Chuan-zi Dou

Moxibustion and Acupuncture Ameliorate Crohn's Disease by Regulating the Balance between Th17 and Treg Cells in the Intestinal Mucosa

Previous studies have demonstrated that acupuncture is beneficial to patients with Crohns disease (CD), but the mechanism underlying its therapeutic effects remains unclear. To identify the mechanism by which acupuncture treats CD, the balance between Th17 and Treg cells was assessed in CD patients. In this study, Ninety-two CD patients were randomly and equally assigned to a treatment group that were treated with herb-partitioned moxibustion and acupuncture or a control group with wheat bran-partitioned moxibustion and superficial acupuncture. The effect of these treatments on Th17 and Treg cells and their related molecular markers in the intestinal mucosa were detected before (week 0) and after (week 12) treatment. The results suggested that the ratio of Th17 and Treg cells was significantly decreased after treatment and that the levels of IL-17 and RORγt in the intestinal mucosa were obviously reduced, while the expression of FOXP3 was increased after treatment in both groups. In the treatment group, the expression of these molecules was more markedly regulated than the control group. In conclusion, moxibustion and acupuncture have been shown to regulate the ratio of Th17 and Treg cells in the intestinal mucosa of CD patients and restore the balance between these immune cell subsets.

Mechanisms Underlying the Analgesic Effect of Moxibustion on Visceral Pain in Irritable Bowel Syndrome: A Review

Irritable bowel syndrome (IBS) is a functional bowel disorder that causes recurrent abdominal (visceral) pain. Epidemiological data show that the incidence rate of IBS is as high as 25%. Most of the medications may lead to tolerance, addiction and toxic side effects. Moxibustion is an important component of traditional Chinese medicine and has been used to treat IBS-like abdominal pain for several thousand years in China. As a mild treatment, moxibustion has been widely applied in clinical treatment of visceral pain in IBS. In recent years, it has played an irreplaceable role in alternative medicine. Extensive clinical studies have demonstrated that moxibustion for treatment of visceral pain is simple, convenient, and inexpensive, and it is being accepted by an increasing number of patients. There have not been many studies investigating the analgesic mechanisms of moxibustion. Studies exploring the analgesic mechanisms have mainly focused on visceral hypersensitivity, brain-gut axis neuroendocrine system, and immune system. This paper reviews the latest developments in moxibustion use for treatment of visceral pain in IBS from these perspectives. It also evaluates potential problems in relevant studies on the mechanisms of moxibustion therapy to promote the application of moxibustion in the treatment of IBS.

Moxibustion Inhibits the ERK Signaling Pathway and Intestinal Fibrosis in Rats with Crohn’s Disease

Intestinal fibrosis is the main pathological process in Crohns disease (CD); acupuncture and moxibustion can inhibit the process of fibrosis in CD rats, but the regulatory mechanism remains unknown. The present study observed the effect of moxibustion on the extracellular signal-regulated kinase (ERK) signaling pathway in the CD rat. The result shows that the phosphorylation of the Ras, Raf-1, MEK-1, and ERK-1/2 proteins and the expression of the corresponding mRNAs in the colon tissue of CD rat were significantly higher than the normal control group. Both treatments with mild moxibustion and with herb-separated moxibustion significantly reduced the expression of the Ras, Raf-1, MEK-1, and ERK-1/2 proteins and Ras and Raf-1 mRNA. MEK-1 and ERK-1/2 mRNA expression in each treatment group showed a downward trend, and the ERK-1/2 mRNA levels were significantly lower in the mild moxibustion group. It indicates that Ras, Raf-1, MEK-1, and ERK-1/2 are involved in the process of intestinal fibrosis in CD rats. Moxibustion can downregulate the abnormal expression of colonic Ras, Raf-1, MEK-1, and ERK-1/2 protein and mRNA levels in CD intestinal fibrosis in rats. Moxibustion may play a role in the treatment of CD intestinal fibrosis by regulating ERK signaling pathway.

Research Advance in Intestinal Mucosal Barrier and Pathogenesis of Crohn’s Disease

To date, the etiology and pathogenesis of Crohns disease (CD) have not been fully elucidated. It is widely accepted that genetic, immune, and environment factors are closely related to the development of CD. As an important defensive line for human body against the environment, intestinal mucosa is able to protect the homeostasis of gut bacteria and alleviate the intestinal inflammatory and immune response. It is evident that the dysfunction of intestinal mucosa barriers plays a crucial role in CD initiation and development. Yet researches are insufficient on intestinal mucosal barriers action in the prevention of CD onset. This article summarizes the research advances about the correlations between the disorders of intestinal mucosal barriers and CD.

