Effect of direct moxibustion on blood pressure and clinical symptoms in elderly patients with essential hypertension

Objective

To assess the effects of direct moxibustion on 24-hour ambulatory blood pressure (ABP) and clinical symptoms of traditional Chinese medicine (TCM) in elderly patients with essential hypertension, and to explore the antihypertensive effect and influencing factors of moxibustion.

Methods

A total of 101 elderly hypertension patients who met the inclusion criteria were randomly assigned to a direct moxibustion I group (n=33), a direct moxibustion II group (n=34), and a control group (n=34). The treatment of calcium antagonist (CCB) or angiotensin II receptor antagonist (ARB) was adopted in the control group. The treatment of direct moxibustion I plus the same medicine as the control group were adopted in the direct moxibustion I group, five cones per acupoint and three times per week, for 5 weeks in total. The treatment of direct moxibustion II plus the same medicine as the control group were adopted in the direct moxibustion II group, five cones per acupoint and three times per week, for 5 weeks in total. The changes of 24-hour ABP and clinical symptoms of TCM after treatment were compared in the three groups.

Results

The mean 24-hour ambulatory systolic blood pressure (mean 24 h ASBP), night ASBP, percentage of mean 24-hour ambulatory diastolic blood pressure (mean 24 h ADBP)>90 mmHg, and percentage of day ADBP>90 mmHg in the control group were elevated after treatment (P<0.05). The percentage of night ADBP>80 mmHg in the direct moxibustion I group was reduced by treatment (P<0.01). There were no significant differences in the other outcome measures of 24 h ABP, such as day ASBP, percentage of mean 24 h ASBP>140 mmHg, percentage of day ASBP>140 mmHg, percentage of night ASBP>120 mmHg, mean 24 h ADBP, day ADBP, night ADBP, 24 h ambulatory pulse pressure (APP), after treatment in all groups (P>0.05). The degree of improvement of the clinical symptoms of TCM showed significant differences among the three groups of patients (P<0.01). The total effective rate in the direct moxibustion I group was 73.3%, which was superior to those in the direct moxibustion II group and control group (13.3% and 10.0%, respectively).

Conclusion

The direct moxibustion has benign regulative effect on blood pressure of elderly patients with essential hypertension, and improves their clinical symptoms. The direct moxibustion method I (burning the next moxa cone after the previous one had totally burnt out) was superior to method II (burning the next moxa cone when the previous one had not totally burnt out ) in lowering blood pressure and improving symptoms of elderly patients with essential hypertension.

     

Influence of moxa smoke on mitochondrial transmembrane potential and Bax/Bcl-2 in alveolar type II epithelial A549 cells

Objective

To investigate the influence of moxibustion products on mitochondrial transmembrane potential (MTP) and mRNA expression of Bax/Bcl-2 in alveolar type II epithelial A549 cells, and to further explore influence of moxibustion products on the oxidative damage of A549 cells.

Methods

Smoke and particles generated by moxibustion were collected using the filter box for gas sampling. The moxa smoke extract (MSE) was diluted sequentially to the final concentrations of 0.05 mg/mL, 0.1 mg/mL, 0.2 mg/mL, 0.3 mg/mL and 0.4 mg/mL using the cell culture medium, and A549 cells were then intervened by the above MSE solution. Cell MTP was detected by JC-1 staining. Fluorescence quantitative polymerase chain reaction (PCR) was used to detect Bax/Bcl-2 mRNA expression of A549 cells.

