Efficacy of moxibustion in the treatment of knee osteoarthritis in model rabbit: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

HUA Fanghui ¹ ,  XIONG Jun ² , XIANG Jie ¹ , HUANG Shouqiang ¹

1. Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, P.R.China;
2. The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, P.R.China;

Corresponding author：

XIONG Jun, Email: xiongjun196071@163.com

Keywords：

Moxibustion; Knee osteoarthritis; Systematic review; Meta-analysis; Animal experiment; Rabbit

DOI：

10.7507/1672-2531.202011115

Video：

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Objective To systematically review the efficacy of moxibustion in the treatment of model rabbits with knee osteoarthritis (KOA).Methods CNKI, WanFang Data, VIP, CBM, PubMed, EMbase and The Cochrane Library databases were electronically searched to collect animal experiments on moxibustion in the treatment of model rabbits with KOA from inception to January 31^st, 2019. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed by using RevMan 5.3 software.Results A total of 13 articles involving 226 model rabbits were included. The results of meta-analysis showed that moxibustion could reduce Mankin score (MD=−6.47, 95%CI −7.63 to −5.32, P<0.000 01), positive expression rate of chondrocyte apoptosis (MD=−22.21, 95%CI −23.22 to −21.21, P<0.000 01), level of IL-1β in joint fluid (SMD=−8.40, 95%CI −15.09 to −1.72, P=0.01), NO content in joint fluid (SMD=−11.03, 95%CI −17.87 to −4.19, P=0.002), the level of serum IL-1β (MD=−19.94, 95%CI −23.61 to −16.27, P<0.05), and serum NO content (MD=−22.69, 95%CI −28.77 to −16.61, P<0.05) of model rabbits with KOA.Conclusions Current evidence shows that moxibustion can improve articular cartilage injury, strengthen chondrocyte activity, inhibit the inflammatory response, and inhibit chondrocyte apoptosis of model rabbits with KOA. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.

Citation： HUA Fanghui, XIONG Jun, XIANG Jie, HUANG Shouqiang. Efficacy of moxibustion in the treatment of knee osteoarthritis in model rabbit: a systematic review. Chinese Journal of Evidence-Based Medicine, 2021, 21(6): 683-688. doi: 10.7507/1672-2531.202011115 Copy