Analysis of the frequency of clinical acupoint use based on ‘Traditional Chinese Medical Acupuncture-moxibustion Information Databank’

The frequencies of use of 361 human acupoints in 74 academic journals of traditional Chinese medicine published between 1949 and 2010 are arranged in order using ‘Traditional Chinese Medical Acupuncture-moxibustion Information Databank’. The frequencies of use are divided into five grades: most frequent use, more frequent use, frequent use, less frequent use and infrequent use. The most frequently used acupoints and infrequently used acupoints are summarized and analyzed to help point selection for clinical acupuncture and selection of acupuncture research projects in the future.

Comparison of Electroacupuncture and Moxibustion for Relieving Visceral Hypersensitivity in Rats with Constipation-Predominant Irritable Bowel Syndrome

Aim. To compare whether there is different effect between electroacupuncture (EA) and moxibustion (Mox) on visceral hypersensitivity (their analgesic effects) in constipation-predominant irritable bowel syndrome (C-IBS). Methods. EA at 1 mA and 3 mA and Mox at 43°C and 46°C were applied to the Shangjuxu (ST37, bilateral) acupoint in rats with C-IBS and normal rats. An abdominal withdrawal reflex (AWR) score was used to assess visceral hypersensitivity. Toluidine blue staining was used to assess mast cell (MC) activity in colon of rats. Immunochemistry was used to measure 5-HT and 5-HT4 receptor expression in the colon. Results. AWR scores in all EA (1 mA and 3 mA) and Mox (43°C and 46°C) treatment groups after colorectal distention (CRD) stimulation pressure of 20, 40, 60, and 80 mmHg were significantly lower than those of the model (MC) group (P all < 0.01). The MC counts and degranulation rates in the colon of all EA and Mox treatment groups and the MC group were significantly higher than those of the NC group (P all < 0.01). MC degranulation rates in the colon of all EA and Mox treatment groups were lower than those of the MC group (P all < 0.05). 5-HT expression in colon of all EA and Mox treatment groups was significantly lower than that of the MC group (P all < 0.01), and 5-HT4R expression in colon of both EA groups was significantly higher than that of the MC group (P both < 0.01). Conclusion. EA and Mox treatments may both ameliorate visceral hypersensitivity at different degree in rats with C-IBS, and EA treatment was better than Mox.

Thinking on functional mechanism of acupuncture for inflammatory bowel diseases based on Metabolomics

Acupuncture has a good therapeutic effect in treatment of inflammatory bowel diseases (IBD), but its functional mechanism has not been systematically explained. Metabolomics is the scientific study of dynamic chemical processes involving metabolites as well as metabolic response of living organisms. Metabolomics, a research method with integrity and dynamics, corresponds to the overall regulatory effect of acupuncture and is in line with the overall concept of traditional Chinese medicine (TCM) and the concept of homeostasis. In the recent years, metabolomics has been extensively applied to the clinical and experimental study of IBD, and its potential applied value has been unanimously acknowledged by the researchers. In this article, the application status of metabolomics in acupuncture is summarized, and the research ideas to study the mechanism of acupuncture in the regulation and control of IBD by metabolomics are preliminarily explored.

Comparative study of electroacupuncture and moxibustion in influencing Tianshu (ST 25) regions mast cells in visceral hyperalgesia rats