Results

Compared with cells in the normal control group, MTP was significantly decreased in cells of 0.3 mg/mL and 0.4 mg/mL MSE intervention groups (P<0.01); while MTP showed no significant changes in cells of 0.05 mg/mL, 0.1 mg/mL and 0.2 mg/mL MSE intervention groups (P>0.05); compared with cells in 0.05 mg/mL MSE intervention group, MTP was decreased significantly in cells of 0.1 mg/mL, 0.2 mg/mL, 0.3 mg/mL and 0.4 mg/mL MSE intervention groups (P<0.05 ); compared with cells in 0.1 mg/mL MSE intervention group, MTP was decreased significantly in cells of 0.4 mg/mL MSE intervention group (P<0.01). Bax mRNA expression of cells in each concentration of MSE intervention group all showed no significant difference compared to that in the normal control group; Bcl-2 mRNA expression of cells was reduced with the increase of MSE intervention concentration. Wherein, Bcl-2 mRNA expressions of cells in 0.4 mg/mL and 0.3 mg/mL MSE intervention groups were significantly reduced compared with that of cells in the normal control group (P<0.05); Bcl-2 mRNA expression of cells in 0.4 mg/mL MSE intervention group was significantly reduced compared to that in 0.05 mg/mL MSE intervention group (P<0.05).

Conclusion

Certain higher concentration of moxa smoke could reduce MTP and mRNA expression of the anti-apoptosis gene Bcl-2 in alveolar type II epithelial A549 cells. Oxidative damage may be the important mechanism of apoptosis caused by the high concentration of moxa smoke solution, and further studies are necessary on the specific mechanisms.

     

艾灸调节炎症性肠病的模式识别受体及信号转导思路与方法

机体免疫功能的异常是炎症性肠病发病的机理之一，艾灸疗法可通过调节机体免疫功能实现对炎症性肠病的防治作用。本文从肠道菌群失调在炎症性肠病发病中的作用、模式识别受体与炎症性肠病的关系、模式识别受体信号转导途径及艾灸调整机体免疫功能的优势等几方面进行论述，认为肠道菌群失调、模式识别受体及其信号转导通路对炎症性肠病的发生发展具有重要意义，采用微生物学和免疫学等现代科学技术，研究艾灸对模式识别受体及其信号转导通路的影响是深入阐释艾灸治疗炎症性肠病作用机理的重要途径。     

周楣声灸法思想探析

周楣声在灸法的传承与创新、研究与临床应用等方面造诣深厚,现将其在灸法理论、灸法临床、灸法器具方面的主要学术思想总结如下。     

针灸治疗胃肠疾病的实验研究文献计量分析与数据挖掘

目的：统计分析2016—2020年期间发表的针灸治疗胃肠疾病的实验研究文献,总结归纳针灸治疗胃肠道疾病的主要研究方向与进展。方法：检索国家知识基础设施数据库（CNKI）、中国学术期刊数据库（CSPD）、中文科技期刊数据库（CCD）、Pubmed及Web of Science数据库,根据纳入与排除标准筛选针灸治疗胃肠疾病的实验研究文献,并对结果进行计量统计分析。结果：近5年来针灸治疗功能性胃肠疾病的实验研究以肠易激综合征与功能性消化不良为主,器质性胃肠病则是以溃疡性结肠炎为主。电针和灸法是针灸治疗胃肠疾病的主要方法,功能性胃肠病以电针干预为主,器质性胃肠病以灸法为主。足三里、天枢、上巨虚、中脘是针灸治疗胃肠疾病的主要穴位。功能性胃肠疾病的针灸实验研究侧重于胃肠动力、内脏高敏感、情绪相关机制,器质性胃肠疾病的针灸实验研究侧重于炎症与免疫相关机制。结论：近5年针灸治疗功能性胃肠疾病实验以电针干预为主,侧重于胃肠动力、内脏高敏感、情绪相关机制研究;器质性胃肠病的针灸实验研究以灸法为主,侧重于炎症与免疫相关机制。     

近代上海针灸学术发展管窥

由于近代中国特殊的社会历史环境,西学东渐,传统文化日渐式微。在这一时代背景下,近代上海针灸的发展遇到了前所未有的困难。近代上海针灸界在逆境中谋求发展,形成了以陆瘦燕、杨永璇、黄鸿舫、方慎盦、党波平等为代表的沪上针灸名家及流派,其学术思想和诊疗特色在一定程度上代表了这一时期上海针灸学术的发展状况。文章根据现有文献资料,对上述医家学术思想进行分析,发现其学术发展总体呈现两大共性特点,一是继承发扬传统,一是力图改革创新。综合诸家学术思想及诊疗特色,可见其在针灸学理论、临床诊疗及治疗方法上呈现以下三方面特点:一是学宗经典,法有渊源;二是重视经络,强调切诊;三是治疗技术,各有千秋。以此为切入点,可管窥近代上海针灸学术的发展状况之一斑。     

