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Fu L, Duan H, Cai Y, Chen X, Zou B, Yuan L, Liu G. Moxibustion ameliorates osteoarthritis by regulating gut microbiota via impacting cAMP-related signaling pathway. Biomed Pharmacother 2024; 170:116031. [PMID: 38113621 DOI: 10.1016/j.biopha.2023.116031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Osteoarthritis (OA) is a prevalent progressive disorder. Moxibustion has found widespread use in clinical practice for OA, while its underlying mechanism remains elusive. OBJECTIVE To investigate whether moxibustion can ameliorate OA by influencing the metabolic processes in OA and to elucidate the specific metabolic mechanisms involved. METHODS C57BL/6J WT mice were randomly assigned to one of three groups: the SHAM group, the ACLT group, and the ACLT+M group. In the ACLT+M group, mice underwent moxibustion treatment at acupoints Shenshu (BL23) and Zusanli (ST36) for a continuous period of 28 days, with each session lasting 20 min. We conducted a comprehensive analysis to assess the impact of moxibustion on OA, focusing on pathological changes, intestinal flora composition, and serum metabolites. RESULTS Moxibustion treatment effectively mitigated OA-related pathological changes. Specifically, moxibustion treatment resulted in the amelioration of articular cartilage damage, synovial inflammation, subchondral bone sclerosis when compared to the ACLT group. Moreover, 16S rDNA sequencing analysis revealed that moxibustion treatment positively influenced the composition of the flora, making it more similar to that of the SHAM group. Notably, moxibustion treatment led to a reduction in the abundance of Ruminococcus and Proteobacteria in the intestine. In addition, non-targeted metabolomics analysis identified 254 significantly different metabolites between the groups. Based on KEGG pathway analysis and the observed impact of moxibustion on OA-related inflammation, moxibustion therapy is closely associated with the cAMP-related signaling pathway. CONCLUSION Moxibustion can relieve OA by regulating intestinal flora and via impacting cAMP-related signaling pathway.
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Affiliation(s)
- Liping Fu
- Department of Rehabilitation Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China; Third Level Research Laboratory of State Administration of Traditional Chinese Medicine, Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Huimin Duan
- Department of Rehabilitation Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Yisi Cai
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China; Third Level Research Laboratory of State Administration of Traditional Chinese Medicine, Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Xuelan Chen
- Department of Rehabilitation Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Binhua Zou
- Department of Rehabilitation Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China.
| | - Lixia Yuan
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China.
| | - Gang Liu
- Department of Rehabilitation Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China.
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Yin Y, Chen L, Wang X, Fang J, Zhao L, Shen X. A comparison of jade moxibustion and traditional moxibustion in the treatment of knee osteoarthritis: A randomized clinical trial. Medicine (Baltimore) 2023; 102:e34537. [PMID: 37543785 PMCID: PMC10403001 DOI: 10.1097/md.0000000000034537] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND This study was developed to compare the relative clinical efficacy of traditional moxibustion and Jade moxibustion in an effort to define the most effective approaches to treating knee osteoarthritis. METHODS In total, 94 patients were randomly assigned at a 1:1 ratio to the traditional moxibustion (TM) and Jade moxibustion (JM) groups. For JM, a jade kneepad was preheated for 3 minutes via electrification, with the jade in the kneepad being pressed onto acupoints when reaching an initial temperature of 46°C. For patients in the TM group, moxa cones were applied to acupoints for treatment. In total, 12 treatments were performed for patients in each group, with treatment being conducted 3 times per week. Study outcomes included 36-item short-form health survey and Western Ontario and McMaster Universities Osteoarthritis Index knee stiffness scores. In addition, serum levels of osteoarthritis-related cytokines were measured. RESULTS Overall, 89/94 patients completed this study, including 44 and 45 in the TM and JM groups, respectively. The 36-item short-form health survey physical functioning at weeks 12 and 24 (P = .033, 0.001), role-physical at weeks 4 and 24 (P = .030, 0.014), and role-emotional at week 4 (P = .045) were the only scores to differ significantly between the TM and JM groups. Western Ontario and McMaster Universities Osteoarthritis Index stiffness scores in the JM groups improved significantly relative to baseline at weeks 4, 8, 12, and 24 (all P < .01). The scores in the TM group differed significantly at all time points relative to baseline (all P < .01), with no differences between groups (all P > .05). Serum Interleukin-2 levels were lower in both groups (all P < .01). Cartilage oligomeric matrix protein and monocyte chemotactic protein-1 only differed significantly for patients treated via JM (P < .05, P < .01), with the same also being true for Interleukin-1β and Interleukin-8 in the TM group (all P < .01). No significant differences in other cytokines were observed, nor did they differ significantly between groups (all P > .05). CONCLUSION These results suggest that JM treatment can improve knee osteoarthritis patient quality of life, alleviating joint stiffness and restoring joint function with a level of efficacy comparable to TM.
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Affiliation(s)
- Yue Yin
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lusheng Chen
- Shanghai Key Laboratory of Acupuncture Mechanism and Acupoint Function, Department of Aeronautics and Astronautics, Fudan University, Shanghai, China
| | - Xiangyun Wang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Fang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ling Zhao
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xueyong Shen
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai Research Center of Acupuncture and Meridian, Shanghai, China
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Li Y, Hong E, Ye W, You J. Moxibustion as an Adjuvant Therapy for Cancer Pain: A Systematic Review and Meta-Analysis. J Pain Res 2023; 16:515-525. [PMID: 36824500 PMCID: PMC9942498 DOI: 10.2147/jpr.s396696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 01/28/2023] [Indexed: 02/19/2023] Open
Abstract
Purpose Pain is one of the most common and feared symptoms among cancer patients. Unrelieved pain denies patients comfort and greatly affects their overall quality of life. Moxibustion is commonly used to manage chronic pain. However, its efficacy on cancer pain remains inconclusive. This study aimed to evaluate the efficacy of moxibustion for cancer pain. Methods We searched seven databases to obtain articles about moxibustion combined with pharmacotherapy for cancer pain published before November 2022. All data extraction was carried out independently by two investigators. RevMan 5.4 software was used for data analysis. Results A total of ten trials involving 999 cases were included. The results of the meta-analysis revealed that moxibustion combined with pharmacotherapy was significantly better than drug therapy alone in improving pain relief rate (RR =1.16, 95% CI = [1.04, 1.30], P = 0.01), reducing pain scores (SMD = -1.43, 95% CI = [-2.09, -0.77], P < 0.0001), Shortening the onset of analgesia (MD = -12.07, 95% CI = [-12.91, -11.22], P < 0.00001), prolonging the duration of analgesia (MD = 3.69, 95% CI = [3.21, 4.18], P < 0.00001), and improving quality of life (SMD = 2.48, 95% CI = [0.67, 4.29], P = 0.007). In addition, moxibustion combined with pharmacotherapy can effectively reduce adverse reactions of drugs (RR =0.35, 95% CI = [0.21, 0.57], P < 0.0001). Conclusion The evidence in this review supports moxibustion as an effective adjuvant therapy for cancer pain management. However, high-quality RCTs are needed to further confirm these findings. Registration Number PROSPERO CRD42022370942.
