J. Acupunct. Tuina. Sci.

(2009) 7: 80-83
DOI: 10.1007/s11726-009-0080-1

Clinical Study

Clinical Research of Ulcerative Colitis Treated with

Herbal Cake-partitioned Moxibustion
WU Huan-gan (), SHI Zheng (), ZHU Yi (), MA Xiao-peng (), YAO Yi (),
CUI Yun-hua (), ZHAO Tian-ping (), LIU Hui-rong ()
Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, P. R. China

UC
TNF- 67 UC35
32

TNF-
TNF-TNF-R1TNF-R2
TNF-R1 UC

TNF-TNF-R1TNF-R2 TNF-R1

-
Abstract Objective: To observe the effects of herbal cake-partitioned moxibustion and
bran-partition moxibustion in improving symptoms of ulcerative colitis (UC) and the TNF-
and its receptor of colon mucosa. Method: 67 UC cases were randomly allocated into herbal
cake-partition moxibustion group of 35 cases and bran-partitioned moxibustion group of 32
cases, to compare the improvement and detect the TNF- and its receptor with immunohistochemical method in both groups. Result: Herbal cake-partitioned moxibustion is prior to
bran-partitioned moxibustion in improving of diarrhea, flatus, lassitude, tenesmus and lumbar
soreness; The expression of TNF-,TNF-R1, and TNF-R2 are significantly decreased after
treatment in herbal cake-partitioned moxibustion group, while in bran-partitioned moxibustion
group only TNF-R1 expression is significant decreased after treatment. Conclusion:
Moxibustion can well improve the syndromes of UC, Herbal cake-partitioned Moxibustion is
prior to bran-partitioned moxibustion in the improvement of diarrhea and flatus; Herbal
cake-partitioned moxibustion could down-regulate the expression of TNF-,TNF-R1, and
TNF-R2, while bran-partitioned moxibustion could only down-regulate the expression of
TNF-R1.
Key WordsColitis, Ulcerative; Indirect Moxibustion; Diarrhea; Acupuncture-moxibustion
Therapy; Tumor Necrosis Factor-alpha
CLC NumberR246.1
Document CodeA
Ulcerative Colitis (UC) is a common disease in
digestive system which mainly manifested with
diarrhea, abdominal pain, mucus bloody purulent
stool. The incidence of UC is high. The disease
possesses a long-term duration and recurrent attacks
nature, which subject to fibrous degeneration

even worse to be canceration. The author studied and

proved that acupuncture-moxibustion has good
curative effect on UC[1-3], while lack of systematical
observation on the improvement of syndromes. This
article observed the improvement of UC syndromes
and regulating function on TNF- under the treatment
of herbal cake-partitioned moxibustion and bran-

Author: WU Huan-gan (1956- ), male, professor

80 Copyright2009 Shanghai Research Institute of Acupuncture and Meridian

J. Acupunct. Tuina. Sci. (2009) 7: 80-83

partitioned moxibustion so as to supply the theoretical

base on the clinical application.

1 Clinical Data
1.1 General data
Sixty-seven UC patients were diagnosed according
to the revised diagnostic criteria in The Inflammatory
Bowel Disease Seminar in 2000 (Chengdu)[4]. They
all came from the OPD of UC department in Shanghai
Research Institute of Acupuncture and Meridian from
February 2003 to February 2006 and classified as
mild and moderate type. Sixty-seven cases were
divided into 35 cases in herbal cake-partitioned
moxibustion group and 32 cases in bran-partitioned
moxibustion group. Among the 35 cases in herbal
cake-partitioned moxibustion group, male cases: 20,
female cases: 15; the oldest: 71 years old and the
youngest: 15 years old, at the average age of 41.83
years old; the disease duration lasts from 1 month to
40 years. Among the 32 cases in bran-partitioned
moxibustion group, male cases: 17, female cases: 15,
the oldest: 73 years old, the youngest: 20 years, at the
average age of 45.2 years old; the disease duration
lasts from 3 month to 30 years. The data between two
groups are comparable after the statistical treatment.
1.2 Score scale of clinical symptoms
Evaluate the score of 12 symptoms (abdominal
pain, diarrhea, mucosal fluid stool, bloody purulent
stool, rugitus, abdominal distention, flatus, chilly,
lassitude, tenesmus, lumbar soreness and poor
appetite) before and after treatment according to the
severity such as: 0 (no symptoms appear), 1
(occasionally appear) and 2 (always and persistent
appear).
1.3 Observation index
1.3.1 Therapeutic effect
The symptoms of 67 patients before and after
treatment were analyzed to evaluate the effect
according to the symptom score.
Improved: The score difference before and after
treatment1.
Ineffective: The score difference before and after
treatment=1.