基于数据挖掘技术分析腹泻型和便秘型肠易激惹综合征针灸使用规律

目的:通过文献分析临床针灸治疗腹泻型(D-IBS)和便秘型肠易激惹综合征(C-IBS)的经脉、腧穴选择特点和规律。方法:检索中国知网、万方、维普、Pubmed、Web of Science等数据库,收集2000—2016年针灸治疗D-IBS和C-IBS的临床研究报道,提取其所使用的针灸方式、经脉和腧穴。运用描述性分析、关联性分析和聚类分析研究其内在联系与规律规律,同时观察针灸治疗D-IBS和C-IBS的经脉、腧穴各自的规律和它们之间的差异。结果:共纳入针灸治疗D-IBS文献56篇、针灸治疗C-IBS文献6篇,D-IBS的治疗主要用针刺,临床以胃经和任脉的腧穴为主,如天枢、足三里、中脘,关联性分析发现胃经—任脉—脾经的为最常见的经脉组合,腧穴以足三里—天枢—太冲为主要关联群。聚类分析经脉主要分成2个核心聚类群,2个核心群组,腧穴则可以分成5个聚类群,5个核心群组。而C-IBS的研究则主要以悬灸为主,胃经、膀胱经的腧穴应用最多,如天枢、足三里、大肠俞、上巨虚,关联性分析发现经脉组合与D-IBS相同,也是胃经—任脉—脾经组合支持度和置信度最高,而腧穴则是以足三里—天枢的配伍最为常见。聚类分析则发现经脉、腧穴均可以分成2个核心聚类群,2个核心群组。结论:通过分析针灸治疗D-IBS和C-IBS的临床研究,认为虽然两者在针灸方法的使用上略微存在差异,D-IBS针灸并用,C-IBS以灸为主。但是在经脉和腧穴选择上却存在高度相似性。     

Moxibustion treatment restoring the intestinal epithelium barrier in rats with Crohn’s disease by down-regulating tumor necrosis factor alpha, tumor necrosis factor receptor 1, and tumor necrosis factor receptor 2

Objective  

To investigate whether moxibustion regulates tumor necrosis factor alpha (TNF-α), tumor necrosis factor receptor 1 (TNFR1), and TNFR2 in the intestinal mucosa and to explore whether moxibustion could be used by means of this mechanism, to repair the intestinal epithelium barrier disruption in Crohn’s disease (CD).     

艾灸生成物对大鼠肺形态与脏器系数的影响

目的：观察不同浓度艾灸生成物对SD大鼠肺的影响。方法40只大鼠随机分正常对照组、低剂量艾灸生成物组、中剂量艾灸生成物组、高剂量艾灸生成物组,高剂量艾灸生成物恢复组,每天在相应浓度艾灸生成物中暴露4小时,每周5天,持续2个月;高剂量艾灸生成物恢复组经2个月高剂量艾灸生成物刺激后,在空气中自然暴露21天作为恢复期。正常对照组大鼠不进行任何艾灸生成物干预,常规饲养2个月。肉眼、光学显微镜下观察各组大鼠肺的病理形态,比较各组大鼠肺脏器系数。结果肉眼下,除中、高剂量艾灸生成物组分别有1只大鼠肺部表面可见小的灰色或黑色斑点外,余各组别大鼠肺部均未见异常。光镜下,低、中、高剂量艾灸生成物组部分大鼠支气管及肺泡可见不同程度炎性细胞侵润,肺泡隔增厚,其中,高剂量艾灸生成物组较为明显。高剂量艾灸生成物恢复组大鼠支气管及肺泡炎性细胞侵润现象与肺泡隔增厚现象较高剂量艾灸生成物组大鼠明显减少。各组别大鼠肺脏器系数无统计学差异。结论艾灸生成物对大鼠肺形态的影响与艾灸生成物的浓度有一定相关性,艾灸生成物对大鼠肺形态的影响具有可逆性。