Psychophysical and psychophysiological effects of heat stimulation by electric moxibustion

Efficacy and safety comparison of infrared laser moxibustion and traditional moxibustion in knee osteoarthritis: study protocol for a Zelen-design randomized controlled non-inferiority clinical trial

BACKGROUND

Knee osteoarthritis (KOA) is the most common chronic degenerative joint disease and places a substantial burden on the public health resources in China. The purpose of this study is to preliminarily evaluate whether infrared laser moxibustion (ILM) is non-inferior to traditional moxibustion (TM) in the treatment of KOA.

MATERIALS AND METHODS

In the designed Zelen-design randomized controlled non-inferiority clinical trial, a total of 74 patients with KOA will be randomly allocated to one of two interventions: ILM treatment or TM treatment. All participants will receive a 6-week treatment and a follow-up 4 weeks after treatment. The primary outcomes will be the mean change in pain scores on the numeric rating scale (NRS) measured at baseline and the end of last treatment at week 6. The secondary outcomes will be the pain scores on the NRS from weeks 1 to 5 after the start of treatment and the changes from baseline to endpoints (weeks 6 and 10) in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), SF-36, knee circumference, and 6-min walking test. In addition, safety assessment will be performed throughout the trial.

CONCLUSION

The results of our study will help determine whether a 6-week treatment with ILM is non-inferior to TM in patients with KOA, therefore providing evidence to verify if ILM can become a safer alternative for TM in clinical applications in the future.

TRIAL REGISTRATION

Clinical Trial Registration Platform (ChiCTR2200065264); Pre-results. Registered on 1 November 2022.

Ultrasonic device developed for non-invasive moxibustion therapy

Background

Recently, some adverse effects of moxibustion has been reported such as burns, smoke, allergies, and so on. To overcome the adverse effects of traditional moxibustion, an ultrasonic moxibustion device (UMD) was designed, simulated, fabricated, and tested. The objective of this study is to provide detailed information about the main design parameters, simulation outcome, and performance-test results.

Methods

The main components of the UMD are a 1-MHz ultrasonic transducer (UT) with concave lens, and its applicator. The acoustic pressure and temperature distribution of the UT was simulated and described graphically using COMSOL software, which is based on the finite element method (FEM). Experimental verification of the temperature distribution was performed on the skin of pork. The temperature-change profiles of pork in relation to increase of therapy time were obtained at an unfocused point (2 mm) and at a focal distance of 13 mm. For the performance test, moxibustion therapy was conducted on the abdominal skin of mice for 120 min using the new UMD and its histological images were acquired to analyze the skin-tissue damage.

Results

The FEM simulation of temperature distribution and acoustic pressure agreed with the experimental outcome. Histological images showed that there was no skin-tissue damage to the mouse abdomens after therapy. The results clearly show that the newly developed UMD can overcome the disadvantages of traditional moxibustion therapy and achieve the proposed design parameters.

Conclusion

The FEM simulation and performance tests provided valuable information about developing future UMDs. In addition, its performance can be compared with traditional moxibustion therapy for future study.

Effectiveness and safety of electrical moxibustion for knee osteoarthritis: A multicenter, randomized, assessor-blinded, parallel-group clinical trial

BACKGROUND

The prevalence of knee osteoarthritis (KOA) is increasing, and it has emerged as a major health issue. Studies have been reported that moxibustion is effective for treating KOA, but conventional moxibustion is difficult to control the intensity of stimulation and causes smoke, harmful gases, or odors. An electrical moxibustion (EM) device was developed to solve these problems, so we conducted this study to evaluate the effectiveness and safety of EM as a treatment for KOA.

METHODS

This is a multicenter, randomized, assessor-blinded, parallel-group clinical trial. Participants with KOA were randomly allocated into EM, traditional indirect moxibustion (TIM), or usual care groups. The moxibustion groups were received 12 sessions of moxibustion treatment at six acupuncture points (ST36, ST35, ST34, SP9, EX-LE4, SP10) over a period of 6 weeks. The usual care group was received usual treatment and self-care. The primary outcome was the degree of pain measured by numerical rating scale (NRS). The second outcomes were measured using visual analog scale, Korean version of the Western Ontario and McMaster Universities osteoarthritis index, patient global assessment, European quality of life five dimension five level scale, and warm sense threshold and heat pain threshold. For safety assessment, laboratory test and adverse events (AEs) were recorded.

RESULTS

A total of 138 participants were assigned. While there was no significant NRS change in the usual care, EM and TIM showed significant decrease after treatment. Compared to the usual care, the mean change of NRS in the EM and TIM was significantly different, but there was no significance between two groups. Regarding secondary outcomes, EM and TIM also showed significant difference compared to the usual care, but there was no significance between two groups. Regarding safety assessment, while usual care showed significant safety among three groups, EM showed seven treatment-related AEs by four participants compared TIM's 10 events by 10 participants. In addition, there was no blister caused by burns in the EM, which occurred four cases in the TIM.

CONCLUSION

This study shows that EM is effective to improve the pain and function by KOA with a certain level of safety.

Exploring traditional acupuncture point selection patterns for pain control: data mining of randomised controlled clinical trials

BACKGROUND

The underlying principles of traditional acupuncture point selection for pain control are complex. Analysis of acupuncture treatments from clinical studies may provide us with a potential rule when selecting traditional acupuncture points (hereafter abbreviated as "points") in treatment protocols for pain control. The aim of this study was to investigate which points were most commonly used to treat pain in randomised controlled clinical trials (RCTs).

METHODS

We searched acupuncture treatment regimens in RCTs included in the Cochrane Database of Systematic Reviews for pain management. We analysed information on point selection (more than 10 RCTs included) from seven eligible systematic reviews on pain control. The frequency of the points used was calculated and visualised using a human body template.

RESULTS

The points most commonly used across diseases were SP6, ST36, LI4 and LR3. However, the most frequently used points varied across individual conditions. For example, the most frequently used points to treat migraine were GB20, LR3, GV20, Taiyang, LI4 and TE5, while the most frequently used points to manage dysmenorrhoea were SP6, CV4, SP8, LR3 and BL32. Both regional and distal points were used for pain management with acupuncture.

CONCLUSIONS

Our findings suggest that local and segmental/extra-segmental neuromodulation appear to be the most common phenomena for pain control in acupuncture research. Analysis of information on point selection using a data-driven approach may unveil the hidden patterns of traditional acupuncture point utilisation in clinical practice.

Characterization of moxa floss combustion by TG/DSC, TG-FTIR and IR

The combustion of moxa floss was investigated by thermogravimetric/differential scanning calorimeter (TG/DSC), thermogravimetric/Fourier transform infrared spectroscopy (TG-FTIR) and an infrared radiation spectrum-detecting system. The average mass loss rate at the major stage of combustion was 1.08%/min with a peak at 7.86%/min. Moxa floss burning released the integral heat of 9188 mJ/mg from the temperature of 200 °C to 500 °C. The peak heat flow during char combustion stage was higher than those of other stages. The results indicated the combustion of moxa floss was a mild and slow process, releasing heat continuously and steadily. The infrared radiation spectra of burning moxa stick were in a range of 2.5-13.0 µm and showed double peaks at 3.75 µm and 8.75 µm. Thus, this study provided insight into why moxa floss biomass is the optimal material for thermal therapy and is beneficial for the development of electric thermal stimulation alternative.