| Objective:In order to explore the correlation between moxibustion and moxa smoke effect,and the role and influencing factors of moxibustion smoke and heat in the process of moxibustion.Based on the clinical application of moxibustion,the effects of moxibustion,smoke abatement moxibustion and different temperatures moxa smoke on the local cartilage injury of knee osteoarthritis,as well as the effects on the cartilage and plasma metabolites and metabolism mode of knee joint were observed,and the correlation and difference between the effects of moxibustion,smoke effect and heat effect were discussed.It provides a certain reference for the clinical evaluation of the retention of moxa smoke during moxibustion,and provides a new scientific basis for the clinical application and mechanism research of moxibustion.Method:Through the development of moxibustion smoke and heat separation device,and the application test,the basic parameters of the device are defined,its performance is evaluated,and the control methods of moxibustion smoke,heat separation and temperature of moxibustion smoke in this experimental study are determined;The dose-effect relationship between the specifications of moxibustion sticks,the distance of moxibustion and the skin surface temperature of local acupoints in rats is observed,which is the selection standard of the specifications of moxibustion sticks and the distance of moxibustion in this experiment to provide reference;To establish knee osteoarthritis model rats,and to observe the effects of moxibustion(moxibustion group),smoke abatement moxibustion(smoke abatement group),moxa smoke moxibustion at 43℃-50℃(warm moxa smoke group)and moxa smoke moxibustion at 28℃-30℃(cold moxa smoke group)on the exercise ability,the level of IL-1β,TNF-α,cartilage tissue the morphology and ultrastructure of chondrocytes were studied.The local effect of moxibustion smoke and heat on knee osteoarthritis and the correlation between the effect of moxibustion smoke and temperature were discussed.The use of non-targeted metabolomics technology based on ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UUHPLC-Q-TOF MS)to perform a full spectrum analysis of metabolites in plasma and knee cartilage of rats in each group,Through orthogonal partial least squares discriminant analysis(OPLS-DA),hierarchical clustering analysis,KEGG pathway enrichment analysis and other bioinformatics analysis methods,preliminary screening and identification of different metabolites and metabolic pathways between different intervention methods.In order to explore the metabolic mechanism of cartilage injury and the difference of smoke and heat effect of Moxibustion in knee osteoarthritis model rats.Results:1.Experimental results of moxibustion smoke,heat separation and moxibustion temperature control.Moxibustion smoke and heat separation device can realize effective separation of moxibustion smoke,no visible smoke escapes from the hot moxibustion mouth,and the smoke can be automatically discharged through the smoke outlet;moxibustion mouth can realize moxibustion temperature of 43℃-48℃ for more than 40 minutes,and the smoke outlet connected with extension tubes of 5 cm and 25 cm or more can respectively achieve the smoke output of 43℃-50℃ and 28℃-30℃(environment temperature is equivalent)for more than 20 minutes.The skin surface temperature of 1.8cm diameter moxa stick at 4cm distance is stable between 43℃-48℃,which can be used in the moxibustion experiment of rats in this study.2.Experimental results of the effect of moxibustion smoke and heat on the local joint effect of KOA model rats.1)The average running distance of the model group was(50.5 ± 15.26)m,which was significantly lower than that of the normal group(125.1 ± 26.09)m(P < 0.01),and the concentrations of IL-1β and TNF-α in the joint fluid were higher than that of the normal group(P < 0.01);The average running distance of moxibustion group was(99.4 ± 17.41)m,that of smoke abatement group was(94.5 ± 16.53)m,that of warm moxa group was(74.8 ± 14.2)m,which was higher than that of model group(P < 0.05),and that of moxibustion group,smoke abatement group and warm moxa smoke group was lower than that of model group(P < 0.01);The average running distance of cold moxa smoke group was(55.5 ± 12.83)m,which was higher than that of model group,but there was no difference significant difference(P > 0.05),IL-1β,TNF-α concentration also showed a downward trend,also no significant statistical significance(P > 0.05);the average running distance of moxibustion group was higher than that of smoke abatement group,and the levels of IL-1β,TNF-α were lower than that of smoke abatement group,but there was no statistical difference(P > 0.05);2)The pathological changes of chondrocytes in knee osteoarthritis model rats were abnormal proliferation,nuclear pyknosis,endoplasmic reticulum expansion and lysis,mitochondria swelling and vacuolation degeneration.Moxibustion,smoke removing moxibustion,warm smoke moxibustion and room temperature smoke moxibustion could improve the cartilage damage of KOA model rats in different degrees.The effect of moxibustion,smoke removing moxibustion and warm smoke moxibustion was obvious,but the effect of room temperature smoke on chondrocyte proliferation and injury was not significant.3.The result of metabonomics analysis of KOA model rats with moxibustion smoke and heat.1)In the knee osteoarthritis model rats,the aerobic and anaerobic metabolism of energy substances in plasma and cartilage were inhibited,the synthesis and degradation of amino acids were disordered,the fatty acid metabolites in plasma were decreased,the lipid metabolism in cartilage was disordered,the nucleic acids and their derivatives and polypeptide metabolites were increased;2)Moxibustion,moxibustion in addition to smoke and moxibustion in warm moxa can improve the imbalance of energy metabolism and amino acid metabolism in plasma and cartilage of knee osteoarthritis model rats,improve the level of aerobic metabolism,inhibit the anaerobic metabolism pathway,regulate the synthesis and catabolism of amino acids,and reduce the level of cartilage lipid metabolites and branched chain amino acids.Conclusion:1.Among the effects of moxibustion on improving the movement ability of KOA model rats,reducing the inflammatory reaction and cartilage damage,the thermal effect is the key factor,and the Moyam itself does not play a significant role.After the Moyam is separated,it has no significant effect on the effect of moxibustion,and Moyam moxibustion needs to have a certain thermal factor to produce a significant effect;2.Enhancing energy metabolism,balancing amino acid metabolism and reducing lipid metabolism may be one of the effective ways for moxibustion,smoke abatement moxibustion and warm moxa smoke moxibustion to improve knee joint cartilage injury,reduce inflammatory response and promote joint function repair in koa model rats;3.The changes of ascorbic acid and aldehyde metabolism,glycerophospholipin metabolism,D-GLUTAMINE and D-glutamate metabolism,glutamate synapse and pantothenic acid and coenzyme a biosynthesis in cartilage,dopaminergic synapse,purine metabolism,phenylalanine,tyrosine and tryptophan biosynthesis,nicotinic acid ester and nicotinamide metabolism,sphingomyelin signaling pathway may be the difference between smoke effect and heat effect of moxibustion.The heterometabolic pathway is worthy of further study and verification. |
PDF Full Text Request