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2.	van Dijk GM, Veenhof C, Schellevis F, et al. Comorbidity, limitations in activities and pain in patients with osteoarthritis of the hip or knee. BMC Musculoskelet Disord, 2008, 9: 95.
3.	Litwic A, Edwards MH, Dennison EM, et al. Epidemiology and burden of osteoarthritis. Br Med Bull, 2013, 105: 185-199.
4.	任燕, 石娅娅, 谭波, 等. 中国人群膝骨关节炎危险因素的 Meta 分析. 现代预防医学, 2015, 42(12): 2282-2284, 2292.
5.	林雪娟, 陈朝阳. 中药内治腰椎间盘突出症研究进展. 中国中药杂志, 2007, 32(3): 186-191.
6.	于隽, 熊俊. 热敏灸治疗膝骨性关节炎临床疗效的系统评价与 Meta 分析. 广州中医药大学学报, 2015, 32(1): 60-66.
7.	Choi TY, Lee MS, Kim JI, et al. Moxibustion for the treatment of osteoarthritis: an updated systematic review and meta-analysis. Maturitas, 2017, 100: 33-48.
8.	Song GM, Tian X, Jin YH, et al. Moxibustion is an alternative in treating knee osteoarthritis: the evidence from systematic review and meta-analysis. Medicine (Baltimore), 2016, 95(6): e2790.
9.	陈匡阳, 马彬, 王亚楠, 等. SYRCLE 动物实验偏倚风险评估工具简介. 中国循证医学杂志, 2014, 14(10): 1281-1285.
10.	廖绪亮, 姜彦彪, 王欢, 等. 如何提高动物实验系统评价质量—基于动物实验系统评价与临床试验系统评价的比较研究. 中国循证心血管医学杂志, 2019, 11(5): 526-529, 533.
11.	熊勇, 彭锐, 夏数数. 兔膝骨性关节炎关节液中白细胞介素 1β 和肿瘤坏死因子 α 表达与艾灸的影响. 中国组织工程研究与临床康复, 2010, 14(41): 7700-7703.
12.	熊勇. 艾灸对膝骨性关节炎的防治作用及其机理的实验研究. 武汉: 湖北中医药大学, 2010.
13.	熊勇, 彭锐, 王华. “双固一通”温针灸实验性膝骨性关节炎模型兔 Bcl-2 及 Bax 蛋白的表达. 中国组织工程研究, 2012, 16(2): 261-264.
14.	肖琳. 艾灸对兔膝骨性关节炎的治疗作用及其机理的研究. 武汉: 武汉体育学院, 2006.
15.	肖琳. 艾灸疗法对兔膝骨性关节炎软骨细胞凋亡的影响. 大众商务(投资版), 2009, (6): 246-247.
16.	樊思琴. 超声波结合艾灸对兔膝骨性关节炎软骨, 滑膜和滑液 VEGF, MMP-9, TIMP-1 影响的研究. 福州: 福建中医药大学, 2018.
17.	李建武, 马志毅, 熊源胤, 等. 隔物温和灸对膝骨性关节炎家兔软骨细胞及滑膜组织病理学的影响. 中西医结合研究, 2010, 2(2): 64-67.
18.	林瑞珠, 许建峰, 朱宁, 等. 回医烙灸疗法对实验性兔膝骨性关节炎软骨细胞凋亡的影响. 甘肃中医学院学报, 2014, 31(1): 1-3.
19.	林瑞珠, 陈美华, 马川, 等. 烙灸对兔膝骨性关节炎软骨细胞外基质Ⅱ型胶原, 蛋白多糖表达的影响. 针灸临床杂志, 2019, 35(1): 54-57, 89.
20.	章海凤, 陈树涛, 冒姣娜, 等. 热敏灸对膝骨性关节炎兔模型 IL-1β, TNF-α, MMP-13 的影响. 中华中医药杂志, 2018, 33(9): 3913-3917.
21.	付勇, 陈树涛, 冒姣娜, 等. 热敏灸干预膝骨性关节炎兔模型效应机制的研究. 中国针灸, 2018, 38(3): 291-296.
22.	武永利, 李春, 刘娣, 等. 温针灸对兔膝骨性关节炎关节软骨尿激酶型纤溶酶原活物系统的影响. 中华中医药杂志, 2017, 32(2): 735-738.
23.	姚畅, 程珂, 赵玲, 等. 艾灸对兔膝骨性关节炎模型血清 IL-1β, COX-2, COMP 表达的影响. 浙江中医杂志, 2017, 52(8): 579-580.
24.	许家科, 赵璐璐, 廖绪亮, 等. 循证构建动物实验系统评价制作流程. 中国循证医学杂志, 2017, 17(11): 1357-1364.
25.	Mankin HJ, Dorfman H, Lippiello L, et al. Biochemical and metabolic abnormalities in articular cartilage from osteo-arthritic human hips. II. Correlation of morphology with biochemical and metabolic data. J Bone Joint Surg Am, 1971, 53(3): 523-537.
26.	Goldring MB. The role of cytokines as inflammatory mediators in osteoarthritis: lessons from animal models. Connect Tissue Res, 1999, 40(1): 1-11.
27.	管剑龙, 施桂英. 基质金属蛋白酶与骨关节炎. 中华风湿病学杂志, 2000, (1): 54-56.
28.	Manacu CA, Martel-Pelletier J, Roy-Beaudry M, et al. Endothelin-1 in osteoarthritic chondrocytes triggers nitric oxide production and upregulates collagenase production. Arthritis Res Ther, 2005, 7(2): R324-332.
29.	Takács-Buia L, Iordachel C, Efimov N, et al. Pathogenesis of osteoarthritis: chondrocyte replicative senescence or apoptosis? Cytometry B Clin Cytom, 2008, 74(6): 356-362.
30.	Ling S, Lai A, Borschukova O, et al. Activation of nitric oxide signaling by the rheumatoid arthritis shared epitope. Arthritis Rheum, 2006, 54(11): 3423-3432.