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Affiliation(s)
- Yan Li
- Jiangxi University of Chinese Medicine, Nanchang, People’s Republic of China
| | - Ensi Hong
- Jiangxi University of Chinese Medicine, Nanchang, People’s Republic of China,The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, People’s Republic of China
| | - Wenguo Ye
- The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, People’s Republic of China,Correspondence: Wenguo Ye, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, Jiangxi Province, People’s Republic of China, Email
| | - Jianyu You
- Jiangxi University of Chinese Medicine, Nanchang, People’s Republic of China,Jianyu You, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi Province, People’s Republic of China, Email
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Zhang S, Wang Y, Zhou M, Jia S, Liu Y, Zhang X, Tai X. A bibliometric analysis of traditional Chinese non-pharmacological therapies in the treatment of knee osteoarthritis from 2012 to 2022. Front Neurosci 2023; 17:1097130. [PMID: 36937664 PMCID: PMC10014606 DOI: 10.3389/fnins.2023.1097130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/13/2023] [Indexed: 03/05/2023] Open
Abstract
Objective The benefits of traditional Chinese non-pharmacological therapies in the treatment of Knee osteoarthritis (KOA) are receiving increasing attention. Therefore, this study aims to systematically analyze the global research on the treatment of KOA by Chinese traditional non-pharmacological therapies using bibliometric analysis and present the results with a knowledge map form. Methods Literature related to traditional Chinese non-pharmacological therapies used in the treatment of KOA from 2012 to 2022 was searched from the Web of Science core database and PubMed database. CiteSpace, SCImago Graphica and VOSviewer were used to extract nations, institutions, journals, authors, references, keywords, as well as the most widely used acupoints, therapies and evaluation indexes. Results A total of 375 literature have been included. 32 countries around the world have participated in the research. China, the United States, and Europe were at the center of the global cooperation network. The most prolific institutions and authors were from China represented by Cun-zhi Liu and Jian-feng Tu of Beijing University of Chinese Medicine, the institution with the highest cited frequency was University of York, and "Osteoarthritis Cartilage" was the most frequently cited journal. The most frequently cited literature was "OARSI guidelines for the non-surgical management of knee, hip, and poly articular osteoarthritis." 22 kinds of Chinese non-pharmacological therapies were used to treat KOA, among which acupuncture was the most commonly used one, and ST36 (Zusanli) and WOMAC were the most commonly selected acupoint and evaluation index. Conclusion In the past decade, the value of Chinese non-pharmacological therapies in the treatment of KOA has received widespread attention. It was a common concern of global researchers to relieve the pain of KOA patients and restore the quality of life. Under the background that acupuncture accounts for a relatively high proportion, the next step may consider how to make the balanced development of a variety of Chinese non-pharmacological therapies. In addition, the problem of how to eliminate the placebo effect maybe the direction of future research.
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Kwak SG, Jung HJ, Choi WK. Integrative medicine in patients with degenerative arthritis of the knee: A pilot randomized control study. Medicine (Baltimore) 2022; 101:e30385. [PMID: 36042635 PMCID: PMC9410661 DOI: 10.1097/md.0000000000030385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND We aimed to comparatively analyze the effect of integrative medicine treatments (lifestyle change education, use of anti-inflammatory drugs, acupuncture, manual therapy-type massage) and conventional medical treatments (lifestyle change education and use of anti-inflammatory drugs) on pain control, knee function improvement, and quality of life improvement in patients with degenerative knee arthritis. METHODS In this study, 30 patients were randomly divided into the control group (n = 15) and the experimental group (n = 15). Both groups were prescribed anti-inflammatory drugs and lifestyle change education for 12 weeks. The experimental group underwent acupuncture including electroacupuncture, moxibustion, and manual therapy-type massage 12 times during the first 6 weeks. Evaluations were performed at 3 visits: visit 1 (before treatment), visit 2 (6 weeks after initial treatment), and visit 3 (12 weeks after initial treatment). The effect of each treatment was measured using Visual Analog Scale (VAS, 0-10), Western Ontario and McMaster Universities index (WOMAC), and SF-36. RESULTS From visit 1 to visit 2, the mean value of VAS decreased by 0.72 and 3.17 in the control and experimental groups, respectively. From visit 2 to visit 3, the mean VAS value decreased by 0.25 in the control group but increased by 0.87 in the experimental group. Among the sub-area of SF-36, the physical role restriction area and mental health area showed significant differences between the 2 groups over time (P = .024, P = .006). CONCLUSION Integrative medicine treatment has superior effects in pain control over conventional medical treatment. In integrative medicine treatment, pain control tends to decrease with time, but still superior over conventional medical treatment up to 6 weeks after treatment (12 weeks after initial treatment).
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Affiliation(s)
- Sang Gyu Kwak
- Department of Medical Statistics, College of Medicine, Daegu Catholic University, Daegu, Republic of Korea
| | - Hyun Jung Jung
- Department of Diagnostics, College of Korean Medicine, Daegu Haany University, Daegu, Republic of Korea
| | - Won-Kee Choi
- Department of Orthopaedic Surgery, College of Medicine, Daegu Catholic University, Daegu, Republic of Korea
- *Correspondence: Won-Kee Choi, Department of Orthopaedic Surgery, Daegu Catholic University Hospital, 3056-6, Daemyung-4-dong, Nam-gu, Daegu, Republic of Korea (e-mail: )
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The Effectiveness Comparison of Different Acupuncture-Related Therapies on Knee Osteoarthritis: A Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2831332. [PMID: 35815282 PMCID: PMC9262549 DOI: 10.1155/2022/2831332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/04/2022] [Accepted: 06/10/2022] [Indexed: 11/18/2022]
Abstract
Objective This meta-analysis aims to assess the efficacy of acupuncture-related therapy on knee osteoarthritis (KOA) patients. Method We searched PubMed, Embase, and CNKI databases to screen eligible trials between 2017 and 2022. All trials that used acupuncture/moxibustion of KOA patients were included. Study selection and data extraction were performed by 2 researchers independently. The statistics was performed by using R 4.1.1. Results A total of 17 trials were included in our meta-analysis. Meta-analysis results showed the evidence of the relation of several common acupunture/moxibustion treatments by network meta-analysis. In the fixed effect model, acupuncture/moxibustion has superior therapy efficacy than sham treatment (mean difference = -0.34, 95% confidence interval = (-0.52,-0.16), P=0.95). In fixed effect model, specific acupuncture/moxibustion has superior therapy efficacy than usual acupuncture/moxibustion (mean difference = -0.45, 95% confidence interval = (-0.62, -0.29), P < 0.01). Conclusion Acupuncture/moxibustion has superior therapy efficacy than sham treatment. Specific acupuncture/moxibustion has superior therapy efficacy than usual acupuncture/moxibustion.