ObjectiveTo evaluate and compare electroacupunctures (EA) with different parameters and moxibustion at different temperatures influencing the activation of mast cells (MC) in Tianshu (ST 25) regions of visceral hyperalgesia model rats.MethodsRats (except for model group) respectively accepted 1 mA or 3 mA EA or moxibustion at 43 °C or 4 °C to stimulate Tianshu (ST 25) points after randomization of the fifty visceral hyperalgesia model rats, and then were compared with that in model and normal groups. Number, degranulation numbers, degranulation rates in Tianshu (ST 25) regions MC of rats in each group were observed using toluidine blue staining. Abdominal withdrawl reflex (AWR) score was used to evaluate the rat visceral hyperalgesia reactions.ResultsCompared with the normal group and the model group, MC numbers (P<0.05, P<0.01, P<0.01, P<0.01), degranulation numbers and degranulation rates (P<0.01, P<0.01, P<0.05, P<0.01) of Tianshu (ST 25) MC in regions tissues in 43 °C and 4 °C moxibustion groups, and 1 mA and 3 mA EA groups all increased significantly. Compared with the model group, AWR scores were significantly lower in 43 °C and 4 °C moxibustion groups, and 1 mA and 3 mA EA groups under the stimulation of 20 mmHg, 40 mmHg, 0 mmHg or 80 mmHg colorectal distension (CRD) (P<0.05 in 1 mA and 3 mA EA groups under the stimulation of 20 mmHg, P<0.01 in the other groups). AWR scores in 43 °C and 4 °C oxibustion groups under the stimulation of 20 mmHg, 40 mmHg, 0 mmHg or 80 mmHg CRD were not significantly different from those in the normal group (all P>0.05); AWR scores in 1 mA EA group under the stimulation of 0 mmHg or 80 mmHg were significantly higher than that in the normal group (P<0.01); AWR score in 3 mA EA group under the stimulation of 0 mmHg was significantly higher than that in the normal group (P<0.01), and AWR scores in 3 mA EA group under the stimulation of 20 mmHg or 80 mmHg were also higher than that in the normal group (P<0.05). AWR scores were higher in 1 mA EA group under the stimulation of 40 mmHg or 80 mmHg than that in 4 °C moxibustion group (P<0.05); AWR score was higher in 3 mA EA group under the stimulation of 40 mmHg than that in 4 °C moxibustion group (P<0.05).ConclusionThere are differences among EA of different parameters and moxibustion of different temperatures in activating on Tianshu (ST 25) regions MC of visceral hyperalgesia model rats, as well as in improving the visceral hyperalgesia reaction. The effect of 4 °C moxibustion is the most significant.摘要目的观察并比较不同参数电针和不同温度艾灸对内脏高敏感模型大鼠穴区肥大细胞(mast cells, MC)活化的影响。方法将50 只内脏高敏感模型大鼠随机分组后分别给予1 mA、3 mA电针和43 ℃、4 ℃艾灸刺激天枢穴, 并与模型组和正常大鼠进行对照, 采用甲苯胺蓝染色法观察各组大鼠天枢穴区肥大细胞MC数量、脱颗粒数、脱颗粒率情况, 同时采用腹部撤回反射(abdominalwithdrawl reflex, AWR)评分评价各组大鼠的内脏高敏感反应。结果与正常组和模型组比较, 艾灸43 ℃组、艾灸4 ℃组、电针1 mA组及电针3 mA组大鼠穴区组织MC个数有显著性增加(P<0.05, P<0.01, P<0.01, P<0.01), 大鼠穴区组织MC脱颗粒数和脱颗粒率均有显著性增加 (P<0.01, P<0.01, P<0.05, P<0.01)。与模型组相比, 在20 mmHg、40 mmHg、 0 mmHg、80 mmHg结直肠扩张(colorectal distension, CRD)刺激下, 艾灸43 ℃组、艾灸4 ℃组、电针1 mA组和电针3 mA组的AWR评分均显著降低(20 mmHg刺激下电针1 mA 和电针3 mA组, P<0.05, 其余均P<0.01); 艾灸4 ℃组、艾灸43 ℃组大鼠在CRD刺激强度为20 mmHg、40 mmHg、 0 mmHg、80 mmHg时与正常组的AWR评分均无统计学差异(均P>0.05); 电针1 mA组在 0 mmHg和80 mmHg时AWR评分均显著高于正常组(均P<0.01); 电针3 mA组在 0 mmHg时AWR评分亦显著高于正常组(P<0.01), 在20 mmHg和80 mmHg时亦高于正常组(均P<0.05); 在40 mmHg和80 mmHg时, 电针1 mA组AWR评分高于艾灸4 ℃组(均P<0.05); 电针3 mA组在40 mmHg时AWR评分高于艾灸4 ℃组(P<0.05)。结论不同参数电针和不同温度艾灸刺激对内脏高敏感模型大鼠穴区肥大细胞活化的影响以及改善其内脏高敏感反应存在差异, 其中以4 ℃的艾灸效应最显著。

Effect of moxibustion on expressions of TGF-β and Smad4 in colonic mucosa of rats with intestinal fibrosis in Crohn disease

