| Rheumatoid Arthritis (RA) is a chronic, progressive, systemic autoimmune disease thatinvolves large and small joints. The pathological alterations of RA begin with synovitis, whichfurther affects cartilage, ligament, and tendon, resulting in swollen and painful joints. Theunderlying bone is eventually affected, which finally leads to cartilage destruction, boneerosions, tendon inflammation and rupture, joint damage, early disability and systemiccomplications. RA has raised much debate worldwide due to its high incidence of occurrenceand disability. RA affects approximately 0.5-3% of the population worldwide, and 0.1-1.08% of thepopulation in China. The disease can occur at any age, ranging from 1.5 months to 70 year oldsin other countries and from 10 months to 82 year olds in China, but it begins most oftenbetween the ages of 25 and 55, with an average age of 46. Women are affected more often thanmen, with a 1.5-1.8 to 1 ratio of women to men. This dissertation first reviewed the recent progress of clinical application and basicmechanism researches on regular and electrothermal acupuncture treatment of RA. The secondpart of this dissertation focused on the study of electrothermal acupuncture treatment of RAwith three different approaches: theories of traditional Chinese medicine, studies on animalmodel, and clinical trial.I. Theoretical Study: Theoretical study focused on discussion of RA etiology and pathogenesisin traditional Chinese medicine, and summary of traditional acupuncture treatment described in"Nei Jing".II. Clinical trial: The diagnostic standards of RA and evaluation standards of illness state fromAmerican College of Rheumatology (ACR) were used in this study. 40 patients were dividedinto two groups randomly, and were treated by regular acupuncture and electrothermalacupuncture respectively. Points of Quchi, Shenshu, and Zusanli, along with the actual points ofpain on the body, were used. Acupuncture treatment was applied once a day for a total of 20days with a 3-5 day intermission after the 10th day. The following results were achieved by theend of study.1. Electrothermal acupuncture was more effective on RA patients although both ofelectrothermal and regular acupunctures worked. Electrothermal acupuncture improvedACR-20 of 80% patients. This was significantly different from the effects that were achieved byregular acupuncture, which improved ACR-20 of 55% patients (P=0.047<0.05).2. ACR standards of illness state can be used to evaluate not only effects of drug treatment, butalso acupuncture treatment of RA.3. Better curative effects on RA patients were accomplished by coordinating systematic andlocal selections of points on "Yang Jing".4. The therapeutic effects of electrothermal acupuncture involved in warming the body todiminish cold and damp, and moving blood to dispel wind and blockage.III. Study on animal model: 50 Wistar male rats with body weights from 180g to 200g weredivided into five groups as follow: normal control, Collagen-induced arthritis (CIA) withouttreatment, CIA with high current electrothermal acupuncture treatment, CIA with low currentelectrothermal acupuncture treatment, CIA with no current electrothermal acupuncturetreatment. Electrothermal acupuncture treatment was performed once every other day with 20minutes treatment each time for 20 times. Results were showed as follows.1. Electrothermal acupuncture treatment significantly decreased onset of synovitis,angiohyperplasia and pannus formation, resulting in alleviation of synovium proliferation,cartilage and bone erosion, and joint swelling.2. Electrothermal acupuncture treatment decreased ratio of CD4+/CD8+ T cells in peripheralblood by decreasing CD4+ cells and increasing CD8+ cells. In addition, it regulated cellular andhumoral immunity by inhibiting ConA-induced spleen lymphocyte proliferation withoutaffecting LPS-induced spleen lymphocyte proliferation.3. Electrothermal acupuncture treatment decreased mRNA expression of Cox-2 in jointsynovium, resulting in decrement of protease secretion and pannus formati...
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