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Jia YJ, Li TY, Han P, Chen Y, Pan LJ, Jia CS. Effects of different courses of moxibustion treatment on intestinal flora and inflammation of a rat model of knee osteoarthritis. JOURNAL OF INTEGRATIVE MEDICINE 2022; 20:173-181. [PMID: 35101368 DOI: 10.1016/j.joim.2022.01.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/15/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE This study was done to determine the effects of different courses of moxibustion on a rat knee osteoarthritis (KOA) model, and explore the dose-effect relationship of moxibustion on KOA from the perspectives of intestinal flora and inflammatory factors. METHODS Wistar rats were randomly divided into five groups: normal, model, moxibustion for 2 weeks, moxibustion for 4 weeks and moxibustion for 6 weeks groups (n = 5 each group). A KOA rat model was induced by monosodium iodoacetate, and moxibustion intervention was performed at the acupoints "Dubi" (ST35) and "Zusanli" (ST36), once every other day. Pathologic changes in the cartilage of rat knee joints were assessed after intervention, and fecal samples were subjected to 16S rRNA high-throughput sequencing for microbial diversity analysis. RESULTS Damage to the knee articular cartilage was obvious in the model group, which also had increased levels of pro-inflammatory factors, decreased levels of anti-inflammatory factors, and intestinal flora disorders with decreased diversity. The degree of cartilage damage in the 4 and 6 weeks of moxibustion groups was significantly improved compared with the model group. The 4 and 6 weeks of moxibustion groups also demonstrated reduced levels of interleukin-1β and tumor necrosis factor-α and increased levels of interleukin-10 (P < 0.05). Both the abundance and diversity of the intestinal flora were increased, approaching those of the normal group. Abundances of probiotics Eubacterium coprostanoligenes group and Ruminococcaceae UCG-014 increased, while that of the pathogenic bacteria Lachnospiraceae NK4A136 group decreased (P < 0.05). Although the abundance of Lachnospiraceae NK4A136 group decreased in the 2 weeks of moxibustion group compared with the model group (P < 0.05), there was no statistically significant difference in serum inflammatory factors, flora species diversity or degree of pathological damage compared with the model group. CONCLUSION Moxibustion treatment led to significant improvements in the intestinal flora and inflammatory factors of rats with KOA. Moxibustion treatment of 4 and 6 weeks led to better outcomes than the 2-week course. Moxibustion for 4 and 6 weeks can regulate intestinal flora dysfunction with increased probiotics and reduced pathogenic bacteria, reduce pro-inflammatory factors and increase anti-inflammatory factors. No significant differences were seen between the effects of moxibustion for 4 weeks and 6 weeks.
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Affiliation(s)
- Ye-Juan Jia
- School of Acupuncture, Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang 050200, Hebei Province, China
| | - Tian-Yu Li
- School of Acupuncture, Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang 050200, Hebei Province, China
| | - Peng Han
- School of Acupuncture, Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang 050200, Hebei Province, China
| | - Yu Chen
- School of Acupuncture, Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang 050200, Hebei Province, China
| | - Li-Jia Pan
- School of Acupuncture, Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang 050200, Hebei Province, China
| | - Chun-Sheng Jia
- School of Acupuncture, Moxibustion and Tuina, Hebei University of Chinese Medicine, Shijiazhuang 050200, Hebei Province, China.
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Yao Z, Xu Z, Xu T, Liu X, Xu S, Wan C, Zhou X. Moxibustion for alleviating chemotherapy-induced gastrointestinal adverse effects: A systematic review of randomized controlled trials. Complement Ther Clin Pract 2022; 46:101527. [PMID: 34999499 DOI: 10.1016/j.ctcp.2021.101527] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 12/04/2021] [Accepted: 12/27/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This systematic review aims to assess whether moxibustion is effective and safe for gastrointestinal adverse effects, a common and thorny issue arising from chemotherapy. METHODS Seven electronic databases were searched up to August 28, 2021, to identify randomized controlled trials (RCTs) comparing moxibustion versus non-moxibustion treatments for various gastrointestinal adverse effects after chemotherapy. The Karnofsky performance status (KPS) and quality of life scores and the incidence of moxibustion-related adverse events were also investigated. Effects in meta-analyses were measured by risk ratios (RRs) or mean differences (MDs). RESULTS Thirty-two RCTs (n = 2990) were included. Compared to the controls, moxibustion significantly reduced the incidences of nausea/vomiting (RR 0.70, 95% CI 0.61-0.79), severe nausea/vomiting (RR 0.39, 95% CI 0.29-0.51), diarrhoea (RR 0.56, 95% CI 0.38-0.82), constipation (RR 0.59, 95% CI 0.44-0.78), and abdominal distension (RR 0.60, 95% CI 0.46-0.78). The KPS (MD 7.53, 95% CI 3.42-11.64) and quality of life (MD 8.88, 95% CI 0.96-16.80) scores were also significantly improved after moxibustion. The results did not support a benefit of moxibustion on inappetence (RR 0.69, 95% CI 0.40-1.22) or abdominal pain (RR 0.60, 95% CI 0.28-1.30). All adverse events related to moxibustion were mild. CONCLUSIONS Moderate-to very-low-quality evidence suggests that moxibustion may be safely used as an adjuvant treatment after chemotherapy to reduce the incidences of nausea and vomiting, diarrhoea, constipation, and abdominal distension and improve the performance status and quality of life in patients with malignant tumours. Its effects on abdominal pain and inappetence are uncertain.
