Effect of Moxibustion on HIF-1α and VEGF Levels in Patients with Rheumatoid Arthritis

Background. Moxibustion has a therapeutic effect of reducing swelling and relieving pain in patients with rheumatoid arthritis (RA) but its mechanism is uncertain. Objective. To evaluate the effect of moxibustion on serum levels of hypoxia-inducible factor-1 alpha (HIF-1 alpha) and vascular endothelial growth factor (VEGF) in patients with RA and to explore the possible mechanism of moxibustion. Methods. This study involved 46 RA patients who had fulfilled the inclusion criteria and were randomly assigned to a treatment group and a control group in an equal ratio. The control group was treated with methotrexate or leflunomide, while the treatment group received methotrexate or leflunomide and moxibustion at ST 36 (Zusanli), BL 23 (Shenshu), and Ashi points. Patients' clinical symptoms, RA-associated serum markers, and serum levels of TNF-alpha, IL-1 beta, HIF-1 alpha, and VEGF were compared in the two groups before and after intervention. Statistical analysis was performed using SPSS 21.0 statistical software. Results. 37 of 46 RA patients eventually completed the whole treatment course. Compared with the control group, the treatment group significantly improved the clinical symptoms (P<0.05) but with no significant differences in RA-associated serum markers (P>0.05). There were significant differences in TNF-alpha and IL-1 beta among the groups after 8 weeks of treatment (P<0.05). HIF-1 alpha and VEGF were decreased in the treatment group after therapy (P<0.05). VEGF was reduced in the control group (P<0.05), while HIF-1 alpha was not significantly improved (P>0.05). The reductions of HIF-1 alpha and VEGF in the treatment group were superior to the control group (P<0.05). Conclusions. Moxibustion enhanced the anti-inflammatory and analgesic effects of conventional medicine and can enhance the effect of conventional medicine, downregulating HIF-1 alpha/VEGF contents to inhibit angiogenesis.