The Effects and Potential Mechanisms of Moxibustion for Rheumatoid Arthritis-Related Pain: A Randomized, Controlled Trial

Overview

Journal J Pain Res

Publisher Dove Medical Press

Date 2023 Jun 1

PMID 37261035

Authors

Chenxi Liao

Siyu Tao

Yan Xiong

Jingyang Dai

Yu Bai

Xue Wang

Yuan Li

Ping Wu

Affiliations

Soon will be listed here.

Abstract

Purpose: To investigate the effects of moxibustion in relieving pain, and other clinical symptoms for patients with rheumatoid arthritis (RA), and explore the potential mechanism of moxibustion treatment for RA.

Patients And Methods: Seventy qualified RA patients were randomly assigned in a 1:1 ratio to the moxibustion group or the routine group. The routine group only took oral methotrexate tablets and folic acid tablets. The moxibustion group was treated with moxibustion based on oral pharmaceutical. Moxibustion was performed two times weekly for 8 weeks, a total of 16 sessions. Patients scored their pain on a visual analog scale (VAS). The American College of Rheumatology improvement criteria of 20%, 50% and 70% (ACR20, ACR50 and ACR70) after treatment were investigated. Clinical symptoms, a disease activity score using 28 joint counts (DAS28), simplified disease activity index (SDAI), clinical disease activity index (CDAI), health assessment questionnaire (HAQ), interleukin 1β (IL-1β), tumor necrosis factor-alpha (TNF-α), and vascular endothelial growth factor (VEGF) of RA patients were analyzed before and after treatment.

Results: After treatment, the VAS scores, tender and swollen joint counts, morning stiffness scores, disease activity scores (DAS28, SDAI, CDAI), HAQ scores in the two groups were both improved, and the effects of moxibustion group were more obvious ( < 0.05). The ACR20 and ACR50 of the moxibustion group were greater than that of the routine group ( < 0.05), no significant difference of the ACR70 existed between the two groups ( > 0.05). In addition, the decreases of IL-1β, TNF-α, VEGF of the moxibustion group were better than that of the routine group ( < 0.05).

Conclusion: Moxibustion could effectively relieve pain, ameliorate the clinical symptoms, and decrease the disease activity of RA. The potential mechanism may be the decrease in the level of serum inflammatory factors.

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References

Shen B, Sun Q, Chen H, Li Y, Du X, Li H . Effects of moxibustion on pain behaviors in patients with rheumatoid arthritis: A meta-analysis. Medicine (Baltimore). 2019; 98(30):e16413. PMC: 6708866. DOI: 10.1097/MD.0000000000016413. View

Jensen M, Chen C, Brugger A . Interpretation of visual analog scale ratings and change scores: a reanalysis of two clinical trials of postoperative pain. J Pain. 2003; 4(7):407-14. DOI: 10.1016/s1526-5900(03)00716-8. View

Wang S, Ye G, Zhang Y, Guan S, Liu X, Ren W . [Flipping moxibustion of medicine combined with western medication for rheumatoid arthritis with cold dampness syndrome]. Zhongguo Zhen Jiu. 2018; 37(10):1047-51. DOI: 10.13703/j.0255-2930.2017.10.006. View

Orange D, Blachere N, DiCarlo E, Mirza S, Pannellini T, Jiang C . Rheumatoid Arthritis Morning Stiffness Is Associated With Synovial Fibrin and Neutrophils. Arthritis Rheumatol. 2019; 72(4):557-564. PMC: 7113097. DOI: 10.1002/art.41141. View

Gong Y, Yu Z, Wang Y, Xiong Y, Zhou Y, Liao C . Effect of Moxibustion on HIF-1 and VEGF Levels in Patients with Rheumatoid Arthritis. Pain Res Manag. 2019; 2019:4705247. PMC: 6900949. DOI: 10.1155/2019/4705247. View

Hongwu Y, Yan Z, Yuzhen P, Jia Y, Bingkun W, Xue H . [Clinical efficacy of moxibustion as supplement on rheumatoid arthritis and the exploration on its mechanism]. Zhongguo Zhen Jiu. 2016; 36(1):17-20. View