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Affiliation(s)
- Ziqian Yao
- Evidence-based Medicine Research Centre, Jiangxi University of Chinese Medicine, Nanchang, China.
| | - Zhongbo Xu
- Department of Emergency, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, China.
| | - Tielong Xu
- Evidence-based Medicine Research Centre, Jiangxi University of Chinese Medicine, Nanchang, China.
| | - Xiaowu Liu
- Evidence-based Medicine Research Centre, Jiangxi University of Chinese Medicine, Nanchang, China.
| | - Sheng Xu
- Evidence-based Medicine Research Centre, Jiangxi University of Chinese Medicine, Nanchang, China.
| | - Chanjun Wan
- Department of Cardiology, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, China.
| | - Xu Zhou
- Evidence-based Medicine Research Centre, Jiangxi University of Chinese Medicine, Nanchang, China.
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Xu D, Lee M, Huang C, Wei J, Zhou M, Yao T, Lu J, Zhao W, Xu N, Huang R, He J, Zheng L. Effect of acupotomy in knee osteoarthritis patients: study protocol for a randomized controlled trial. Trials 2021; 22:295. [PMID: 33879221 PMCID: PMC8056725 DOI: 10.1186/s13063-021-05247-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 04/02/2021] [Indexed: 12/05/2022] Open
Abstract
Background Symptomatic knee osteoarthritis (KOA) is common in China. Pharmacological therapy is not the first recommendation because of its safety issues. Nonpharmacological therapy, such as lifestyle adjustments, weight loss, muscle strengthening, and aerobic exercise programs, is strongly recommended for KOA. However, these approaches may fail due to poor patient compliance. There is a lack of high-quality randomized controlled trials of acupotomy, an effective treatment for KOA. This study was designed to investigate the efficacy of acupotomy in patients with KOA. Methods A total of 136 patients will be enrolled at the First Affiliated Hospital of Guangzhou University of Chinese Medicine and assigned to the acupotomy group or sham acupotomy group according to the block randomization scheme. Patients in the acupotomy group will receive 2 sessions of acupotomy for 2 weeks (once a week). Patients in the sham group will receive 2 sessions of sham stimulation for 2 weeks (once a week). All patients will use indomethacin cream externally. The primary outcome will be the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the secondary outcomes will be the visual analog scale (VAS) score, plantar pressure distribution test result, X-ray examination findings, musculoskeletal ultrasound findings, maximum knee circumference, joint mobility, and quality of life. Measurements will be taken at baseline, 1 week after the end of treatment, and at the 3- and 6-month follow-ups. Discussion To the best of our knowledge, this will be the first single-blind, sham-controlled study of acupotomy. The outcome assessors will also be blinded. The aim of this work is to demonstrate the efficacy of acupotomy in treating KOA. Trial registration Chinese Clinical Trial Registry ChiCTR2000033047. Registered on 18 May 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05247-z.
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Affiliation(s)
- Danghan Xu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Minghui Lee
- The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Cihui Huang
- The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jia Wei
- The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Mengxue Zhou
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Taotao Yao
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jingjing Lu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wenjing Zhao
- Shenzhen Pingle Orthopaedic Hospital, Shenzhen, China
| | - Nuo Xu
- The University of Alabama at Birmingham, Birmingham, USA
| | - Ruina Huang
- The Eighth Affiliated Hospital of Sun Yat Sen University, Shenzhen, China
| | - Jun He
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Liang Zheng
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
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Li LJ, Shi YC, Luo MX, Zhao CL. Effects of moxibustion on Treg cells in sarcoma microenvironment. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2021; 19:251-257. [PMID: 33642209 DOI: 10.1016/j.joim.2021.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 11/17/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the therapeutic effect of moxibustion on sarcomas from mesenchymal tissues, which have a low response rate to chemotherapy and radiotherapy. METHODS S180 sarcoma cell line was inoculated in C57BL/6 mice to form transplanted tumor. Moxibustion therapy was directly applied at the transplanted tumor sites, at a distance of 3.0 cm, 10 min per session, till skin temperature reached 45 °C, once a day, for 14 consecutive days of intervention. After the mice were killed, serum was collected and used to detect concentrations of interleukin-10 (IL-10), transforming growth factor-β1 (TGF-β1), IL-4 and interferon-γ (IFN-γ) by Luminex liquid suspension chip. The numbers of Treg+ T cells and CD4+CD25+Forkhead Box P3 (Foxp3)+ T cells were detected by flow cytometry. Fluorescence in situ hybridization was used to analyze the changes of CD4, CD8, Foxp3 and TGF-β1 in the tumor microenvironment (TME). RESULTS Weight of S180 transplanted tumor in the control group was (2.03 ± 0.54) g, and that in the moxibustion group was (1.27 ± 0.29) g, which was statistically different (P = 0.023). The mean value of Foxp3+ T cells in the normal group was 2.01%, which increased to 3.63% after the formation of transplanted tumor, and decreased to 1.48% after moxibustion treatment. The moxibustion group also had reduced numbers of CD4+CD25+Foxp3+ T cells in the spleen of mice with transplanted tumor. The concentrations of IL-10, TGF-β1 and IL-4 decreased in the serum of mice with transplanted tumor, while the concentration of IFN-γ increased. Moxibustion was associated with downregulation in expression of Foxp3, IL-10 and TGF-β1 genes in the transplanted tumor, and increases in the gene expression of CD4+ T cells and CD8+ T cells in the TME. CONCLUSION Moxibustion may have therapeutic effects on sarcomas by reducing the number of Treg cells in the blood and controlling the infiltration of Treg cells in the TME.
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Affiliation(s)
- Li-Jun Li
- Department of Acupuncture, Guangdong Clifford Hospital, Guangzhou 511495, Guangdong Province, China
| | - Yu-Chong Shi
- School of Traditional Chinese Medicine, Jinan University, Guangzhou 510632, Guangdong Province, China
| | - Min-Xiang Luo
- Department of Acupuncture, Guangdong Clifford Hospital, Guangzhou 511495, Guangdong Province, China
| | - Chang-Lin Zhao
- Health Science College, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong Province, China.
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Shi X, Yu W, Wang D, Zhao Y, Deng X, Chen C, Shi S. A comparison of the effects of Chinese non-pharmaceutical therapies for pain control in knee osteoarthritis: A protocol for a systematic review and network meta-analysis. Medicine (Baltimore) 2021; 100:e24501. [PMID: 33663057 PMCID: PMC7909139 DOI: 10.1097/md.0000000000024501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is a chronic degenerative joint disease, leading to pain and functional limitation in the elderly. The non-pharmaceutical therapy is recommended firstly by different guidelines for KOA management strategies. In China, there are various forms of non-pharmaceutical treatments for KOA, which are considered beneficial in relieving KOA pain. However, there is no consensus on which is the optimal non-pharmaceutical regimens. Thus, present network meta-analysis aims to assess the comparative efficacy of available Chinese non-pharmaceutical therapies, especially in pain management. METHODS PubMed, EMBASE, Cochrane library, Web of Science, China national knowledge infrastructure, VIP, Wan Fang will be systematically searched their inception to April 2020. Randomized controlled trials that compared the effect of non-pharmaceutical therapies on pain control in KOA will be included, including traditional acupuncture, electroacupuncture, warming needle, fired needle, acupuncture followed by moxibustion, moxibustion and massage. The primary outcome was the knee pain levels, and secondary outcome was the comprehensive indicators. Risk of bias assessment of the included studies will be performed according to the Cochrane risk of bias tool. The pairwise and network meta-analysis will be performed by STATA 14.0 and GeMTC softwares. RESULTS This study is ongoing and will be submitted to a peer-reviewed journal for publication. CONCLUSION This study will provide a comprehensive evidence on the effects of Chinese non-pharmaceutical therapies for pain control in KOA. PROSPERO REGISTRATION NUMBER CRD42018106575.
