptive fatigue in the department of internal medicine, blood-vessel Bi, stiff neck and hernia in surgery department, urticarial, skin Bi and skin cancer in dermatological department, malposition, infertility and amenorrhea in gynecology department, diarrhea, indigestion and stomachache in pediatrics department, blepharoptosis, blurred vision and dryness syndrome in ENT department; the ones involved with fire needling alone were numbness, coldness syndrome and acute renal colic in the department of internal medicine, lipoma, soft tissue injury and papilloma in surgery department, bromhidrosis, freckle and erysipelas in dermatological department, uterine fibroid in gynecology department, umbilical polyp in pediatrics department, auricle pseudocyst, starred nebula and phlegmatic mass in ENT department.

CONCLUSION

Moxibustion is frequently applied in department of internal medicine and surgery, while fire needling is frequently used in surgery and dermatological department; the application of moxibustion is broader than that of fire needling in gynecology and pediatrics department. Among the diseases which have differences in clinical practice in each department, moxibustion is commonly seen for clinical symptoms featured with deficiency syndrome, while fire needling is commonly applied for the diseases that have obvious local symptoms.

Efficacy and safety of ginger-salt-indirect moxibustion for urge urinary incontinence after stroke: protocol for a pilot multicentre randomised controlled trial

INTRODUCTION

Ginger-salt-indirect moxibustion is widely applied to treat urge urinary incontinence after stroke, which is a common complication in stroke survivors. Moxa cone moxibustion and moxa box moxibustion are the main techniques of ginger-salt-indirect moxibustion. Our previous study had shown that ginger-salt-indirect moxibustion using moxa cones was feasible and effective for urination disorders post-stroke. This pilot study aims to assess the feasibility of conducting research to evaluate the efficacy and safety of ginger-salt-indirect moxibustion for patients with post-stroke urge urinary incontinence.

METHODS AND ANALYSIS

This is a multicentre, prospective, single-blinded, pilot randomised controlled trial. 120 eligible patients will be randomly allocated to three groups. Treatment group A (n=40) will receive moxa cone moxibustion and routine care; treatment group B (n=40) will receive moxa box moxibustion and routine care; control group (n=40) will only receive routine care for stroke recovery. The entire moxibustion treatment will consist of a total of 28 sessions during the course of 4 weeks. The primary outcome measure will be the increase in mean volume per void assessed at week 4 from the first moxibustion session (baseline). Secondary outcome measures will include mean frequency of urination per day and quality of life assessments measured by completion of the Incontinence Quality of Life Questionnaire and Barthel Index. All outcome measures will be assessed at baseline and at 4 and 16 weeks from baseline. Adverse events in the three groups will be recorded to assess the safety of moxibustion.

ETHICS AND DISSEMINATION

Research ethics was approved by the Research Ethical Committee of Beijing Hospital of Traditional Chinese Medicine Affiliated to the Capital Medical University (ref: 2013BL-094). Written informed consent will be obtained from all participants. Study results will be published in peer reviewed journals.

TRIAL REGISTRATION NUMBER

ISRCTN 44706974.

[Comparison of different moxibustion techniques in clinical treatment of diseases based on data mining]

OBJECTIVE

To explore the specific efficacy of different moxibustion techniques in treatment of common diseases and clinical indications, and compare the specificity in clinical indications and efficacy among different moxibustion techniques so as to guide clinical practice better.

METHODS

The modern computerization and data mining technology were adopted to set up moxibustion literature database. The relevant literature of moxibustion techniques in recent 60 years were collected, screened, examined, extracted and analyzed statistically so as to explore the advantages of different moxibustion techniques in clinical treatment.

RESULTS

(1) Of 2,516 literature, moxa stick, moxe cone and moxa device were used in the highest frequency in internal medicine department, for 730 times, 278 times and 102 times respectively. The warm needling technique was used in the highest frequency, for 70 times in the surgical department. (2) In the dermatology department, the curative rate with moxa cone was the highest, 75%. In the ear-nose-throat department, the warm needing technique and moxa device achieved the highest curative rate, 49% for both of them. In the internal medicine department and surgical department, the curative rate of warm needling technique was 53% and 58% respectively. In the gynecology department, the curative rate of moxa device was the highest, 59%. In the pediatrics department, the curative rate of moxa cone was the highest, 80%. (3) The numbers of priority disorders, frequency ≥20 times: 24 kinds of disease for moxa stick, five kinds of disease for moxa cone, 2 kinds of disease for warm needling technqiue and one disorder for moxa device. Facial paralysis, diarrhea, lumbar and leg pain and elbow and knee swelling pain were of the highest priority, treated with these 4 moxibustion techniques, with a certain of literature research values. (4) The warm needling technique achieved the better efficacy on elbow and knee swelling pain, lumbar and leg pain and diarrhea compared with the other three techniques and the curative rate was higher. The moxa device tecnique achieved the higher curative rate for facial paralysis compared with the other three techniques.