1.3.2 Expression of TNF-, TNF-R1, TNF- R2 of

colon mucosa
The above indexes were detected by the immunohistochemical method and image analysis.
2 Therapeutic Methods
2.1 Herbal cake-partitioned moxibustion group
The herb formulae are: Fu Zi (Radix Aconiti
Lateralis)
Rou Gui (Cortex Cinnamomi)Dan Shen
(Radix Salviae Miltiorrhizae) Hong Hua (Flos
Carthami)Mu Xiang (Radix Aucklandiae).
Points: bilateral Tianshu (ST 25)Qihai (CV 6),
Guanyuan (CV 4). The herbal powder was mixed up
with rice wine to make paste (2.5 g powder for each).
The herbal cake-partition moxibustion treatment was
given once daily, each point was treated for two cones
of moxa. 12 times as a treatment course with 3 d
interval and 6 courses were treated totally.
2.2 Bran-partitioned moxibustion group
The paste was made by bran powder, the point
selection, treatment method and courses are same as
herb-partitioned moxibustion.

3 Results
3.1 Improvement of symptoms in the two groups
All syndromes were improved well in both groups.
There is no significant difference between two groups
in the improvement of abdominal pain, mucosal fluid
stool, bloody purulent stool, abdominal distention,
rugitus, chilly and poor appetite; while the herbal
cake-partitioned moxibustion group is superior to
bran-partitioned moxibustion in improving diarrhea,
flatus, lassitude, tenesmus and lumbar soreness (see
table 1).
3.2 Expression of TNF-TNF-R1TNF-R2
of colon mucosa
The unit integrate optical density of TNF-
TNF-R1TNF-R2 are comparable since there is no
statistical difference between two groups before
treatment. The unit integrate optical density of
TNF-TNF-R1TNF-R2 decreased significantly
in herbal cake-partitioned moxibustion group after
treatment; Only TNF-R1 decreased significantly in
bran-partitioned moxibustion group. There is no
significant change of TNF-R1 in two groups after
treatment (table 2).

Copyright2009 Shanghai Research Institute of Acupuncture and Meridian 81

J. Acupunct. Tuina. Sci. (2009) 7: 80-83

Table 1. Improvement of UC symptoms in two groups
Symptoms
Abdominal pain

Herb-partitioned moxibustion group

Bran-partitioned moxibustion group

Improved

Ineffective

Effective rate (%)

Improved

Ineffective

Effective rate (%)

26

19

73.08

25

20

80.00

1)

Diarrhea

25

24

96.00

26

19

73.08

Mucous stool

21

18

85.71

22

16

72.73

Bloody purulent stool

20

15

75.00

23

17

73.91

Abdominal distention

20

19

95.00

22

17

77.27

Rugitus

20

19

95.00

19

15

78.95

Flatus

19

18

94.741)

21

15

71.43

Lassitude

25

19

76.001)

25

17

32.00

Chilly

10

70.00

17

52.94

1)

Tenesmus

15

60.00

17

13

23.53

Lumbar soreness

75.001)

16

14

12.50

Poor appetite

10

70.00

10

50.00

NoteCompared with bran-partitioned moxibustion group, 1) P<0.05

Table 2. Unit integrate optical density of TNF-TNF-R1TNF-R2 ( x s)
Groups
Herb-partitioned moxibustion
Bran-partitioned moxibustion

Time

TNF-

TNF-R1

TNF-R2

Before treatment

15

0.1060.0270

0.1880.0779

0.1040.0093

After treatment

15

0.0870.0234 1)

0.1580.0707 1)

0.0630.0014 1)

Before treatment

15

0.1150.0498

0.1770.0099

0.0890.0084

After treatment

15

0.1010.0295

0.1540.00851)

0.0730.0034

Note: Compared before treatment, 1) P <0.05

4 Discussion
UC belongs to the scope of "diarrhea", "Chang pi"
in traditional Chinese Medicine, the main mechanism
of UC is deficiency of spleen and stomach. It always
induced or aggravated by the heat-damp and liver qi
attacking spleen. Long term duration or frequent
attacks could lead to the yang deficiency of spleen
and kidney and appear a serious of complicated
intestinal syndromes. The main treatment principal is
warm nourishing the spleen and kidney as well as
activating blood and smoothing qi. Thus the points
Tianshu (ST 25), Qihai (CV 6) and Guanyuan (CV 4)
were selected to treat both root and branches of the
disease. Tianshu (ST 25) can remove dampness and
turbid and activate blood, Qihai (CV 6) and
Guanyuan (CV 4) reinforcing the lower Jiao and
strengthen the kidney. Tianshu (ST 25) and Guanyuan
(CV 4) are the Front-Mu points for the large and small
intestines which regulating the complicated excess
and deficiency situation between Zheng qi (the vital
qi) and Xie qi (the evil qi). The research indicated that

