Huangan Wu

Suspended moxibustion relieves chronic visceral hyperalgesia via serotonin pathway in the colon

Experiments in rats have shown that chronic visceral hyperalgesia can be relieved by electro-acupuncture, but the efficacy of suspended moxibustion for relieving chronic visceral hyperalgesia is still unclear. The present study aimed to evaluate the effect of suspended moxibustion on rectal sensory thresholds and to analyze its possible mechanisms when treating chronic visceral hypersensitivity rats. Suspended moxibustion was administered once daily to 37-day-old chronic visceral hypersensitivity rats for 7 days. The two acupoints (ST25, bilateral) were simultaneously given suspended moxibustion. Each treatment lasted for 15 min. Rats in treatment of suspended moxibustion was not anesthetized. Untreated chronic visceral hypersensitivity rats and normal rats were used as controls. The abdominal withdrawal reflex was determined during 30-90 min after the first treatment. A 5-cm long segment of distal colon was harvested after seven treatments and 5-hydroxytryptamine concentrations in the colon were assayed by enzyme-linked immunosorbent assay. Abdominal withdrawal reflex scores from the rectus abdominis in response to colorectal distention were increased in rats with chronic visceral hypersensitivity, and the stimulation at strength of 20 mmHg was significantly depressed by suspended moxibustion. Suspended moxibustion increased the pain threshold and restored normal sensitivity by reducing 5-hydroxytryptamine concentrations in the colon of chronic visceral hypersensitivity rats.

Electroacupuncture and moxibustion promote neutrophil apoptosis and improve ulcerative colitis in rats.

The purpose of this study was to investigate the effect of electroacupuncture (EA) and moxibustion on promoting neutrophil apoptosis. A rat model of ulcerative colitis was established by immunological methods using human colonic mucosa as antigen. All rats were randomly assigned to the model control (MC) group, EA group, or herbs-partition moxibustion (HPM) group. Normal rats were used as the normal control (NC) group. Peripheral blood mononuclear cells (PBMCs) from all rats and circular neutrophils from NC rats were isolated and cultured. Circular neutrophils were incubated with cultured supernatants of PBMCs from the MC, NC, EA, and HPM groups, respectively. Neutrophil apoptosis and concentration of IL-1β, IL-6, and TNF-α from induced cultured supernatants were detected by cell cytometry and ELISA, respectively. Compared with MC, HPM, and EA rats, mucosal inflammatory lesions abated remarkably. No hyperemia or edema was seen in the lamina propia, inflammatory cell infiltration decreased, neutrophil infiltration disappeared, and epithelial and crypt cells proliferated and repaired the ulceration of the mucosa. Neutrophil apoptosis was promoted. Concentrations of IL-1β, IL-6, and TNF-α were decreased, respectively. We conclude that EA and HPM therapy can improve ulcerative colitis rats histologically, which may be due to promoting neutrophil apoptosis and down-regulating monocyte cytokines. EA and moxibustion are effective for treating ulcerative colitis.

Moxibustion inhibits interleukin-12 and tumor necrosis factor alpha and modulates intestinal flora in rat with ulcerative colitis

AIM To investigate the effect of moxibustion on intestinal flora and release of interleukin-12 (IL-12) and tumor necrosis factor-α (TNF-α) from the colon in rat with ulcerative colitis (UC). METHODS A rat model of UC was established by local stimulation of the intestine with supernatant from colonic contents harvested from human UC patients. A total of 40 male Sprague-Dawley rats were randomly divided into the following groups: normal (sham), model (UC), herb-partition moxibustion (HPM-treated), and positive control sulfasalazine (SA-treated). Rats treated with HPM received HPM at acupuncture points ST25 and RN6, once a day for 15 min, for a total of 8 d. Rats in the SA group were perfused with SA twice a day for 8 d. The colonic histopathology was observed by hematoxylin-eosin. The levels of intestinal flora, including Bifidobacterium, Lactobacillus, Escherichia coli (E. coli), and Bacteroides fragilis (B. fragilis), were tested by real-time quantitative polymerase chain reaction to detect bacterial 16S rRNA/DNA in order to determine DNA copy numbers of each specific species. Immunohistochemical assays were used to observe the expression of TNF-α and IL-12 in the rat colons. RESULTS HPM treatment inhibited immunopathology in colonic tissues of UC rats; the general morphological score and the immunopathological score were significantly decreased in the HPM and SA groups compared with the model group [3.5 (2.0-4.0), 3.0 (1.5-3.5) vs 6.0 (5.5-7.0), P < 0.05 for the general morphological score, and 3.00 (2.00-3.50), 3.00 (2.50-3.50) vs 5.00 (4.50-5.50), P < 0.01 for the immunopathological score]. As measured by DNA copy number, we found that Bifidobacterium and Lactobacillus, which are associated with a healthy colon, were significantly higher in the HPM and SA groups than in the model group (1.395 ± 1.339, 1.461 ± 1.152 vs 0.045 ± 0.036, P < 0.01 for Bifidobacterium, and 0.395 ± 0.325, 0.851 ± 0.651 vs 0.0015 ± 0.0014, P < 0.01 for Lactobacillus). On the other hand, E. coli and B. fragilis, which are associated with an inflamed colon, were significantly lower in the HPM and SA groups than in the model group (0.244 ± 0.107, 0.628 ± 0.257 vs 1.691 ± 0.683, P < 0.01 for E. coli, and 0.351 ± 0.181, 0.416 ± 0.329 vs 1.285 ± 1.039, P < 0.01 for B. fragilis). The expression of TNF-α and IL-12 was decreased after HPM and SA treatment as compared to UC model alone (4970.81 ± 959.78, 6635.45 ± 1135.16 vs 12333.81 ± 680.79, P < 0.01 for TNF-α, and 5528.75 ± 1245.72, 7477.38 ± 1259.16 vs 12550.29 ± 1973.30, P < 0.01 for IL-12). CONCLUSION HPM treatment can regulate intestinal flora and inhibit the expression of TNF-α and IL-12 in the colon tissues of UC rats, indicating that HPM can improve colonic immune response.