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Affiliation(s)
| | - Wenjing Yu
- Department of Pediatrics, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | | | - Ying Zhao
- Department of Pediatrics, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
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12
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Cheung T, Ho YS, Yuen CS, Lam CS, Chun-Lung So B, Chen SC, Leung DYP, Kwai-Ping Suen L, Tin-Yau So L, Chun-Hei Ho A, Yeung WF. Electromoxibustion for knee osteoarthritis in older adults: A pilot randomized controlled trial. Complement Ther Clin Pract 2020; 41:101254. [PMID: 33190009 DOI: 10.1016/j.ctcp.2020.101254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/06/2020] [Accepted: 10/25/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Electromoxibustion devices are commercially available and can be self-administered by patients. Nevertheless, little is known about the effectiveness and potential burn injury of these devices as this topic is under-investigated. OBJECTIVE To assess the preliminary effects and safety of an electromoxibustion (EM) device for improving knee pain and joint functions in older adults with knee osteoarthritis (KOA). DESIGN, SETTING, PARTICIPANTS AND INTERVENTION This was a pilot two-armed assessor-blinded randomized controlled trial to assess the effects of electromoxibustion (EM) on older adults with KOA. A total of 38 subjects aged 60 or above, with KOA for 3 months or above were recruited. Participants were randomized to the EM group or the knee health education group. The intervention group (n = 21) received 12 sessions of EM spanning across four weeks, while the control group (n = 17) received two sessions of knee health education. MAIN OUTCOME MEASURES Primary outcome included the pain severity Numerical Rating Scale (NRS) at baseline and week 4. Secondary outcomes included the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), Short-Form Six-Dimension (SF6D), Timed Up & Go Test (TUG) and Fast Speed Gait (FSG). RESULTS Both groups showed a decreasing trend in knee pain intensity by NRS at post-intervention. There were also trends of improvement in the WOMAC score, TUG score, FGS test score and SF-6D score at week 4. Only a small between-group effect size (d = 0.13) was found, but medium between-group effects sizes were found in the WOMAC total score (d = 0.40) and WOMAC functional sub-score (d = 0.51). However, the differences were not statistically significant. CONCLUSION This study suggested that EM may be beneficial for KOA in older adults, particularly in terms of improving knee function. Replication of similar studies in larger RCTs is warranted to confirm the effectiveness of EM on reducing pain and knee function of older adults with KOA. TRAIL REGISTRATION NUMBER NCT04034394.
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Affiliation(s)
- Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Yuen Shan Ho
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Chun-Sum Yuen
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China.
| | - Chun-Sing Lam
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Billy Chun-Lung So
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Shu-Cheng Chen
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Doris Y P Leung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China.
| | | | - Larry Tin-Yau So
- Yan Chai Hospital Social Services Department, Yan Chai Hospital, Hong Kong SAR, China.
| | - Alex Chun-Hei Ho
- Yan Chai Hospital Social Services Department, Yan Chai Hospital, Hong Kong SAR, China.
| | - Wing-Fai Yeung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China.
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He R, Liu J, Huang C, Liu J, Cui H, Zhao B. A Urinary Metabolomics Analysis Based on UPLC-MS and Effects of Moxibustion in APP/PS1 Mice. Curr Alzheimer Res 2020; 17:753-765. [PMID: 33167836 DOI: 10.2174/1567205017666201109091759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/03/2020] [Accepted: 09/08/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Alzheimer's disease (AD) is a common neurodegenerative disorder with the symptoms of cognitive impairment and decreased learning and memory abilities. Metabolomics can reflect the related functional status and physiological and pathological changes in the process of AD. Moxibustion is a unique method in traditional Chinese medicine, which has been used in the treatment and prevention of diseases for thousands of years. METHODS A total of 32 APP/PS1 mice were randomly divided into the model group, moxibustion group, moxa smoke group and smoke-free moxibustion group (n=8/group), using the random number table method, while eight C57BL/6 mice were used as the control group. The five groups were measured for 20 min/day, 6 days/week, for 4 weeks. After 4 weeks' experiment, all the mice were placed in metabolic cages to collect urine continuously for 24 hours, for UPLC-MS analysis. RESULTS Principal component analysis (PCA) was used to identify the different metabolites among the five groups, and partial least squares discriminant analysis (PLS-DA) was performed to reveal the effects on the metabolic variance. Sixteen potential biomarkers were identified among the five groups, primarily related to amino acid metabolism, starch metabolism, sucrose metabolism, interconversion of pentose and glucuronate, and aminoacyl biosynthesis. There were 17 differences in the potential metabolites between the control and model groups, involving the metabolism of amino acid, purine, pyrimidine, nicotinic acid and nicotinamide, and biosynthesis of pantothenate and coenzyme A. Fifteen potential biomarkers were identified between the model and moxibustion groups, related to starch metabolism, sucrose metabolism, interconversion of pentose and glucuronate, glyoxylate, dicarboxylate anions and some amino acid metabolism. CONCLUSION Moxibustion can regulate the metabolism of substance and energy by improving the synthesis and decomposition of carbohydrates and amino acids in APP/PS1 transgenic AD model mice.
