Objective To observe influences of heat-reinforcing needling(HRN)on scores of traditional Chinese medicine(TCM)symptoms and expression of plasma ATP synthase subunit O(Atp 5O)mRNA and lysosomal V1 subunit B2(Atp 6V1B2)mRNA in patients with wind-cold-damp retention type rheumatoid arthritis(RA)

so as to investigate its biological mechanisms in"heat production".Methods Sixty wind-cold-damp retention type RA patients were randomly allocated to HRN group(n=30)and control group(n=30).Guanyuan(CV 4)

Qihai(CV6)

bilateral Zusanli(ST 36)

and local acupoints near the knee-joint were selected for needling stimulation.Patients of the HRN group were treated by manipulating the acupuncture needle with HRN

and those of the control group treated by manipulating the needle with uniform reinforcing-reducing method.The treatments were performed once daily

5days a week

and two weeks altogether.The other 30 healthy volunteers were recruited as the normal control group.The TCM symptom scoring system(0-31 points

11items as the severities of pain

swelling and tenderness of the knee-joint)was used to evaluate the status of RA

and quantitative real-time PCR(RT-PCR)was used to detect the expression of plasma Atp 5O mRNA and Atp 6 V1B2 mRNA following removal of red blood cells.Results After the treatment

the TCM scores of both the HRN and control groups were significantly decreased(P<0.05)

and that of the HRN group was significantly lower than that of the control group(P<0.05).Before the treatment

the expression levels of plasma Atp 5 O mRNA and Atp 6 V1B2 mRNA in RA patients were significantly lower than those of the normal group(P<0.05)

and after the treatment

the expression levels of plasma Atp 5O mRNA and Atp 6 V1B2 mRNA were significantly increased in both HRN and control groups compared to pre-treatment in the same one group(P<0.05)

and the up-regulated Atp 5O mRNA and Atp 6 V1B2 mRNA levels were remarkably higher in the control group than in the HRN group(P<0.05).Conclusion Both heat-producing needling and uniform reinforcing-reducing needling can improve RA patients' clinical symptoms

which may be associated with their actions in up-regulating expressions of plasma Atp 5 O mRNA and Atp 6 V1B2 mRNA.