CONCLUSION

Through the comparison of application frequency, curative rate, clinical application frequency in disorders and the efficacy of priority disorders in the treatment with different moxibustion techniques, it is found that moxa stick, moxa cone and moxa device are simple in manipulation, safe and effective. Hence, they can be extensively used in the treatment of common disorders in every department in clinic. The warm needling technique acts on the body by the co-work of needling and warming stimulation of mugwort. It achieves the particular effect on the disorders with complicated etiologies compared with the other three techniques. It can be chosen in priority for the disorders caused by blockage in meridian and collateral and stagnation of qi and blood.

[Ancient clinical application of herb-participated moxibustion on umbilicus]

In order to further improve the curative effect of the herb-participated moxibustion on umbilicus, we collected a wide range of literature on herb-participated moxibustion on umbilicus and then systematically arranged them to analyze and summarize the technology and operating methods of herb-participated moxibustion on umbilicus. We also briefly discussed issues on application of medicine, locust tree skin and ginger, the method of kneading dough for medical uses, and the appropriate size of moxa cone and its using frequency in order to form clear concepts and standardized operations to provide theories and operational basis for the clinical application of modern herb-participated moxibustion on umbilicus.

[Acupuncture master Xu Yi-nian and his Practical Acupuncture in the Republic of China]

By collecting and studying Practical Acupuncture written by XU Yi-nian, Guangdong acupuncture master in the Republic of China, and using literature methodology, the life story of XU Yi-nian is textually researched and his acupuncture characteristics is analyzed. The results indicate that XU Yi-nian emphasizes on the utility of acupuncture manipulations and acupoint selection, the application of folk experiences in moxibustion and Sha disorders. He pays attention to the co-work of acupuncture and medicine and his work collects the therapeutic experiences of different schools and deserves to be further explored and validated.

[Zhu Lian's contribution to international communication of acupuncture-moxibustion]

ZHU Lian is the founder of international communication of acupuncture-moxibustion after establishment of New China. This article discussed ZHU Lian's great deal of pioneering work and historic contributions from the aspects of acupuncture-moxibustion treatments for foreign people, international training and communication, and the international influence of Xin Zhenjiu Xue. Our research showed that ZHU Lian's early work didn't only enlarge acupuncture's worldwide influence and spreading pace, especially in Soviet Union, India and Korea, but also accumulated precious experiences for each subject of Chinese medicine attending into international medical care and academic communication in the future.

[Exploration on sensation positioning method of heat-sensitive moxibustion: the inheritance and development of ashi method]

From original concept and literature of acupoint, the concept and clinical significance of ashi method is discussed, which clarifies that the essence of ashi method is to locate the acupoints by patients' sensitivity on force. The clinical application of heat-sensitive moxibustion has illustrated that positioning method of this therapy is based on the appearance of heat-sensitive moxibustion sensation. Although both types are based on patients' feeling, positioning method of heat-sensitive moxibustion stands on a new angle and uses a new method to locate acupoint. Therefore, it is believed that the positioning method of heat-sensitive moxibustion is the inheritance and development of ashi method.

[A brief talk on the embodiment of Three-Layer thought in the science of acupuncture and moxibustion]

Three-Layer thought is an important proposition in Chinese traditional philosophy. This thought embodies the Chinese people's cosmology and methodology and exerts a far-reaching influence on various aspects of Chinese culture. The embodiment of Three-Layer thought in the theory and practice of acupuncture and moxibustion from naming of acupoints, principles of treatment, needling instruments, prescription of acupoints as well as needling techniques is elaborated and briefly analyzed. Thus it illustrates the comprehensive application of Three-Layer thought in acupuncture and moxibustion through the history and the significance of Chinese traditional philosophy in the science of acupuncture and moxibustion.

[WU Xiao-ren: an outstanding physician of acupuncture and moxibustion]

WU Xiao-ren devoted his whole life into acupuncture practice and education. During his 50 years clinical practice, teaching and researching, he focused on standardization and application of acupuncture manipulations. Through the integration of western and Chinese medicine as well as technique innovation, he developed new therapies for hypertension, stroke and various pain syndromes with the combination of acupuncture and materia medica and various acupoint prescription. He was against parochial prejudice by advocating absorption of others successful experiences and integration of different schools. Moreover, being conscientious and meticulous, WU Xiao-ren was always strict with his followers. He set up examples for his students with both precept and practice, and made great contribution to the inheritance of both acupuncture theory and practice.