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Affiliation(s)
- Rui He
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Juntian Liu
- Beijing Hospital of Acupuncture and Moxibustion, Beijing, China
| | - Chang Huang
- Acupuncture and Moxibustion Department, Beijing University of Chinese Medicine Affiliated Huguo Temple Hospital of Traditional Chinese Medicine, Beijing, China
| | - Jinyi Liu
- Acupuncture and Moxibustion Department, Beijing University of Chinese Medicine Affiliated Huguo Temple Hospital of Traditional Chinese Medicine, Beijing, China
| | - Herong Cui
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, China
| | - Baixiao Zhao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Yu H, Wang H, Cao P, Ma T, Zhao Y, Xie F, Yao C, Zhang X. Complementary and alternative therapies for knee osteoarthritis: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) 2020; 99:e23035. [PMID: 33126393 PMCID: PMC7598879 DOI: 10.1097/md.0000000000023035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/07/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is a degenerative disease, making a unique contribution to chronic pain, edema, and limited mobility of knee joint. This disease is an important factor affecting the quality of life of middle-aged and elderly people. Complementary and alternative medicine (CAM) therapies have been used clinically to treat KOA; however, the selection strategies of different CAM interventions in clinical practice are still uncertain, and the purpose of this study is to evaluate the efficacy and acceptability of different CAM therapies using systematic review and network meta-analysis. METHODS According to the strategy, the authors will retrieve a total of 7 electronic databases by October 2020, including PubMed, the Cochrane Library, EMbase, China National Knowledge Infrastructure, China Biological Medicine, Chongqing VIP, and Wan-fang databases After a series of screening, 2 researchers will use Aggregate Data Drug Information System and Stata software to analyze the data extracted from the randomized controlled trials of CAM therapies for the KOA. Finally, the evidence grade of the results will be evaluated. RESULTS This study will provide a reliable evidence for the selection of CAM therapies for KOA. CONCLUSION The results of this study will provide references for evaluating the influence of different CAM therapies for KOA, and provide decision-making references for clinical research. ETHICS AND DISSEMINATION This study does not require ethical approval. The results will be disseminated through a peer-reviewed publication. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/GJMF4.
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Affiliation(s)
- Haiyang Yu
- Clinical College of Traditional Chinese Medicine, Gansu University of Chinese Medicine
- Department of Orthopedics
| | - Haiyan Wang
- Department of Acupuncture and Moxibustion, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu Province, China
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province
| | - Panju Cao
- Department of Spine, Baoji Hospital of Traditional Chinese Medicine, Baoji, Shanxi Province, China
| | - Tao Ma
- Clinical College of Traditional Chinese Medicine, Gansu University of Chinese Medicine
| | | | - Feiyang Xie
- Clinical College of Traditional Chinese Medicine, Gansu University of Chinese Medicine
| | - Chuanjiang Yao
- Clinical College of Traditional Chinese Medicine, Gansu University of Chinese Medicine
| | - Xiaogang Zhang
- Clinical College of Traditional Chinese Medicine, Gansu University of Chinese Medicine
- Department of Orthopedics
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Effectiveness and safety of electrical moxibustion for knee osteoarthritis: A multicenter, randomized, assessor-blinded, parallel-group clinical trial. Complement Ther Med 2020; 53:102523. [PMID: 33066857 DOI: 10.1016/j.ctim.2020.102523] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 06/25/2020] [Accepted: 07/18/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The prevalence of knee osteoarthritis (KOA) is increasing, and it has emerged as a major health issue. Studies have been reported that moxibustion is effective for treating KOA, but conventional moxibustion is difficult to control the intensity of stimulation and causes smoke, harmful gases, or odors. An electrical moxibustion (EM) device was developed to solve these problems, so we conducted this study to evaluate the effectiveness and safety of EM as a treatment for KOA. METHODS This is a multicenter, randomized, assessor-blinded, parallel-group clinical trial. Participants with KOA were randomly allocated into EM, traditional indirect moxibustion (TIM), or usual care groups. The moxibustion groups were received 12 sessions of moxibustion treatment at six acupuncture points (ST36, ST35, ST34, SP9, EX-LE4, SP10) over a period of 6 weeks. The usual care group was received usual treatment and self-care. The primary outcome was the degree of pain measured by numerical rating scale (NRS). The second outcomes were measured using visual analog scale, Korean version of the Western Ontario and McMaster Universities osteoarthritis index, patient global assessment, European quality of life five dimension five level scale, and warm sense threshold and heat pain threshold. For safety assessment, laboratory test and adverse events (AEs) were recorded. RESULTS A total of 138 participants were assigned. While there was no significant NRS change in the usual care, EM and TIM showed significant decrease after treatment. Compared to the usual care, the mean change of NRS in the EM and TIM was significantly different, but there was no significance between two groups. Regarding secondary outcomes, EM and TIM also showed significant difference compared to the usual care, but there was no significance between two groups. Regarding safety assessment, while usual care showed significant safety among three groups, EM showed seven treatment-related AEs by four participants compared TIM's 10 events by 10 participants. In addition, there was no blister caused by burns in the EM, which occurred four cases in the TIM. CONCLUSION This study shows that EM is effective to improve the pain and function by KOA with a certain level of safety.
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Effect of Moxibustion on the Intestinal Flora of Rats with Knee Osteoarthritis Induced by Monosodium Iodoacetate. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:3196427. [PMID: 32714401 PMCID: PMC7355364 DOI: 10.1155/2020/3196427] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/07/2020] [Accepted: 06/02/2020] [Indexed: 12/16/2022]
Abstract
In this study, a knee osteoarthritis (KOA) rat model induced by monosodium iodoacetate (MIA) was used to study the effect of moxibustion on improving knee cartilage damage and its effect on the intestinal flora. The experimental rats were divided into the normal group (N), model group (M), moxibustion treatment group (MS), and diclofenac sodium treatment group (DS). After 4 weeks, cartilage pathological damage in the knee joint was evaluated using hematoxylin-eosin and safranin O-fast green staining analysis. ELISAs and Western blots were used to detect the expression levels of IL-1β and TNF-α in the serum and cartilage, respectively. The total DNA of the fecal samples was extracted and subjected to high-throughput sequencing of the V3-V4 region of the 16S rRNA gene to analyze the changes in the intestinal flora. In the model group, the cartilage was obviously damaged, the expression levels of IL-1β and TNF-α in the serum and cartilage were increased, and the abundance and diversity of the intestinal flora were decreased. Moxibustion treatment significantly improved the cartilage damage and reduced the concentration of inflammatory factors in the serum and cartilage. The high-throughput sequencing results showed that compared to the model group, the moxibustion treatment regulated some specific species in the intestinal microorganisms rather than the α diversity. In conclusion, our findings suggest that moxibustion treatment may work through two aspects in rats. On one hand, it directly acts on knee cartilage to promote repair, and on the other hand, it regulates the composition of the intestinal flora and reduces the production of inflammatory factors.
