Abstract
Background This study aims to systematically evaluate the effect of moxibustion on the level of inflammatory cytokines in animal models with rheumatoid arthritis (RA) and to provide evidence for the clinical application of moxibustion to the treatment of RA and related basic researches. Methods The databases employed in this study include PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), SinoMed, and Wanfang Data Information Site. The retrieval time was from the establishment of these databases to March 2020. The reviewers made use of the CAMARADES 10-item checklist to evaluate the quality of each included study. The inflammatory cytokines were considered as the outcome measure. The Revman 5.3 software was used to conduct meta-analysis on the outcome indicators of the studies included. Results A total of 648 articles were retrieved and 18 animal experiments were included in this study. The quality scores of the studies ranged from two to eight with a mean of 5.8. Compared with the effect of the control group, moxibustion reduced the expression of TNF-α (SMD 2.95, 95% CI: 1.99–3.92, P < 0.00001), IL-1β (SMD 4.10, 95% CI: 2.37–5.84, P < 0.00001), IFN-γ (MD 25, 95% CI: 16.17–33.82, P < 0.00001), IL-6 (MD 11.83, 95% CI: 6.22–17.44, P < 0.0001), and IL-17 (MD 99.3, 95% CI: 86.83–111.76, P < 0.00001). At the same time, the level of IL-2 (SMD 8.89, 95% CI: 0.93–16.86, P=0.03), IL-4 (MD 1.79, 95% CI: 0.26–3.32, P=0.02), and IL-10 (MD 5.93, 95% CI: 1.37–10.49, P=0.01) increased after moxibustion treatment. Asymmetric funnel plots indicated that there was publication bias. Conclusion The findings of the present review indicate that moxibustion can protect the synovium of joint in animal models with RA by upregulation of the level of anti-inflammatory cytokines and downregulation of the level of proinflammatory cytokines. Moxibustion has the potential to relieve inflammation of RA.
Highlights
Rheumatoid arthritis (RA) is an autoimmune disease that starts with the inflammation of synovium. e main symptoms of rheumatoid arthritis (RA) include pain, swelling, and stiffness of the joint
According to the titles and abstracts of these records, the reviewers excluded 173 articles, because some studies were not about animal experiments, some studies were conducted in vitro, and some were reviews or case reports, while others were related to moxibustion therapies combined with other therapies and so on
By analyzing different causes of RA models, we found that CFA models (SMD 4.75, 95% confidence interval (CI): 2.19–7.30, P 0.0003) performed better than CIA models (SMD 3.47, 95% CI: 0.67–6.27, P 0.02) in decreasing IL-1β. e study found that IL-1β levels were significantly reduced in experiments using male rats (SMD 3.89, 95% CI: 2.14–5.65, P < 0.0001), but there was no statistically significant difference in experiments using male–female rats (SMD 5.36, 95% CI: −4.87–15.60, P 0.3)
Summary
Rheumatoid arthritis (RA) is an autoimmune disease that starts with the inflammation of synovium. e main symptoms of RA include pain, swelling, and stiffness of the joint. E pain and joint dysfunction caused by RA urgently need an effective treatment to alleviate the inflammatory reaction and delay the progression of the disease. Among the RA therapeutic strategies, drug treatment is the most prominent one Both anti-inflammatory and biological agents have side effects Accumulate studies demonstrate that moxibustion plays an important role in anti-inflammatory and pain relief, especially for the treatment of musculoskeletal diseases, such as primary osteoporosis [11], cervical spondylosis [12], and knee osteoarthritis [13]. Studies found that the therapeutic effects of moxibustion seem to be related to anti-inflammatory and immune regulation. Erefore, the current study conducted a systematic review and meta-analysis to analyze the effect of moxibustion on inflammatory cytokines in animal models of RA to provide guidance for future animal experiments and clinical trials
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