Effect of Moxibustion on the Serum Levels of MMP‐1, MMP‐3, and VEGF in Patients with Rheumatoid Arthritis

Abstract

Background. Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease, which will eventually lead to joints deformity and functional damage. The aim of this research is to evaluate the effect of moxibustion on the serum indicators related to bone and cartilage metabolism, matrix metalloproteinase 1 (MMP-1), matrix metalloproteinase 3 (MMP-3), and vascular endothelial growth factor (VEGF) in patients with RA and to explore the mechanism of moxibustion in the treatment of RA. Methods. We recruited 70 RA patients who met the inclusion criteria, and they were randomly divided into two groups, a treatment group and a control group in equal ratio. The control group took methotrexate, folate, or leflunomide orally, while the treatment group received methotrexate, folate, or leflunomide orally and moxibustion at ST36 (Zusanli), BL23 (Shen shu), and Ashi points. We compared the clinical symptoms, RA serological disease markers and serum contents of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), MMP-1, MMP-3, and VEGF of RA patients before and after treatment. Results. (1) The clinical symptoms and RA serological disease markers of the two groups improved after treatment (P < 0.05), while the clinical symptoms of the treatment group were significantly improved in comparison with the control group (P < 0.05). (2) The levels of IL-1β, TNF-α, and VEGF decreased in both groups after treatment (P < 0.05), but the treatment group was significantly decreased compared with the control group (P < 0.05). (3) There were significant differences in MMP-1 and MMP-3 contents after treatment in the treatment group (P < 0.05, P < 0.05), while there were no significant differences in the control group (P > 0.05, P > 0.05). Above all, the contents of IL-1β, TNF-α, MMP-1, MMP-3, and VEGF in the treatment group decreased more significantly than those in the control group (P < 0.05). Conclusion. The improvement effect of moxibustion on the clinical symptoms of RA patients may be related to influence on the contents of IL-1β, TNF-α, MMP-1, MMP-3, and VEGF, and moxibustion may play a potential role in bone protection.

The Efficacy of Moxibustion on the Serum Levels of CXCL1 and β-EP in Patients with Rheumatoid Arthritis

“…e results of our study showed that, under standard treatment, the values of RAI, SJC, DAS28, and SF-MPQP in the two groups were significantly decreased, which objectively reflected that the symptoms of joint swelling and pain and disease activity of the patients were significantly improved, and the improvement degree in the treatment group with moxibustion was more significant. is result is basically consistent with our previous research results [20,21], which all prove that moxibustion therapy combined with western medicine can improve the curative effect to a greater extent, improve the clinical symptoms of patients, and reduce the pain of patients.…”

“…In our previous study, it was found that the contents of inflammatory factors dominated by IL-1β and TNF-α in serum of RA patients treated with moxibustion decreased significantly, which was also fully reflected in this study [20,21]. It is worth noting that, in this study, the CXCL1 content in patient serum of the treatment group was significantly decreased, and it was significantly positively correlated with the improvement of IL-1β and TNF-α.…”

“…e selection of acupoints is based on our previous research, which found that moxibustion at ST36, BL23, and A-Shi points can effectively improve the clinical symptoms of RA and the content of related serum markers [20,21], and according to the State Standard of the People's Republic of China (GB/T123462006).…”

“…Traditional Chinese medicine believes that RA is mostly "deficient root and excessive superficial," so in the study, we take "strengthening the body resistance to eliminate pathogenic factors" as the basic treatment principle, select two acupoints ST36 and BL23 to warm the yang and tonify the kidney, in order to strengthen the body resistance, and cooperate with local Ashi acupoints, warming the meridians and dredging collaterals to eliminate pathogenic factors. Our previous studies have proved that moxibustion ST36 and BL23 combined with ashi point can play an anti-inflammatory and analgesic role and can significantly relieve the clinical symptoms of patients [20,21]. In addition, a large number of animal experiments also proved that moxibustion ST36 and BL23 could effectively reduce the proliferation of the synovial tissue and fibrous tissue in RA model, restore the balance between osteoblasts and osteoclasts, reduce inflammatory cytokines level, and thus improve the symptoms of joint swelling and pain [19,29,30].…”

“…However, most of the relevant studies focus on animal studies, while few clinical studies. In recent years, we gradually focus on the clinical mechanism of moxibustion [20,21]. In this study, the effects of moxibustion on serum levels of CXCL1 and β-EP in RA patients were observed to further explore the mechanism of moxibustion in improving joint swelling and pain symptoms in RA patients, so as to provide evidence for the clinical treatment of RA.…”