1. Jones G. Osteoarthritis: where are we for pain and therapy in 2013? Aust Fam Physician, 2013, 42(11): 766-769.
2. van Dijk GM, Veenhof C, Schellevis F, et al. Comorbidity, limitations in activities and pain in patients with osteoarthritis of the hip or knee. BMC Musculoskelet Disord, 2008, 9: 95.
3. Litwic A, Edwards MH, Dennison EM, et al. Epidemiology and burden of osteoarthritis. Br Med Bull, 2013, 105: 185-199.
4. 任燕, 石娅娅, 谭波, 等. 中国人群膝骨关节炎危险因素的 Meta 分析. 现代预防医学, 2015, 42(12): 2282-2284, 2292.
5. 林雪娟, 陈朝阳. 中药内治腰椎间盘突出症研究进展. 中国中药杂志, 2007, 32(3): 186-191.
6. 于隽, 熊俊. 热敏灸治疗膝骨性关节炎临床疗效的系统评价与 Meta 分析. 广州中医药大学学报, 2015, 32(1): 60-66.
7. Choi TY, Lee MS, Kim JI, et al. Moxibustion for the treatment of osteoarthritis: an updated systematic review and meta-analysis. Maturitas, 2017, 100: 33-48.
8. Song GM, Tian X, Jin YH, et al. Moxibustion is an alternative in treating knee osteoarthritis: the evidence from systematic review and meta-analysis. Medicine (Baltimore), 2016, 95(6): e2790.
9. 陈匡阳, 马彬, 王亚楠, 等. SYRCLE 动物实验偏倚风险评估工具简介. 中国循证医学杂志, 2014, 14(10): 1281-1285.
10. 廖绪亮, 姜彦彪, 王欢, 等. 如何提高动物实验系统评价质量—基于动物实验系统评价与临床试验系统评价的比较研究. 中国循证心血管医学杂志, 2019, 11(5): 526-529, 533.
11. 熊勇, 彭锐, 夏数数. 兔膝骨性关节炎关节液中白细胞介素 1β 和肿瘤坏死因子 α 表达与艾灸的影响. 中国组织工程研究与临床康复, 2010, 14(41): 7700-7703.
12. 熊勇. 艾灸对膝骨性关节炎的防治作用及其机理的实验研究. 武汉: 湖北中医药大学, 2010.
13. 熊勇, 彭锐, 王华. “双固一通”温针灸实验性膝骨性关节炎模型兔 Bcl-2 及 Bax 蛋白的表达. 中国组织工程研究, 2012, 16(2): 261-264.
14. 肖琳. 艾灸对兔膝骨性关节炎的治疗作用及其机理的研究. 武汉: 武汉体育学院, 2006.
15. 肖琳. 艾灸疗法对兔膝骨性关节炎软骨细胞凋亡的影响. 大众商务(投资版), 2009, (6): 246-247.
16. 樊思琴. 超声波结合艾灸对兔膝骨性关节炎软骨, 滑膜和滑液 VEGF, MMP-9, TIMP-1 影响的研究. 福州: 福建中医药大学, 2018.
17. 李建武, 马志毅, 熊源胤, 等. 隔物温和灸对膝骨性关节炎家兔软骨细胞及滑膜组织病理学的影响. 中西医结合研究, 2010, 2(2): 64-67.
18. 林瑞珠, 许建峰, 朱宁, 等. 回医烙灸疗法对实验性兔膝骨性关节炎软骨细胞凋亡的影响. 甘肃中医学院学报, 2014, 31(1): 1-3.
19. 林瑞珠, 陈美华, 马川, 等. 烙灸对兔膝骨性关节炎软骨细胞外基质Ⅱ型胶原, 蛋白多糖表达的影响. 针灸临床杂志, 2019, 35(1): 54-57, 89.
20. 章海凤, 陈树涛, 冒姣娜, 等. 热敏灸对膝骨性关节炎兔模型 IL-1β, TNF-α, MMP-13 的影响. 中华中医药杂志, 2018, 33(9): 3913-3917.
21. 付勇, 陈树涛, 冒姣娜, 等. 热敏灸干预膝骨性关节炎兔模型效应机制的研究. 中国针灸, 2018, 38(3): 291-296.
22. 武永利, 李春, 刘娣, 等. 温针灸对兔膝骨性关节炎关节软骨尿激酶型纤溶酶原活物系统的影响. 中华中医药杂志, 2017, 32(2): 735-738.
23. 姚畅, 程珂, 赵玲, 等. 艾灸对兔膝骨性关节炎模型血清 IL-1β, COX-2, COMP 表达的影响. 浙江中医杂志, 2017, 52(8): 579-580.
24. 许家科, 赵璐璐, 廖绪亮, 等. 循证构建动物实验系统评价制作流程. 中国循证医学杂志, 2017, 17(11): 1357-1364.
25. Mankin HJ, Dorfman H, Lippiello L, et al. Biochemical and metabolic abnormalities in articular cartilage from osteo-arthritic human hips. II. Correlation of morphology with biochemical and metabolic data. J Bone Joint Surg Am, 1971, 53(3): 523-537.
26. Goldring MB. The role of cytokines as inflammatory mediators in osteoarthritis: lessons from animal models. Connect Tissue Res, 1999, 40(1): 1-11.
27. 管剑龙, 施桂英. 基质金属蛋白酶与骨关节炎. 中华风湿病学杂志, 2000, (1): 54-56.
28. Manacu CA, Martel-Pelletier J, Roy-Beaudry M, et al. Endothelin-1 in osteoarthritic chondrocytes triggers nitric oxide production and upregulates collagenase production. Arthritis Res Ther, 2005, 7(2): R324-332.
29. Takács-Buia L, Iordachel C, Efimov N, et al. Pathogenesis of osteoarthritis: chondrocyte replicative senescence or apoptosis? Cytometry B Clin Cytom, 2008, 74(6): 356-362.
30. Ling S, Lai A, Borschukova O, et al. Activation of nitric oxide signaling by the rheumatoid arthritis shared epitope. Arthritis Rheum, 2006, 54(11): 3423-3432.

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Efficacy of moxibustion in the treatment of knee osteoarthritis in model rabbit: a systematic review

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