Objective: To observe the clinical efficacy of moxibustion on rheumatoid arthritis (RA) and its effect on related negative emotions, and to explore the possible mechanism.
Methods: A total of 70 patients with RA were randomized into an observation group (35 cases, 1 case dropped off) and a control group (35 cases, 2 cases dropped off). Conventional western medication therapy was adopted in the control group. On the basis of the treatment in the control group, moxibustion at Zusanli (ST 36), Shenshu (BL 23) and ashi points was adopted in the observation group, once every other day, 3 times a week, and totally 5-week treatment was required in the two groups. Before and after treatment, the scores of visual analogue scale (VAS), morning stiffness, 28-joint disease activity score (DAS28), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were observed and levels of serum 5-hydroxytryptamine (5-HT), glucocorticoid receptor (GR) and interleukin (IL)-1β were detected by ELISA method in the two groups respectively.
Results: Compared before treatment, the scores of VAS and DAS28 were decreased after treatment in both groups (P<0.01, P<0.05), and the scores of morning stiffness, SAS, SDS and the serum levels of 5-HT, GR, IL-1β were decreased after treatment in the observation group (P<0.01). After treatment, the scores of VAS, morning stiffness, DAS28, SAS, SDS and the serum levels of GR, IL-1β in the observation group were lower than those in the control group (P<0.05, P<0.01). The clinical symptoms of RA (scores of VAS, morning stiffness and DAS28) were positively correlated with negative emotions (scores of SAS and SDS, r=0.439, P<0.01), the VAS score was positively correlated with serum levels of 5-HT (r=0.189, P<0.05) and IL-1β (r=0.189, P<0.05).
Conclusion: Moxibustion can improve the clinical symptoms and negative emotions in patients with RA by regulating the inflammatory reactions.
目的：观察艾灸治疗类风湿关节炎（RA）的临床疗效及对相关负性情绪的影响，探讨其可能的作用机制。方法：将70例RA患者随机分为观察组（35例，脱落1例）和对照组（35例，脱落2例）。对照组予常规西药治疗；观察组在对照组基础上予艾灸足三里、肾俞和阿是穴，隔日1次，每周3次，两组均治疗5周。分别于治疗前后观察两组患者视觉模拟量表（VAS）、晨僵、28个关节疾病活动度（DAS28）、焦虑自评量表（SAS）、抑郁自评量表（SDS）评分，ELISA法检测患者血清5-羟色胺（5-HT）、糖皮质激素受体（GR）和白细胞介素（IL）-1β含量。结果：与治疗前比较，治疗后两组患者VAS、DAS28评分降低（P<0.01，P<0.05），观察组患者晨僵、SAS、SDS评分和血清5-HT、GR、IL-1β含量降低（P<0.01）。治疗后，观察组患者VAS、晨僵、DAS28、SAS、SDS评分和血清GR、IL-1β含量低于对照组（P<0.05，P<0.01）。RA疾病症状（VAS、晨僵、DAS28评分）与负性情绪（SAS、SDS评分）呈正相关（r=0.439，P<0.01），VAS评分与血清5-HT（r=0.183，P<0.05）、IL-1β（r=0.189，P<0.05）含量呈正相关。结论：艾灸可通过调控炎性反应达到改善RA患者临床症状与负性情绪的目的。.
Keywords: anti-inflammatory and analgesic; moxibustion; negative emotions; randomized controlled trial (RCT); rheumatoid arthritis.