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基于“热证可灸”探讨不同悬灸方法对类风湿关节炎热证大鼠证候特征的影响

[Effect of different suspension moxibustion methods on syndrome characteristics of rats with rheumatoid arthritis of heat syndrome based on "moxibustion can be used for heat syndrome"].

作者信息

Zhao Zhong-Ting, Zhao Yi-Kun, Chen Jia-Lian, Zhu Tian-Tian, Yan Xing-Ke, Zhang Yan-Feng

机构信息

College of Acupuncture-Moxibustion and Tuina, Gansu University of CM, Lanzhou 730101, China.

出版信息

Zhongguo Zhen Jiu. 2023 Sep 12;43(9):1062-9. doi: 10.13703/j.0255-2930.20220807-0001.

DOI:10.13703/j.0255-2930.20220807-0001
PMID:37697883
Abstract

OBJECTIVE

To observe the effects of different suspension moxibustion methods on the syndrome characteristics and inflammatory factors of rats with rheumatoid arthritis (RA) of heat syndrome and to prove the concept of "moxibustion can be used for heat syndrome".

METHODS

Among seventy Wistar rats, 12 rats were randomly selected as a normal group, and the remaining rats were induced by collagen combined with wind, dampness, and heat environmental stimulation to establish the RA model of heat syndrome. Forty-eight rats with successful model establishment were further randomly divided into a model group and three moxibustion groups (mild moxibustion group, rotating moxibustion group and sparrow-pecking moxibustion group), with 12 rats in each group. The acupoints "Quchi" (LI 11), "Dazhui" (GV 14) and point were used in all moxibustion groups, with mild moxibustion, rotating moxibustion, and sparrow-pecking moxibustion intervention given respectively, each acupoint was treated with moxibustion for 10 min a day, and 6 days were considered one course of treatment, with a total of three courses. After the intervention, the arthritis index (AI), the Evans blue (EB) extravasated volume in the soft tissue of the right hind paw, and the levels of tumor necrosis factor (TNF)-α and interleukin (IL)-10 in the serum were measured by ELISA in each group. The volume of the bilateral hind paw was measured; the infrared thermal imaging was collected to analyze the temperature of the plantar area of the bilateral foot pads, and the reaction time of plantar heat pain was calculated before and after modeling, as well as after the 1st, 2nd and 3rd courses of interrention. The ankle dorsiflexion angle of the right hind foot was also measured before and after modeling, as well as after the intervention.

RESULTS

After modeling, compared with the normal group, the rats in the model group had more high-temperature areas in the bilateral hind limbs, abnormal AI score, abnormal bilateral hind paw volume, abnormal temperature of the plantar area of the bilateral foot pads, abnormal foot pain response time, abnormal right hind ankle dorsiflexion angle, abnormal right hind paw soft tissue EB extravasation, and abnormal serum TNF-α and IL-10 levels (<0.01, <0.05). After the intervention, compared with the model group, the rats in each moxibustion group had decreased or disappeared high-temperature areas in the bilateral hind limbs, EB extravasated volume in the soft tissue of the right hind paw was reduced (<0.05), and the right ankle dorsiflexion angle was increased (<0.05), serum level of TNF-α was reduced, and level of IL-10 increased (<0.05); the AI scores in the mild moxibustion group and the sparrow-pecking moxibustion group was decreased (<0.01, <0.05). After the 1st, 2nd and 3rd courses of intervention, compared with the model group, the bilateral hind paw volume of rats in each moxibustion group was decreased (<0.05, <0.01), and plantar heat pain reaction time was increased (<0.05). After the 2nd course and the 3rd course of intervention, the temperature of the right hind paw pad area was decreased in each moribustion group (<0.05); after the 3rd courses of intervention, the temperature of the left hind paw pad area was decreased in the mild moxibustion group (<0.05).

CONCLUSION

Suspension moxibustion could adjust the serum levels of TNF-α and IL-10 to improve the syndrome characteristics of RA rats of heat syndrome, such as joint redness, swelling, heat, pain and activity restriction. The effect of mild moxibustion is the most prominent. The findings could provide scientific basis for "moxibustion can be used for heat syndrome".

摘要

目的

观察不同悬灸方法对类风湿关节炎(RA)热证大鼠证候特征及炎症因子的影响,验证“热证可灸”的观点。

方法

将70只Wistar大鼠,随机选取12只为正常组,其余大鼠采用胶原联合风、湿、热环境刺激诱导建立RA热证模型。将造模成功的48只大鼠进一步随机分为模型组和3个艾灸组(温和灸组、回旋灸组、雀啄灸组),每组12只。各艾灸组均选取“曲池”(LI 11)、“大椎”(GV 14)等穴位,分别给予温和灸、回旋灸、雀啄灸干预,每日每个穴位艾灸10分钟,6天为1个疗程,共3个疗程。干预后,每组采用ELISA法检测关节炎指数(AI)、右后爪软组织伊文思蓝(EB)渗出量及血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-10水平;测量双侧后爪体积;采集红外热成像分析双侧足垫跖面温度,并计算造模前、造模后及干预第1、2、3疗程后足底热痛反应时间;测量造模前、干预后右后足踝关节背屈角度。

结果

造模后,与正常组比较,模型组大鼠双侧后肢高温区域增多,AI评分异常,双侧后爪体积异常,双侧足垫跖面温度异常,足痛反应时间异常,右后踝关节背屈角度异常,右后爪软组织EB渗出异常,血清TNF-α、IL-10水平异常(P<0.01,P<0.05)。干预后,与模型组比较,各艾灸组大鼠双侧后肢高温区域减少或消失,右后爪软组织EB渗出量减少(P<0.05),右踝关节背屈角度增大(P<0.05),血清TNF-α水平降低,IL-10水平升高(P<0.05);温和灸组和雀啄灸组AI评分降低(P<0.01,P<0.05)。干预第1、2、3疗程后,与模型组比较,各艾灸组大鼠双侧后爪体积减小(P<0.05,P<0.01),足底热痛反应时间延长(P<0.05)。干预第2、3疗程后,各艾灸组右后爪垫区温度降低(P<0.05);干预第3疗程后,温和灸组左后爪垫区温度降低(P<0.05)。

结论

悬灸可调节血清TNF-α、IL-10水平,改善RA热证大鼠关节红肿热痛、活动受限等证候特征,其中温和灸效果最为显著。本研究结果可为 “热证可灸” 提供科学依据。

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