Acupuncture and Moxibustion for Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background. Inflammatory bowel diseases (IBD) are recurrent and refractory which include ulcerative colitis (UC) and Crohns disease (CD). Clinical researches about acupuncture and moxibustion treatments for IBD are increasing, while systematic reviews about their efficacy remains in a shortage. This study sought to evaluate the efficacy of acupuncture and moxibustion for IBD. Methods. Seven significant databases both in and abroad were searched for randomized controlled trials (RCTs) which compared acupuncture and moxibustion as the main intervention to pharmacotherapy in treating IBD. A meta-analysis was performed. Results. A total of 43 RCTs were included. Among the 43 included trials, 10 trials compared oral sulphasalazine (SASP) with acupuncture and/or moxibustion treatments. A meta-analysis of the 10 trials indicated that acupuncture and moxibustion therapy was superior to oral SASP. Conclusion. Acupuncture and moxibustion therapy demonstrates better efficacy than oral SASP in treating IBD. However, given the limitations of this systematic review and the included literature, definitive conclusions regarding the exact efficacy of acupuncture and moxibustion treatment for IBD cannot be drawn. Extant RCTs still cannot provide sufficient evidence and multicentre, double-blind RCTs with large sample sizes are needed to provide higher-quality evidence.

Moxibustion activates mast cell degranulation at the ST25 in rats with colitis

AIM To investigate the effects of moxibustion on the morphology and function of mast cells (MC) at Tianshu (ST25) in rats with trinitro-benzene-sulfonic acid (TNBS)-induced colitis. METHODS A total of 53 male Sprague-Dawley rats were randomly divided into a normal group and experimental group. In the experimental group, a rat model of TNBS-induced colitis was established, and the rats were then randomly divided into a model group, moxibustion group, moxibustion plus disodium cromoglycate (M + DC) group and moxibustion plus normal saline (M + NS) group. Rats in the moxibustion group received suspended moxibustion at bilateral ST25 for 10 min, once a day for 7 d. Rats in the M + DC and M + NS groups were pretreated with disodium cromoglycate and normal saline at bilateral ST25, respectively, and were then concurrently subjected to the same treatment as rats in the moxibustion group. The hematoxylin-eosin staining method was used to observe histology of the colon and the toluidine blue-improved method was used to observe mast cells at ST25 acupoint areas. RESULTS An improvement in colonic injury in the moxibustion group was observed and the degranulation ratio of MC at ST25 acupoint was markedly higher in the moxibustion group than in the model group (45.91 ± 11.41 vs 32.58 ± 8.28, P < 0.05). After inhibition of degranulation of MC at ST25 by disodium cromoglycate, no improvement in colon tissue injury was observed. CONCLUSION Moxibustion exerted its effect on healing impaired colonic mucosa in rats with TNBS-induced colitis by increasing the degranulation ratio of local MC, but had little effect on the morphology of MC at ST25 acupoint.

Herb-partition moxibustion relieves chronic visceral hyperalgesia and 5-HT concentration in colon mucosa of rats.

