Zhongguo quanke yixue (Jul 2023)
Effect of Pricking-bloodletting Therapy Combined with Zhuang-medicine-thread Moxibustion on TLRs/MyD88 Signal Pathway in a Rat Model of Acute Gouty Arthritis
Abstract
Background With the change of people's environment and diet structure, acute gouty arthritis (AGA) has become a common clinical disease, which is prone to recurrence, causing harm to patients' health. Pricking-bloodletting therapy combined with Zhuang-medicine-thread moxibustion (moxibustion with a threat prepared with Zhuang herbal medicine) has proven to have a definite therapeutic effect on AGA clinically, but the mechanism of action is not very clear. Objective To assess the effect of pricking-bloodletting therapy combined with Zhuang-medicine-thread moxibustion on toll-like receptors /myeloid differentiation factor 88 (TLRs/MyD88) signal pathway in a rat model of AGA to explore the mechanism of action of this treatment in AGA. Methods The experiment lasted from May 2021 to March 2022, sixty SD rats were equally randomized into 6 groups: blank group, model group, pricking-bloodletting group, medicated thread group, colchicine group and pricking-bloodletting with medicated thread group. Except for the blank group, the other groups received sodium urate suspension injected into the right ankle cavity to prepare the AGA model. Twenty-four hours after the modelling, colchicine group received intragastric administration of colchicine suspension, pricking-bloodletting group received bloodletting after pricking the Ashi acupoint with a needle, medicated thread group received Zhuang-medicine-thread moxibustion at the site of lesion, and pricking-bloodletting with medicated thread group first received bloodletting after pricking the Ashi acupoint with a needle, then Zhuang-medicine-thread moxibustion at the site of lesion. The swelling degree of the right ankle joint was observed at 6, 12, 24 h and 72 h after modeling. Hematoxylin-eosin staining was used to observe the pathological changes of the synovium of the right ankle joint. The serum levels of interleukin (IL) -10, IL-8 and cyclooxygenase-2 (COX-2) were determined by ELISA. The expressions of MyD88 and IKK-β in the synovium of the right ankle were detected by western blotting. Results The transverse diameter of right lateral malleolus in model group, pricking-bloodletting group, medicated thread group or colchicine group was larger than that in blank group at 6, 12, 24, 48 h and 72 h after modeling (P<0.05). The transverse diameter of right lateral malleolus in pricking-bloodletting with medicated thread group was larger than that in blank group at 6, 12, 24 h and 48 h after modeling (P<0.05). The transverse diameter of the right lateral malleolus of the pricking-bloodletting group, medicated thread group, colchicine group or pricking-bloodletting with medicated thread group was smaller than that of the model group at 48 h and 72 h after modeling (P<0.05). Compared with model group, the inflammatory cell infiltration of right ankle in pricking-bloodletting group, medicated thread group, colchicine group and pricking-bloodletting with medicated thread group was improved. The blank group had lower levels of IL-8 and COX-2 and higher level of IL-10 than each of the other 5 groups (P<0.05). The model group had higher levels of IL-8 and COX-2 and lower level of IL-10 than colchicine group, pricking-bloodletting with medicated thread group, pricking-bloodletting group or medicated thread group (P<0.05). The colchicine group had lower levels of IL-8 and COX-2 and higher level of IL-10 than pricking-bloodletting group or medicated thread group (P<0.05). The pricking-bloodletting with medicated thread group had lower levels of IL-8 and COX-2 and higher level of IL-10 than pricking-bloodletting group or medicated thread group (P<0.05). The blank group had lower level of MyD88 than each of the other 5 groups (P<0.05). The blank group had lower level of IKK-β than model group, medicated thread group, pricking-bloodletting group or pricking-bloodletting with medicated thread group (P<0.05). The model group had higher IKK-β level than medicated thread group or colchicine group (P<0.05). The model group had higher MyD8 level than medicated thread group, colchicine group, pricking-bloodletting group or pricking-bloodletting with medicated thread group (P<0.05) . Conclusion Pricking-bloodletting with Zhuang-medicine-thread moxibustion is effective in improving the symptoms of AGA by regulating the TLRs/MyD88 signaling pathway, which may be a potential alternative therapy for AGA.
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