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Chen L, Huang Z, Cheng K, Wu F, Deng H, Lin L, Zhao L, Shen X. The efficacy of jade moxibustion in knee osteoarthritis. Medicine (Baltimore) 2020; 99:e19845. [PMID: 32332638 PMCID: PMC7220689 DOI: 10.1097/md.0000000000019845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 03/12/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION This study aims to compare clinical effect between Jade moxibustion and traditional moxibustion, and to determine the clinical effect of Jade moxibustion on knee osteoarthritis (KOA). METHODS/DESIGN This is a 2-parallel-group, randomized controlled trial. A total of 148 subjects with KOA (Kellgren-Lawrence grade II or III) will be recruited and randomized to receive Jade moxibustion treatment or a traditional moxibustion treatment in a 1:1 ratio. Jade moxibustion group: The affected knee of the subjects will be covered with jade kneepad. Traditional moxibustion group: Chosen the ST35, ST34, EX-LE4, SP10 and Ashi points at the affected knee. The subjects will receive treatment three times a week, altogether 12 times in 4 weeks. The main outcomes are WOMAC knee pain score, knee function score and SF-36 quality of life questionnaire changes at the 4th week. Secondary outcomes include WOMAC knee pain score and knee function score, overall clinical efficacy evaluation, medication, safety evaluation at the 2nd, 12th, and 24th week, and cytokines related to osteoarthritis in serum. DISCUSSION This randomized controlled trial used traditional moxibustion as a control group to provide rigorous evidence for the clinical efficacy and safety of Jade moxibustion in treatment of KOA. TRIAL REGISTRATION ISRCTN registry, No 21174552. Registered on 28 February 2020.
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Affiliation(s)
- Lusheng Chen
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine
| | - Zouqin Huang
- Shanghai Pudong New Area Hospital of Traditional Chinese Medicine, Pudong New Area, Shanghai, China
| | - Ke Cheng
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine
- Shanghai Research Center of Acupuncture and Meridian, Shanghai, China
| | - Fan Wu
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine
| | - Haiping Deng
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine
- Shanghai Research Center of Acupuncture and Meridian, Shanghai, China
| | - Lin Lin
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine
| | - Ling Zhao
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine
| | - Xueyong Shen
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine
- Shanghai Research Center of Acupuncture and Meridian, Shanghai, China
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Zhang Q, Fang J, Chen L, Wu J, Ni J, Liu F, Sun J. Different kinds of acupuncture treatments for knee osteoarthritis: a multicentre, randomized controlled trial. Trials 2020; 21:264. [PMID: 32171318 PMCID: PMC7071766 DOI: 10.1186/s13063-019-4034-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 12/29/2019] [Indexed: 01/12/2023] Open
Abstract
Introduction Knee osteoarthritis (KOA) is a chronic disease with symptoms of persistent pain or resting pain, joint stiffness, numbness, limitation of activity and even disability, with significant associated costs and effects on individuals’ life quality. The use of acupuncture for the management of chronic pain is receiving increasing recognition from both the public and professionals. The aim of this study is to identify the effects of three commonly used acupuncture treatments for KOA. Methods/analysis In a prospective trial involving six hospitals in Zhejiang Province (China), 360 patients with KOA will be included. Eligible patients will be randomized into six groups: Acupuncture, Electro-acupuncture, Mild moxibustion, Warm-needling, Sham acupuncture and Celebrex treatment. Twelve treatment sessions will be performed over a 4-week period. The primary outcome will be the visual analogue scale and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function scores (the average of the past 3 days) at weeks 2 and 4 and at 3-month and 6-month follow-up. Secondary outcome measures will be as follows: the WOMAC pain score and WOMAC stiffness score (the average of the past 3 days); the Physical Activity Scale of the Elderly (PASE); knee joint swelling measurement; the WHO Quality Of Life-BREF (WHOQOL-BREF) life quality scale; and the incidence of adverse events. Trial registration ClinicalTrials.gov, NCT03563690. Registered on 2rd July 2018.
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Affiliation(s)
- Qifei Zhang
- The Third Clinical Medical College, Zhejiang Chinese Medical University, No.548 Binwen Rd, Binjiang District, Hangzhou Zhejiang, China
| | - Jianqiao Fang
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, No.548 Binwen Rd, Binjiang District, Hangzhou Zhejiang, China.
| | - Lifang Chen
- Department of Acupuncture, Third Affiliated Hospital of Zhejiang Traditional Chinese Medical University, NO.219 Moganshan Road, Xihu District, Zhejiang, China
| | - Jiayao Wu
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, No.548 Binwen Rd, Binjiang District, Hangzhou Zhejiang, China
| | - Jing Ni
- Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, No.548 Binwen Rd, Binjiang District, Hangzhou Zhejiang, China
| | - Fang Liu
- Department of Acupuncture, Hangzhou Red Cross Hospital, NO.208 Huanchengdong Road, Hangzhou, Zhejiang, China
| | - Jing Sun
- Department of Acupuncture, Third Affiliated Hospital of Zhejiang Traditional Chinese Medical University, NO.219 Moganshan Road, Xihu District, Zhejiang, China
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Wang HY, Xu X, Li L, Ding CY, Lu J, Zhang YY, Zhang YF, Zhang YL, Sun ZQ. Moxibustion therapy in Chinese patients with ankylosing spondylitis: A randomized controlled pilot trial. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.100952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Yu C, Zhang N, Zhu W, Zhang Y, Yang J, Wang Y, Song X, Hu L, Wu Z, Liu Q, Tang Y, Wu Q, Yu S. Does Moxa Smoke Have Significant Effect on the Acupuncturist's Respiratory System? A Population-Based Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:4873235. [PMID: 31636685 PMCID: PMC6766099 DOI: 10.1155/2019/4873235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/27/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To evaluate the safety of moxa smoke, especially to provide quantitative information and details for the occupational prevention of acupuncturists. METHODS We combined the questionnaire-based cross-sectional survey and lung function testing-based historical retrospective cohort research to investigate the safety of moxa smoke exposure (MSE) among acupuncturists. A mathematical regression model was established to quantitatively evaluate the relationship between moxa smoke exposure and the respiratory health of the acupuncturist. The smoke exposure time of the acupuncturist and the prevalence of abnormal respiratory symptoms or diseases were also evaluated. RESULTS (1) The cross-sectional research showed that the incidence of expectoration (18.7%) and rhinitis (22.7%) was the most common respiratory symptom and disease after MSE. No statistical difference was found between smoke exposure time of the acupuncturist and the prevalence of abnormal respiratory symptoms or diseases, except the prevalence of rhinitis and shortness of breath (P < 0.01). Regression model for the incidence of first three symptoms (expectoration, shortness of breath, and wheezing) from the cross-sectional survey indicated that the weight coefficients of factors associated with moxa smoke were lower than those of factors unrelated to moxa smoke, such as gender and personal history of respiratory diseases. (2) Historical retrospective cohort research showed that there was no significant difference in the % predicted PEF. No statistic difference was found between the exposed and nonexposed group in large airway function indexes (% predicted FEV1, % predicted FVC, and % predicted FEV1/FVC) and small airway function indexes (% predicted FEF25, % predicted FEF50, % predicted FEF75, and % predicted MMEF), either. Especially, the % predicted MVV among males (106.23 ± 2.92 vs. 95.56 ± 1.92, P < 0.01 and % predicted VC among females (100.70 ± 1.59 vs. 95.91 ± 1.61, P < 0.05) between the two groups had statistical significance, but did not cause pulmonary ventilation dysfunction. CONCLUSIONS MSE has no significant effect on the respiratory health of acupuncturists.