Abstract Objective: The aim of this study was to evaluate the effect of herb-partition moxibustion on rectal sensory thresholds and to analyse possible mechanism of herb-partition moxibustion in treating chronic visceral hypersensitivity rats. Methods: Herb-partition moxibustion was administered to chronic visceral hypersensitivity rats for 7 days (once daily). Two moxa cylinders were used for each point in one treatment. Chronic visceral hypersensitivity rats without herb-partition moxibustion and normal rats were chosen as the control groups. Detection of abdominal withdrawal reflex was performed during 30–90 minutes after the first treatment. After seven treatments, a segment of distal colon (5 cm in length) was harvested, and 5-hydroxytryptamine concentration in the colon tissue was detected by enzyme-linked immunosorbent assay. Results: Herb-partition moxibustion significantly depressed abnormally increased AWR scores from the rectus abdominis in response to colorectal distention stimulation at strengths of 40 and 60 mmHg. Herb-partition moxibustion decreased 5-hydroxytryptamine concentration in colon tissue of chronic visceral hypersensitivity rats. Conclusion: Herb-partition moxibustion enhances the pain threshold of chronic visceral hypersensitivity rats and restores normal sensitivity by 5-hydroxytryptamine concentration decreased in the colon tissue. However, whether herb-partition moxibustion could enhance the pain threshold of IBS patients or not is not concluded in this study because of only small sample rats experiment.

Bibliometric analysis of diseases spectrum of moxibustion therapy

摘要目的对1954 至2007 年间有关灸法的针灸论文进行文献计量分析与评价, 以期客观地反映灸法的疾病谱及适宜病症。方法根据《中国现代针灸信息数据库》中的数据, 采用文献计量分析方法进行统计。结果和结论灸法疾病谱涉及364 种病症。 灸法适宜病症为胎位不正、 腹泻、 结肠炎。 常用适宜病症为尿失禁、 痛经。 次常用适宜病症为膝骨关节炎、 颞下颌关节综合征、 软组织损伤、 足跟痛、 哮喘、 尿潴留、 带状疱疹。 灸法疾病谱随着时间的变化也在不断变化。AbstractObjectiveTo make a bibliometric analysis and evaluation of acupuncture-moxibustion papers on moxibustion therapy published from 1954 to 2007, thus to reflect the diseases spectrum of moxibustion therapy and proper indications of moxibustion therapy objectively.MethodsStatistics were taken by a bibliometric analysis of the data from China Modern Acupuncture-moxibustion Information Databank.Results and ConclusionThe diseases spectrum of moxibustion therapy has 364 kinds of diseases. The most proper indications of moxibustion therapy are malposition, diarrhea, and colitis. The common proper indications are urinary incontinence and dysmenorrhea. The next common proper indications are knee osteoarthritis, temporomandibular joint disturbance syndrome, soft tissue injury, heel pain, asthma, urinary retention and herpes zoster. Diseases spectrum of moxibustion therapy varies with time.

Electro-acupuncture relieves visceral sensitivity and decreases hypothalamic corticotropin-releasing hormone levels in a rat model of irritable bowel syndrome

Previous studies into electro-acupuncture (EA) treatment of irritable bowel syndrome (IBS) have principally focused on the peripheral effects of EA in a rat model of IBS. It is not known whether EA exerts central effects in this rat model. We have examined the effects of EA on hypothalamic corticotropin-releasing hormone (CRH) levels in a rat model of IBS provoked by colorectal distension (CRD) and forelimb immobilization. EA was administered once daily to IBS model rats over a period of 7 d; untreated IBS rats and controls were also studied. The behavioral response to distension was rated according to the abdominal withdrawal reflex (AWR) score; hypothalamic CRH levels were measured by radioimmunoassay. We report that EA treatment significantly decreased visceral sensitivity to CRD in this rat model. In treated animals, EA also decreased hypothalamic CRH to control levels. Reduced hypothalamic CRH levels may mediate the beneficial effects of EA in this rat IBS model.

Moxibustion down-regulates colonic epithelial cell apoptosis and repairs tight junctions in rats with Crohn’s disease