[Discussion on XU Shu-wei's clinical application of moxibustion]

The experiences and features of XU Shu-wei's clinical application of moxibustion is studied in this article with method of review research. XU Shu-wei attached great importance on yangqi and the functions of spleen and kidney. At the same time, warming-reinforcing method was recommended in treatment as well. Not only treatment with medicine was emphasized, but also moxibustion was encouraged to be applied in clinic. A warming-reinforcing method with moxibustion was recommended for diseases such as yinzheng (yin syndrome), yin-du (extreme yin syndrome), yang deficiency syndrome, stroke, prolapse of anus and furuncles on back. Flexible moxibustion methods were applied based on differentiation of syndromes. Various acupoints and moxibustion manipulations were selected according to different conditions. With the proved therapeutic effect, XU Shu-wei was held as the forerunner of warming-reinforcing method in the acupuncture history of China. Meanwhile, he also made certain contribution on the establishment of the Wenbu Xuepai (the warming-reinforcing school) in the Ming Dynasty (1368-1644).

[Effects of mild moxibustion intervention on serum and liver amyloid-A protein, serum IL-6, TNF-alpha and IL-10 contents in atherosclerosis rabbits]

OBJECTIVE

To observe the effect of mild-moxibustion on serum amyloid-A (SAA) protein, cytokine contents and liver amyloid-A protein expression in atherosclerosis rabbits, so as to explore its anti-inflammation mechanism.

METHODS

A total of 40 Japanese male rabbits were equally randomized into normal control, model, mild moxibustion and medication (lovastatin) groups. The atherosclerosis model was established by feeding the animals with high-fat diet for 14 weeks and intravenous injection of bovine serum albumin (250 mg/kg, once every week, 3 times altogether). Mild moxibustion was applied to "Shenque" (CV 8), "Housanli" (ST 36) for 10 min, once daily for 14 weeks beginning from the first day of modeling. The SAA, serum IL-6, TNF-alpha and IL-10 contents were determined by double antibody sandwich method, and liver amyloid-A protein expression was detected by Western blot. The pathological changes of the cervical common artery were detected by H. E. staining.

RESULTS

In comparison with the normal control group, SAA, serum IL-6, IL-10 and TNF-alpha contents and liver amyloid-A protein expression level were significantly increased in the model group (P < 0.01, P < 0.05). Compared to the model group, SAA, serum IL-6 and TNF-alpha contents, and liver amyloid-A protein expression level were considerably down-regulated and serum IL-10 content was obviously up-regulated in the moxibustion and medication groups (P < 0.05, P < 0.01). No significant differences were found between the moxibustion and medication groups in the five indexes (P > 0.05). In addition, the pathological changes of the cervical common arterial endomembrane in the moxibustion and medication group were relatively milder, suggesting a protective effect of moxibustion on liver tissue in atherosclerosis rabbits.

CONCLUSION

Mild moxibustion can relieve liver injury in atherosclerosis rabbits, which is associated with its effects in suppressing serum inflammatory cytokines and liver amyloid-A protein expression and up-regulating anti-inflammatory cytokine IL-10 level.

[Effects of warm moxibustion on CD40-CD40L axis in rabbits with atherosclerosis]

OBJECTIVE

To explore effects and action mechanism of warm moxibustion on regulation of blood lipids and anti-atherosclerosis.

METHODS

Forty-one male Japanese big-ear white rabbits were randomly divided into a blank group (10 rabbits), a model group (10 rabbits), a moxibustion group (10 rabbits) and a medication group (11 rabbits). Normal diet was applied in the blank group while high-cholesterol diet combined with injection of bovine serum albumin were applied in the rest groups to establish rabbit model of atherosclerosis. After establishment, the model group was not intervened and warm moxibustion was applied in the moxibustion group at "Zusan-li" (ST 36) and "Shenque" (CV 8), 10 min per acupoint per day for continuous 4 weeks. The medication group was treated with intragastric administration of lovastatin capsule (3.6 mg/kg) for continuous 4 weeks. The level of blood lipids, such as total cholesterol (TC), triglyceride (TG), and content of CD40 ligand (CD40L), soluble CD40 ligand (sCD40L) and expression of nuclear factor NF-kappaB were tested after 4 weeks.

RESULTS

Compared with the model group, the moxibustion group and medication group could effectively reduce the contents of TC and low density lipoprotein (all P < 0.05), lower the level of sCD40L [(8.310 +/- 1.221) ng/mL in the model group, (7.097 +/- 0.846) ng/mL in the moxibustion group and (7.354 +/- 0.631) ng/mL in the medication group], reduce expression of CD40L [(0.235 +/- 0.179) mm2 in the model group, (0.072 +/- 0.079) mm2 in the moxibustion group and (0.039 +/- 0.015) mm2 in the medication group] and NF-kappaB [(0.145 +/- 0.052)mm2 in the model group, (0.052 +/- 0.012) mm2 in the moxibustion group and (0.036 +/- 0.013) mm2 in the medication group], indicating the significant difference (P < 0.05, P < 0.001). There was no statistical difference between the moxibustion group and medication group (all P > 0.05).

