Abstract

Background Diarrhea-predominant irritable bowel syndrome (IBS-D) is a functional gastrointestinal disorder that severely affects patients' life. Moxibustion is believed to be an effective way to treat IBS-D. However, the therapeutic effects and the underlying mechanisms in symptom management of IBS-D by different moxibustion therapies remain unclear. Methods IBS-D model rats were divided into groups and treated with ginger-partitioned moxibustion (GPM), mild moxibustion (MM), and laser moxibustion (LM) at a temperature of 43°C, respectively. The temperature curves of acupoints were recorded during interventions. The therapeutic effects were evaluated on the basis of general condition, stool, and hematoxylin-eosin staining of the colon tissue. Moreover, the expression of transient receptor potential vanilloid 1 (TRPV1) receptors in both acupoint tissue and colon tissue was analyzed by immunohistochemistry. Results After moxibustion treatment, the symptoms were improved. The expression of TRPV1 was increased in acupoint tissue and decreased in colon tissue. GPM and MM showed a more significant influence on IBS-D rats compared with LM. The temperature profile of GPM and MM was wave-like, while LM had an almost stable temperature curve. Conclusion GPM, MM, and LM could improve the symptoms in IBS-D rats. Moxibustion might activate TRPV1 channels in the acupoint tissue and induce acupoint functions, which in turn inhibit the pathological activation state of the colon's TRPV1, followed by improvements in abdominal pain and diarrheal symptoms. LM with stable temperature might lead to the desensitization of TRPV1 receptors and the tolerance of acupoint. GPM and MM provided dynamic and repetitive thermal stimulations that perhaps induced acupoint sensitization to increase efficacy. Therefore, dynamic and repetitive thermal stimulation is recommended in the application of moxibustion.

Highlights

  • Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by altered bowel habits, abdominal pain, and bloating, with a global incidence as high as 23% [1, 2]

  • We found that the expression of transient receptor potential vanilloid 1 (TRPV1) receptors in both acupoint tissues and colonic tissues of IBSD model rats was higher than that in normal healthy rats, indicating that the acupoint area may become activated from a dormant state, and the colonic tissues showed a pathologically activated state. e intervention of three moxibustion treatments further increased the expression of the TRPV1 receptor in acupoint tissue while decreasing the expression of the TRPV1 receptor in colon tissue

  • Moxibustion might play a role in the treatment of irritable bowel syndrome (IBS-D) by thermal stimulation to activate TRPV1 channels in the acupoint tissue and induce acupoint functions, which in turn inhibit the pathological activation state of TRPV1 ion channels in the colon, followed by a reduction of intestinal hypersensitivity and regulation of colon motility, as well as improvements in abdominal pain and diarrheal symptoms

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Summary

Introduction

Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by altered bowel habits, abdominal pain, and bloating, with a global incidence as high as 23% [1, 2]. Moxibustion, as one treatment of Traditional Chinese Medicine, is carried out by applying thermal stimulation on specific acupoints, which is believed to prevent and treat IBS-D [5]. Tong et al performed mild moxibustion intervention on IBS-D models rats for one week and found that mild moxibustion improved the symptoms of diarrhea significantly [9]. The therapeutic effects and the underlying mechanisms in symptom management of IBS-D by different moxibustion therapies remain unclear. GPM, MM, and LM could improve the symptoms in IBS-D rats. Moxibustion might activate TRPV1 channels in the acupoint tissue and induce acupoint functions, which in turn inhibit the pathological activation state of the colon’s TRPV1, followed by improvements in abdominal pain and diarrheal symptoms. GPM and MM provided dynamic and repetitive thermal stimulations that perhaps induced acupoint sensitization to increase efficacy. GPM and MM provided dynamic and repetitive thermal stimulations that perhaps induced acupoint sensitization to increase efficacy. erefore, dynamic and repetitive thermal stimulation is recommended in the application of moxibustion

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