Bruce B, Fries J . The Stanford Health Assessment Questionnaire: a review of its history, issues, progress, and documentation. J Rheumatol. 2003; 30(1):167-78. View

Gao F, Xiang H, Li H, Jia M, Pan X, Pan H . Electroacupuncture inhibits NLRP3 inflammasome activation through CB2 receptors in inflammatory pain. Brain Behav Immun. 2017; 67:91-100. DOI: 10.1016/j.bbi.2017.08.004. View

Drosos A, Pelechas E, Kaltsonoudis E, Voulgari P . Therapeutic Options and Cost-Effectiveness for Rheumatoid Arthritis Treatment. Curr Rheumatol Rep. 2020; 22(8):44. DOI: 10.1007/s11926-020-00921-8. View

10.

Smolen J, Landewe R, Bijlsma J, Burmester G, Chatzidionysiou K, Dougados M . EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis. 2017; 76(6):960-977. DOI: 10.1136/annrheumdis-2016-210715. View

11.

Juarez M, Filer A, Buckley C . Fibroblasts as therapeutic targets in rheumatoid arthritis and cancer. Swiss Med Wkly. 2012; 142:w13529. DOI: 10.4414/smw.2012.13529. View

12.

Hwang Y, Saag K . The safety of low-dose glucocorticoids in rheumatic diseases: results from observational studies. Neuroimmunomodulation. 2014; 22(1-2):72-82. DOI: 10.1159/000362727. View

13.

Clavel G, Bessis N, Lemeiter D, Fardellone P, Mejjad O, Menard J . Angiogenesis markers (VEGF, soluble receptor of VEGF and angiopoietin-1) in very early arthritis and their association with inflammation and joint destruction. Clin Immunol. 2007; 124(2):158-64. DOI: 10.1016/j.clim.2007.04.014. View

14.

Prevoo M, van t Hof M, Kuper H, van Leeuwen M, van de Putte L, van Riel P . Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995; 38(1):44-8. DOI: 10.1002/art.1780380107. View

15.

Uguz F, Kucuk A, Cicek E, Kayhan F, Salli A, Guncu H . Quality of life in rheumatological patients: The impact of personality disorders. Int J Psychiatry Med. 2015; 49(3):199-207. DOI: 10.1177/0091217415582183. View

16.

Liu Z, Li X, Zhao C, Chen C, Li M, Tan Q . [Effects of moxibustion on Treg/Th17 cell and its signal pathway in mice with rheumatoid arthritis]. Zhongguo Zhen Jiu. 2018; 37(10):1083-91. DOI: 10.13703/j.0255-2930.2017.10.015. View

17.

Koike T, Harigai M, Inokuma S, Ishiguro N, Ryu J, Takeuchi T . Effectiveness and safety of tocilizumab: postmarketing surveillance of 7901 patients with rheumatoid arthritis in Japan. J Rheumatol. 2013; 41(1):15-23. DOI: 10.3899/jrheum.130466. View

18.

Takano S, Uchida K, Inoue G, Matsumoto T, Aikawa J, Iwase D . Vascular endothelial growth factor expression and their action in the synovial membranes of patients with painful knee osteoarthritis. BMC Musculoskelet Disord. 2018; 19(1):204. PMC: 6020436. DOI: 10.1186/s12891-018-2127-2. View

19.

Machin A, Babatunde O, Haththotuwa R, Scott I, Blagojevic-Bucknall M, Corp N . The association between anxiety and disease activity and quality of life in rheumatoid arthritis: a systematic review and meta-analysis. Clin Rheumatol. 2020; 39(5):1471-1482. DOI: 10.1007/s10067-019-04900-y. View

20.

Ovayolu N, Ovayolu O, Karadag G . Health-related quality of life in ankylosing spondylitis, fibromyalgia syndrome, and rheumatoid arthritis: a comparison with a selected sample of healthy ındividuals. Clin Rheumatol. 2010; 30(5):655-64. DOI: 10.1007/s10067-010-1604-2. View