| Warming needel moxibustion therapy is a convenient method combined acupuncture with moxibustion, this kind of therapy is wildly used in diseases which needs both acupuncture and moxibustion. Warming needel moxibustion therapy has its special treatment effects on KOA, promoting flow of qi and blood via acupuncture therapy and warming limbs via moxibustion to release cold.The rabbits modeled by braking method can simulate knee cartilage pathological changes under long-range press; this situation is well-matched with KOA expression because of age and press. Moreover, braking method model avoid the risks such as inflammation caused by surgery, which may change the research results.Cartilage metabolize is a complicated dynamic balance. Once the balance is broken, KOA may ensue. The key to break the balance is destruct cell factor. Among cell factors, IL-1 is trigger while MMP-1 is dominant factor. The former can activate matrix metalloproteinase primary then the latter catalyze the process of cartilage matrix degradation.This article is comprised by three parts to discuss the effects and mechanism of KOA’s treatment through warming needle moxibustion therapy. The first part is theoretical research. Summary One mainly expounds the mechanism of KOA from TCM and modern medicine view, TCM part:relationship between KOA and ancient Bi syndrome; knowledge about Bi syndrome; TCM therapy, modern medicine part: anatomical structure of knee joint; epidemio logical investigation; mechanism of KOA; cause of KOA; modern medicine therapy. Summary Two discusses the relationship between acupuncture and KOA, including:research on ancient theory; mechanism for acupuncture t on KOA; acupuncture and moxibustion therapy in recent 5 years. Summary Three mainly discusses the connection between KOA and cytokine, further summarizes researches on acupuncture and moxibustion’s effects on cytokine during KOA progress. The second part is operating step. The third part is discussion, mainly explain the reason:why choose braking method? Is IL-1 and MMP-1 better than other factors? why choose those five acupoints?Objective To study the effects of MMP-1 and IL-1β in the progress of knee osteoarthritis, then further to discuss the expression of MMP-1 and IL-1β affected by acupuncture combined with moxibustion in knee cartilage.Methods 30 cases of male Japanese white rabbits are randomly assigned into three groups which are normal group, model group and treatment group, each group contained 10 rabbits. Except the normal group, other two groups are modeled by six months knee joint straight-forced method. Rabbits’right legs are extended in 150 to 180 degree, and ankle joints are bended in 60 to 90 degree. Wood and gypsum are used for fixing joints, gauze is winded outside for protection, the toes are exposed for researchers to observe blood flow to prevent ischemia,30 minutes per day and six weeks totally. The first day of 8th week, Each rabbit knee joint is observed morphologically to compare the difference.The normal group is bred normally without any intervention. The treatment group is treated by warming needle moxibustion at Neixiyan, Waixiyan, Yanglingquan, Zusanli and Xuehai,1 time per day,4 weeks totally. The model group is fixed in the same time without treatment. Record the rabbit knee joint swelling, pain, range of motion and gait by Lequesne MG method. Observe knee cartilages by HE. Determine the contents of IL-1β and MMP-1 in knee cartilage.Results The normal group rabbit knees have no deformation. The model group and treatment group rabbit knees are swelling. Normal cartilage cells are evenly distributed, clear structure, clear hierarchy; the model group showed that chondrocytes arranged scattered, and some cells arranged in clusters with unclear hierarchy; The treatment group showed that cartilage cells are regular with a few clusters. After treatment, the score points of model group and treatment group increase obviously, compared with the normal control group, which shows an extremely significant difference (P<0.05); compared with model group, the treatment group swelling scores and active range scores decrease with a significant difference (P< 0.05). Compared with normal group, the contents of IL-1βin cartilage of model group and treatment group both increase (P<0.01, P<0.01); compared with model group, the contents of IL-1βin cartilage of treatment group both decrease significantly (P< 0.01).Compared with normal group, the contents of MMP-1 in cartilage of model group and treatment group both increase (P<0.01, P<0.01); compared with model group, the contents of MMP-1 in cartilage of treatment group both decrease significantly (P<0.01).Conclusion Warming needle moxibustion can decrease the contents of IL-1β and MMP-1 in knee cartilage. Warming needle moxibustion can improve the knee joint cartilage cell arrangement. Warming needle moxibustion can release swelling and expand range of knee joint motion. Warming needle moxibustion’s treatment mechanism may be related with the decrease of IL-1βand MMP-1 in knee cartilage.
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