AIM To investigate the effects of moxibustion on down-regulation of the colonic epithelial cell apoptosis and repair of the tight junctions in rats with Crohns disease (CD). METHODS Sixty male Sprague-Dawley rats were randomly divided into a normal control (NC) group, a model control (MC) group, an herbs-partitioned moxibustion (HPM) group, a mild-warm moxibustion (MWM) group and a salicylazosulphapyridine (SASP) group, with 12 rats in each group. The CD model rats were treated with trinitrobenzene sulphonic acid to induce intestinal inflammation. The rats in the HPM and MWM groups were treated at the Tianshu (ST25) and Qihai (CV6) acupoints once daily for 14 d, and the SASP group was fed SASP twice daily for 14 d. No additional treatment was given to the MC and NC groups. The microstructure of the colonic epithelium was observed under a transmission electron microscope, the transepithelial resistance was measured using a short-circuit current, colonic epithelial cell apoptosis was determined by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labelling assay, and the expression of occludin, claudin-1 and zonula occludens-l (ZO-1) in the colonic epithelial junction was determined by Western blotting and immunofluorescence staining. RESULTS Compared with the MC group, the microstructure of the colonic epithelial barrier was significantly improved in rats treated with HPM, MWM or SASP, meanwhile, the current flow was reduced significantly, with values of 168.20 ± 6.14 vs 99.70 ± 3.13, 99.10 ± 4.28 and 120.30 ± 3.65 mA, respectively (P = 0.001). However, the HPM and MWM groups had higher current flow rates than the SASP group (99.70 ± 3.13, 99.10 ± 4.28 vs 120.30 ± 3.65 mA, P = 0.001). The number of the apoptotic colonic epithelial cells in HPM, MWM and SASP groups was largely reduced (61.5 ± 16.91 vs 15.5 ± 8.89, 14.8 ± 6.27 and 24.7 ± 9.68, respectively (P = 0.001); and the expression of occludin, claudin-1 and ZO-1 in the MWM and HPM groups was significantly enhanced (0.48 ± 0.10, 0.64 ± 0.09 vs 0.18 ± 0.05 for occludin, 0.12 ± 0.02, 0.17 ± 0.03 vs 0.05 ± 0.01 for claudin-1, and 0.08 ± 0.01, 0.11 ± 0.01 vs 0.02 ± 0.01 for ZO-1). And in SASP group, the expression of occludin and ZO-1 was also significantly increased (0.27 ± 0.04 vs 0.18 ± 0.05 for occludin and 0.05 ± 0.01 vs 0.02 ± 0.01 for ZO-1), but there was no significant difference for claudin-1. The HPM and MWM groups had higher expression of occludin, claudin-1 and ZO-1 than the SASP group. CONCLUSION HPM and MWM treatment can down-regulate apoptosis of colonic epithelial cells, repair tight junctions and enhance colonic epithelial barrier function in rats with CD.

Moxibustion combined with acupuncture increases tight junction protein expression in Crohn’s disease patients

AIM To investigate the effect of herb-partitioned moxibustion combined with acupuncture on the expression of intestinal epithelial tight junction (TJ) proteins. METHODS Sixty patients diagnosed with mild to moderate Crohns disease (CD) were allocated into the herb-partitioned moxibustion combined with acupuncture (HMA) group (n = 30) or the mesalazine (MESA) group (n = 30) using a parallel control method. There were 2 sets of acupoints used alternately for HMA treatment. The following points were included in Set A: ST25 (Tianshu), RN6 (Qihai), and RN9 (Shuifen) for herb-partitioned moxibustion and ST36 (Zusanli), ST37 (Shangjuxu), LI11 (Quchi), and LI4 (Hegu) for acupuncture. The points for Set B included BL23 (Shenshu) and BL25 (Dachangshu) for herb-partitioned moxibustion and EX-B2 of T6-T1 (Jiajixue) for acupuncture. The patients received the same treatment 6 times a week for 12 consecutive weeks. The MESA group received 1 g of mesalazine enteric coated tablets 4 times daily for 12 consecutive weeks. Intestinal tissues were stained and examined to compare the morphological and ultrastructural changes before and after the treatment session. Immunohistochemistry and in situ hybridization assays were used to detect the expression of intestinal epithelial TJ proteins zonula occludens-1 (ZO-1), occludin, and claudin-1. The mRNA levels were also evaluated. RESULTS After the treatment, both herb-partitioned moxibustion combined with acupuncture and mesalazine improved intestinal morphology and ultrastructure of CD patients; the patients treated with HMA showed better improvement. HMA significantly increased the expression of ZO-1 (P = 0.000), occludin (P = 0.021), and claudin-1 (P = 0.016). MESA significantly increased the expression of ZO-1 (P = 0.016) and occludin (P = 0.026). However, there was no significant increase in the expression of claudin-1 (P = 0.935). There was no statistically significant difference between the two groups for the expression of occludin and claudin-1 (P > 0.05). The HMA group showed a significant improvement in ZO-1 expression compared to the MESA group (2333.34 ± 352.51 vs 2160.38 ± 307.08, P = 0.047). HMA significantly increased the expression of ZO-1 mRNA (P = 0.000), occludin mRNA (P = 0.017), and claudin-1 mRNA (P = 0.017). MESA significantly increased the expression of ZO-1 mRNA (P = 0.000), occludin mRNA (P = 0.042), and claudin-1 mRNA (P = 0.041). There was no statistically significant difference between the two groups in the expression of occludin and claudin-1 mRNA (P > 0.05). However, the HMA group showed a significant improvement in ZO-1 mRNA expression compared with the MESA group (2378.17 ± 308.77 vs 2200.56 ± 281.88, P = 0.023). CONCLUSION HMA can repair intestinal epithelial barrier lesions and relieve inflammation by upregulating the expression of TJ proteins and their mRNAs.