herbal cake-partitioned moxibustion and branpartitioned moxibustion could well improve all the
symptoms of UC. The Herbal cake-partitioned
moxibustion group is superior to bran-partitioned
moxibustion in the improvement of diarrhea, flatus,
lassitude, tenesmus and lumbar soreness. While there
is no statistical difference between two groups in the
improvement of abdominal pain, mucosal fluid stool,
bloody purulent stool, abdominal distention etc. The
treatments in two groups are both indirect
moxibustion, the effect comes from the synergism of
moxibustion, points and herb (or paste). This article
found that herbal cake-partitioned moxibustion is
prior to bran-partitioned moxibustion in improvement
of certain UC syndromes, which shows that the effect
is closely related with the pastes. The author
presumed that in the herb paste, Fu Zi (Radix Aconiti
Lateralis) and Rou Gui (Cortex Cinnamomi) could
warming yang Mu Xiang (Radix Aucklandiae), Dan
Shen (Radix Salviae Miltiorrhizae) and Hong Hua
(Flos Carthami) have the function of activating blood
and smoothing qiwhile bran paste have no such

82 Copyright2009 Shanghai Research Institute of Acupuncture and Meridian

J. Acupunct. Tuina. Sci. (2009) 7: 80-83

medical function, thats why the different

improvement of certain syndromes occur in both
groups.
TNF- possess an extensive biologic activity which
plays an important role in the mechanism of UC. It is
the important inflammation mediators of epithelium
damage, onset and enlargement of ulceration on colon
mucosa, which also participated in the apoptosis and
increased the apoptosis of colonic epithelium cells,
and delayed the apoptosis of neutrophilic leukocyte
which injured the colonic tissues. The biological
effect of TNF- generated through the combination
with TNF-R, which including TNF-R1 and
TNF-R2. The quantity and distribution of two
TNF- receptors are different in different cells. The
expression of TNF-R1 are mainly expressed on the
endothelial cells while TNF-R2 are mainly
expressed on the lympholeukocytes and monocytes.
This research detected the unit integrate optical
density of positive materials in sample to reflect the
effect on TNF- and its receptors of colonic mucosa
in UC patients through treatment of herbal
cake-partitioned moxibustion and bran-partitioned
moxibustion. The unit integrates optical density value
of TNF-, TNF-R1 and TNF-R2 decreased in the
affected colonic mucosa of UC patients after
treatment. There is significant change of TNF-,
TNF-R1 and TNF-R2 in herbal cake-partitioned
moxibustion
which
indicated
that
herbal
cake-partitioned moxibustion could improve the
inflammation and enhance the tissue repair by down
regulated the expression of TNF-, TNF-R1 and

TNF-R2 in the colonic mucosa. While branpartitioned moxibustion could only significant down
regulated TNF-R1 statistically, TNF- and TNF-R2
could be down regulated by bran-partitioned
moxibustion with no statistical change. It shows that
bran-partitioned
moxibustion
improved
the
inflammation by down-regulating the expression of
TNF-R1 and decreased the reaction of colonic
mucosa epithelium and TNF-. This article studied
initially about the effect of herbal cake-partitioned
moxibustion and bran-partitioned moxibustion in
treating UC and regulating the TNF- and its
receptors, which still needs further research.

References
[1] WU Huan-gan, GAO Zhen-wu, ZHANG Lan. Clinical and
Empirical study of chronic non-specificity Colitis in the
Treatment of Herb-partitioned Moxibustion. Chinese
Acupuncture-moxibustion, 1992, 12 (1): 28-31.
[2] WU Huan-gan, TAN Wei-lin, CHEN Han-ping, et al. Effect
on Ulcerative Colitis and Influence on HLA-DR Antigen of
Enterocyte. Acupuncture Research, 1999, 24 (1):12-16.
[3] LIU Hui-rong, TAN Lin-ying, WU Huan-gan, et al. Effect
of Moxibustion on the Synthesis and Secretion of Collagen
by Colonic Fibroblasts in Ulcerative Colitis Fibrosis Rast.
Journal of Acupuncture and Tuina Science, 2008, 6 (1): 4-7.
[4] OUYANG Qin, FAN Guo-zong, WEN Zhong-hui, et al.
Proposition on the Criteria of Diagnosis and Therapeutic
Effects in Inflammatory Bowel Disease. Chinese Journal of
Digestion, 2001, 21(4): 236-239.
Translator: YANG Ling ( )
Received Date: October 10, 2008

Advance Notice

Main Contents of the Third Issue in 2009

Observation on the Urodynamics Changes of Unstable Bladder Treated with Acupuncture
Study on the Ischemic Stroke Treated by Acupuncture plus rehabilitation
Treatment of 96 Cases of Facial Paralysis by Acupuncture
Therapeutic Effect of Tuina on Lumbar Spondylolisthesis
Documentary Analysis of Acupuncture Treating Headache
Progress of Chronic Fatigue Syndrome Treated by Acupuncture and Tuina
Clinical Study of Acupuncture Treating Ischemic Stroke

Copyright2009 Shanghai Research Institute of Acupuncture and Meridian 83