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Affiliation(s)
- Chang Yu
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Ning Zhang
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Weikang Zhu
- CEMS, NCMIS, MDIS, Academy of Mathematics & Systems Science, Chinese Academy of Sciences, Beijing 100080, China
| | - Yueyue Zhang
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Jiao Yang
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Yong Wang
- CEMS, NCMIS, MDIS, Academy of Mathematics & Systems Science, Chinese Academy of Sciences, Beijing 100080, China
| | - Xiaoge Song
- Acupuncture and Moxibustion College, Anhui University of Traditional Chinese Medicine, Hefei, Anhui 230000, China
| | - Ling Hu
- Acupuncture and Moxibustion College, Anhui University of Traditional Chinese Medicine, Hefei, Anhui 230000, China
| | - Zijian Wu
- Acupuncture and Moxibustion College, Anhui University of Traditional Chinese Medicine, Hefei, Anhui 230000, China
| | - Qi Liu
- Acupuncture and Moxibustion College, Shaanxi University of Traditional Chinese Medicine, Xi'an, Shaanxi 712046, China
| | - Yong Tang
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Qiaofeng Wu
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Shuguang Yu
- Acupuncture and Moxibustion College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
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Jung CY, Cho MJ, Kang HR, Hong SU, Sung WS, Kim EJ. Efficacy and safety of electric heating moxibustion for perennial allergic rhinitis: protocol for a randomized controlled trial. Trials 2019; 20:445. [PMID: 31324214 PMCID: PMC6642592 DOI: 10.1186/s13063-019-3550-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 07/02/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Allergic rhinitis (AR) is an IgE-mediated disease that adversely affects quality of life. Many studies report that moxibustion is an effective treatment for perennial allergic rhinitis (PAR). However, it is difficult to perform moxibustion on the face because of possible burning of the skin and the noxious effects of smoke. Electric heating moxibustion does not have these limitations. The purpose of this clinical trial is to assess the possibility of treating PAR with electric heating moxibustion and to assess the feasibility of conducting a clinical test on a larger scale. METHODS This is a randomized, open-label, assessor-blind, parallel-design pilot clinical study. We will recruit 40 eligible participants and randomly allocate them into an electric heating moxibustion group or an acupuncture group at a 1:1 ratio. Patients in both groups will receive eight treatments over 4 weeks, and the final follow-up will be 4 weeks after the last treatment. Eleven acupuncture points will be used for patients in both groups (EX-HN3 and bilateral EX-HN-8, LI20, LI4, GB20, and ST36). The primary outcome measure is change in the Total Nasal Symptom Score, and the secondary outcome measures are changes in the Rhinoconjunctivitis Quality of Life Questionnaire, nasal endoscopy index for pattern identification, pattern identification questionnaire for AR, total IgE, eosinophil count, and adverse effects. DISCUSSION This clinical trial will examine the effect of electric heating moxibustion on PAR. TRIAL REGISTRATION ClinicalTrials.gov, NCT03342105 . Registered on 14 November 2017.
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Affiliation(s)
- Chan-Yung Jung
- Institute of Oriental Medicine, College of Korean Medicine, Dongguk University, Gyeongju, South Korea
| | - Min-Jin Cho
- College of Korean Medicine, Dongguk University, Gyeonggi-do, South Korea
| | - Ha-Ra Kang
- Department of Acupuncture and Moxibustion, Dongguk University Ilsan Oriental Hospital, Gyeonggi-do, South Korea
| | - Seung-Ug Hong
- Department of Ophthalmology, Otolaryngology and Dermatology, Dongguk University Ilsan Oriental Hospital, Gyeonggi-do, South Korea
| | - Won-Suk Sung
- Department of Acupuncture and Moxibustion, Dongguk University Bundang Oriental Hospital, Gyeonggi-do, South Korea
| | - Eun-Jung Kim
- Department of Acupuncture and Moxibustion, Dongguk University Bundang Oriental Hospital, Gyeonggi-do, South Korea
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Schiphof D, van den Driest JJ, Runhaar J. Osteoarthritis year in review 2017: rehabilitation and outcomes. Osteoarthritis Cartilage 2018; 26:326-340. [PMID: 29330103 DOI: 10.1016/j.joca.2018.01.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 12/14/2017] [Accepted: 01/02/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this systematic review was to describe studies examining rehabilitation for people with osteoarthritis (OA) and to summarize findings from selected key systematic reviews (SRs) and randomized controlled trials (RCTs). DESIGN A systematic search was performed using Pubmed, Embase and Cochrane databases from April 1st 2016 to May 15th 2017 using the terms 'osteoarthritis', 'randomized controlled trial', and 'systematic review'. Inclusion criteria were: clinically or radiologically diagnosed patients with OA, rehabilitation treatment, RCT or SRs. A selection of the included studies is discussed based on study quality and perceived importance to the field; including those that are innovative, inform the direction of the field or generate controversy. Methodological quality of the included studies was assessed using the PEDro-scale for RCTs and the Amstar guideline for SRs. RESULTS From 1211 articles, 80 articles met the eligibility criteria including 21 SRs and 61 RCTs. The median of the methodological quality of the SRs and RCTs was 7 (2-9) and 6 (3-10), respectively. The studies were grouped into several themes, covering the most important rehabilitation fields. CONCLUSIONS Striking is the small number of studies investigating another joint (18%) than the knee (82%). Exercise is the most common treatment evaluated and should be accompanied with education to effectuate a behavioural change in physical activity of people with OA. No new insights in the field of braces (or orthoses) and in the field of acupuncture were found.
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Affiliation(s)
- D Schiphof
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - J J van den Driest
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - J Runhaar
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
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Symptoms of long-term exposure to moxa smoke in acupuncturists: a correlation analysis. J TRADIT CHIN MED 2018. [DOI: 10.1016/j.jtcm.2018.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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