Effect of dog-day moxibustion on chges of soluble cellular adhesion molecules in patients with bronchial asthma

Background: It is thought in traditional Chinese medicine that dog-day moxibustion (DDM) has good clinical effect in treating bronchial asthma. Study of its influence on soluble cellular adhesion molecules in patients with bronchial asthma can help to well understand its mechanism. 

Objective: To observe the effect of dog-day on soluble cellular adhesion molecules in patients with bronchial asthma. 

Design: Self-control, case-control observation. 

Setting: College of Acupuncture and Manipulation and Clinic of the Department of Acupuncture and Moxihustion of the First Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine. 

Participants: Totally 28 patients with bronchial asthma receiving dog-day moxibustion in the Clinic of the Department of Acupuncture and Moxibustion, First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from July to August 2004 were set as dog-day moxibustion group, and 10 concurrent health volunteers were set as normal control group. 

Methods: According to the principle of "treating winter diseases in summer", the Chinese medicine which consists of such herbs as Baijiezi (Semen Sinapis Albae), Mahuang(Herba Ephedrae), Xixin (Herba Asari), Gansui(Radix Kansui), Yanhu(Rhizoma Corydalis)was stuck on the points such as Feishu, Dingchuan. Fengmen, Bailao, Shenshu. Point selection was at the two sides, and a lumpy salve was stuck on the point with adhesive tape. Three to six hours for adult and one to two hours for children in each sticking duration; and the operation was respectively done on the first (July 20), second (July 30) and third (August 9) dog-day. 

Main outcome measures: Short-term effect 3 months later was observed, the levels of soluble cellular adhesion molecules and IgE were assayed before and 10 days after treatment, and comparison with normal control group was performed. The indexes of the patients before treatment were performed Pearson correlation analysis. 

Results: Twenty-eight patients and 10 healthy persons all entered result analysis. 1 Intercellular adhesion molecule-1 level was significantly higher before treatment in dog-day moxibustion group than that after treatment in the dog-day moxibustion group and that in the normal control group [(281.39±64.58), (256.95±44.22), (194.30±39.05)μg/L,P < 0.01]. 2 Vaso-cellular adhesion molecule-1 level was significantly higher before treatment in the dog-day moxibustion group than that after treatment in the dog-day moxibustion group and that in the normal control group [(234.79±89.75), (185.80±84.41), (128.85±51.28)μg/L,P < 0.01]. 3 IgE level was significantly higher before treatment than that after treatment in the dog-day moxibustion group and that in the normal control group [(482.61±123.43), (418.96±134.18), (161.53±43.64)μg/L,P< 0.01]. 4 Pearson correlation analysis result: Intercellular adhesion molecule-1 level is significantly positively correlated with IgE and vascular intercellular adhesion molecule-1 level (r =0.641,0.449,P < 0.01,0.05). 5 Effect: Total effective rate was 93% (26/28)in the treatment of bronchial asthma with dog-day moxibustion. The type of the symptoms, with blister or not, course of disease and condition of disease had no significant influence on effect (P > 0.05). 

Conclusion: Dog-day moxibustion may effect through inhibiting the expression of adhesion molecule or hihibiting leukocyte to adhere endothelial cell directly so as to reduce the infiltration of inflammatory cells.

背景：传统中医认为三伏天灸疗法对支气管哮喘有很好的临床疗效，认 识该疗法对于支气管哮喘患者可溶性细胞黏附分子的影响有助于更好 地了解其作用机制。 

目的：观察三伏天灸疗法对于支气管哮喘患者可溶性细胞黏附分子的 影响。 

设计：前后对照，病例P对照观察。 单位：广州中医药大学针灸推拿学院及第一附属医院针灸科门诊。 

对象：以 IKKLPKN Q KR 在广州中医药大学第一附属医院针灸科门诊行三 伏天灸治疗的哮喘缓解期患者 IR 例为三伏灸组，同期体检健康自愿者 7K 名为正常对照组。 方法：根据“冬病夏治”原则，于初伏（NPIK）、中伏（NPOK）、末伏（RPKM）分 别将药（麻黄、细辛、甘遂、延胡、白芥子（生）等）贴于患者肺俞、定喘、风 门、百劳、肾俞等穴，贴药时双侧取穴，用胶布将块状药膏贴于穴位上， 贴药时间一般为成人 OST +，儿童约 7SI +。 主要观察指标：观察 O 个月后的近期疗效，于治疗前及治疗后 7K 天分 别检测血浆可溶性细胞黏附分子及 /98 水平，并与正常对照组作对照； 同时将治疗前患者各项指标进行 >$42’"0 相关分析。 

结果：IR 例患者和 7K 名正常人全部进入结果分析。!细胞间黏附分子 7 水平：三伏灸组治疗前显著高于治疗后和正常对照组 U（IR7.OMVTL.JR）， （IJT.MJVLL.II），（7ML.OKVOM.KJ）#9 QW，( X K.K7Y。"血管细胞间黏附分子 7 水平：三伏灸组治疗前显著高于治疗后和正常对照组U（IOL.NMVRM.NJ）， （7RJ.RKVRL.L7），（7IR.RJVJ7.IR）#9 Q W，( X K.K7Y。$/98 水平：三伏灸组 治 疗 前 显 著 高 于 治 疗 后 和 正 常 对 照 组 U（LRI.T7 V7IO.LO），（L7R.MT V7OL.7R），（7T7.JOVLO.TL）#9 Q W，( X K.K7Y。%>$42’"0 相关分析结果：细 胞间黏附分子 7 水平与 /98 和血管细胞间黏附分子 7 均呈显著正相关 （) ZK.TL7，K.LLM，( X K.K7，K.KJ）。&疗效：三伏天灸治疗支气管哮喘的 总有效率为 MO[（IT Q IR），患者证型、有无灸疱、疗程长短及病情轻重对 疗效无显著影响（均 ( \ K.KJ）。 

结论：三伏天灸疗法可能通过抑制黏附分子的表达或直接抑制白细胞 与内皮细胞的黏附，从而减少炎细胞的浸润，达到治疗效果。