摘要目的观察艾灸对克罗恩病(Crohn Disease, CD)肠纤维化大鼠结肠转化生长因子-β (Transforming Growth Factor-β, TGF-β)蛋白、 Smad4 蛋白及mRNA 表达的影响, 从TGF-β/Smads 信号途径探讨针灸治疗CD 肠纤维化的作用机制。方法采用雄性清洁级SD 大鼠建立CD 肠纤维化模型, 应用随机的方法, 将大鼠分为正常组、 模型组、 温和灸组、 电针组、 隔药灸组。 正常组和模型组不予任何治疗; 温和灸组、 电针组、 隔药灸组均取天枢、 气海穴, 分别施以温和灸、 电针、 隔药灸治疗。 治疗结束后, 采用免疫组织化学法(Immunohistochemistry, IHC)检测各组大鼠结肠TGF-β 与Smad4 蛋白的表达; 采用荧光定量聚合酶链反应法(Fluorescence Quantitative Polymerase Chain Reaction, FQ-PCR)检测结肠Smad4 mRNA 的表达。结果与正常组比较, 模型组大鼠结肠TGF-β 蛋白、 Smad4 蛋白及mRNA 表达增加(P<0.01)。 经温和灸、 电针、 隔药灸治疗后, 与模型组比较, TGF-β 蛋白、 Smad4 蛋白及mRNA 表达均有不同程度的降低(P<0.01 或P<0.05)。结论CD 肠纤维化大鼠结肠TGF-β 蛋白、 Smad4 蛋白及mRNA 表达显著增多, 温和灸、 电针、 隔药灸天枢和气海穴均可下调CD 肠纤维化大鼠结肠TGF-β 蛋白、 Smad4 蛋白及mRNA 的异常表达。AbstractObjectiveTo observe the effect of moxibustion on the expressions of transforming growth factor-β (TGF-β) protein, and Smad4 protein and mRNA in rats with intestinal fibrosis in Crohn disease (CD), and to discuss the action mechanism of acupuncture-moxibustion in treating intestinal fibrosis in CD from the perspective of TGF-β/Smads signal pathway.MethodsA CD intestinal fibrosis model was developed by using male SD rats of clean grade. The rats were randomized into a normal group, a model group, a mild moxibustion group, an electroacupuncture (EA) group, and a herb-partitioned moxibustion group. The rats in the normal and the model groups did not receive any interventions. Tianshu (ST 25) and Qihai (CV 6) were selected for the rats in the mild moxibustion group, the EA group, and the herb-partitioned moxibustion group. Mild moxibustion, EA, and herb-partitioned moxibustion were given respectively. After treatment, the expressions of TGF-β and Smad4 proteins in rat’s colon were detected by using immunohistochemistry (IHC); the expression of Smad4 mRNA was determined by using fluorescence quantitative polymerase chain reaction (FQ-PCR).ResultsCompared with the normal group, the expressions of TGF-β protein, Smad4 protein and Smad4 mRNA significantly increased in the model group (P<0.01). Compared with the model group, the expressions of TGF-β protein, Smad4 protein, and Smad4 mRNA dropped markedly (P<0.01 or P<0.05) after treatments of mild moxibustion, EA, and herb-partitioned moxibustion.ConclusionThe expressions of TGF-β protein, Smad4 protein and Smad4 mRNA significantly increase in CD rats with intestinal fibrosis; while mild moxibustion, EA and herb-partitioned moxibustion at Tianshu (ST 25) and Qihai (CV 6) all can down-regulate the abnormal expressions.

Effects of Herb-Partitioned Moxibustion on the miRNA Expression Profiles in Colon from Rats with DSS-Induced Ulcerative Colitis

Objective. This study explored the mechanism of herb-partitioned moxibustion (HM) on dextran sulfate sodium- (DSS-) induced ulcerative colitis (UC) from the miRNA perspective. Methods. Rats were randomly divided into 3 groups [normal control (NC) group, UC model (UC) group, and herb-partitioned moxibustion (UCHM) group]. The UC and UCHM groups were administered 4% DSS for 7 days. The UCHM group received HM at the Tianshu (bilateral, ST25). The effect of HM on UC was observed and the miRNA expression profile in the colon tissues was analyzed. Results. Compared with the UC group, the body weights were significantly higher in the UCHM group on day 14 (P < 0.001); the macroscopic colon injury scores and microscopic histopathology scores in the UCHM group decreased (P < 0.05); and there were 15 differentially expressed miRNAs in the UCHM group. The changes in miR-184 and miR-490-5p expression levels on the UC were reversed by HM intervention. Validation using qRT-PCR showed that two miRNAs expression trend was consistent with the sequencing results. Conclusion. HM at ST25 might regulate miR-184 and miR-490-5p expression, act on the transcription of their target genes to regulate inflammatory signaling pathways, and attenuate inflammation and tissue injury in the colons of rats with DSS-induced UC.