CONCLUSION

The warm moxibustion has great effect on regulation of blood lipids and anti-atherosclerosis, in which lowering expression of CD40-CD40L could be one of possible mechanisms to take effect of anti-atherosclerosis.

Moxibustion in the management of irritable bowel syndrome: systematic review and meta-analysis

BACKGROUND

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder. Many patients suffer from IBS that can be difficult to treat, thus complementary therapies which may be effective and have a lower likelihood of adverse effects are being sought.This systematic review and meta-analysis aimed at critically evaluating the current evidence on moxibustion for improving global symptoms of IBS.

METHODS

We searched Medline, EMBASE, the Cochrane Central Register of Controlled Trials, AMED, CINAHL, and CNKI databases for randomised controlled trials (RCTs) of moxibustion comparing with sham moxibustion, pharmacological medications, and other active treatments in patients with IBS. Trials should report global symptom improvement as an outcome measure. Risk of bias for each RCT was assessed according to criteria by the Cochrane Collaboration, and the dichotomous data were pooled according to the control intervention to obtain a risk ratio (RR) of global symptom improvement after moxibustion, with 95% confidence intervals (CI).

RESULTS

A total of 20 RCTs were eligible for inclusion (n = 1625). The risk of bias was generally high. Compared with pharmacological medications, moxibustion significantly alleviated overall IBS symptoms but there was a moderate inconsistency among studies (7 RCTs, RR 1.33, 95% CI [1.15, 1.55], I² = 46%). Moxibustion combined with acupuncture was more effective than pharmacological therapy but a moderate inconsistency among studies was found (4 RCTs, RR 1.24, 95% CI [1.09, 1.41], I² = 36%). When moxibustion was added to pharmacological medications or herbal medicine, no additive benefit of moxibustion was shown compared with pharmacological medications or herbal medicine alone. One small sham-controlled trial found no difference between moxibustion and sham control in symptom severity (mean difference 0.35, 95% CI [-0.77, 1.47]). Moxibustion appears to be associated with few adverse events but the evidence is limited due to poor reporting.

CONCLUSIONS

This systematic review and meta-analysis suggests that moxibustion may provide benefit to IBS patients although the risk of bias in the included studies is relatively high. Future studies are necessary to confirm whether this finding is reproducible in carefully-designed and conducted trials and to firmly establish the place of moxibustion in current practice.

[Anti-inflammatory: effect mechanism of warming-dredging in moxibustion]

The universality of anti-inflammation in moxibustion is analyzed in this article from its adaptation disease and ancient documentary records. The specificity of anti-inflammation in moxibustion is pointed out from its disease series research and scientific fact that moxibustion could be used for heat syndrome. The integrity of anti-inflammation in moxibustion is explained by series research result that four basic circulations of moxibustion for chronic inflammation are all effective. The two-way characteristic of moxibustion anti-inflammation is explained from the fact that moxibustion has regulation function both for excess and insufficiency of inflammation to demonstrate the effect mechanism of warming-dredging in moxibustion lies in its anti-inflammation. At last, the relevant possible mechanism between moxibustion anti-inflammation and transient receptor potential vanilloid (TRPV) is proposed. The effect mechanism of warming-dredging in moxibustion lies in anti-inflammation, which could provide theoretic basis for prevention and treatment of moxibustion for serious diseases.

[Discussion on twenty four moxibustion styles of Meihua acupuncture-moxibustion school]

Nomination, apparatus, manipulating techniques, indications and theoretical basis of 14 single moxibustion styles including Chuijiu (insufflating moxibustion), Dianjiubi Jiu (pecking moxibustion with a pen-like stool), Jiujia Xunjiu (moxibustion with frame), Tongmai Wenyang Jiu (moxibustion for removing meridian obstructions and warming up yang), QifuJiu (moxibustion on umbilicus and abdomen), Xiongyang Jiu (moxibustion on the chest for reinforcing yang qi), Toujing Jiu (moxibustion on head and neck), Anmo Jiu (moxibustion with massage), Zhiti Jiu (moxibustion on extremities), Guan Jiu (moxibustion with a tube), Zu Jiu (moxibustion on foot), Wenzhenjiu (warm needling), Huanong Jiu (festering moxibustion) and Gewu Jiu (indirect moxibustion) are expounded in this article. And 10 compound moxibustion with the combination of 2 or more than 2 above mentioned single moxibustion style under the instruction of combination of local and distal points, combination of upper and lower points as well as combination of frontal and back points are also stated. It suggests to classify moxibustion into categories of festering moxibustion and mild moxibustion, indirect moxibustion and direct moxibustion, and to classify moxibustion apparatus into the categories of treating tools and assisting tools.