Monday, May 19, 2008

Clinical Observation On The Effect Of Acupuncture In Angina Pectoris

Beijing Cooperative Group of Studying Coronary Heart Disease

Since 1975, 621 patients with coronary heart disease were treated with acupuncture and some of these patients were studied with electrooscillography, ultrasonic cardiography and rheoencephalography. Among them the dynamic changes of the left ventricular reserve before and after acupuncture in 123 cases were studied by synchronous recording of the EKG, phonocardiogram (PCG), carotid pulse tracing (CPT) and apexcardiogram (ACG) and in 35 cases serving as self-controls in order to obtain some objective evidences in the treatment of coronary heart disease.


I. Methods:

Shanzhong point, directed subcutaneously for 2.5-2.8 cun toward Jiuwei point after puncture, points Neiguan and Zusanli were selected as the main points, with points Tengli, Quchi, Shenmen, Rugen, Jianshi and Ximen selected according to the differential classification on the basis of "Wuxintong" . Manipulation: mainly "bu" method ( re-enforcing method) retaining the needle for 20 minutes.

II. Results:

1. The improvements were observed in 89.2% of 621 cases with marked improvement in 47.8% and the nitroglycerin was stopped or decreased in dosage in 93.6% of cases. It can be shown that acupuncture does have certain effect in relieving and abolishing the symptoms of angina pectoris.


2. The effects before and after acupuncture were compared and improvements were obtained in 53.2% of 578 cases. Serial observation were made with electrocardioscope in 100 cases and marked improvements in EKG were found in 30 cases after acupuncture for 1-20 minutes. It showed that acupuncture may improve the coronary circulation and thereby EKG changes gradually returned to normal as the symptoms of angina pectoris improved.

3. Observation with ultrasonic cardiograph in 100 cases of coronary heart disease before and after acupuncture showed a marked difference in the amplitude of the posterior wall of the left ventricle as well as in stroke volume, P<0.001, indicating acupuncture may improve the function of the left ventricle of angina pectoris.


4. There were marked changes of each parameter in rheoencephalogram after acupuncture in 50 cases, P<0.001, indicating improvement of cerebral and coronary circulation. These may be closely related with the improvement of left ventricular function.

5. The difference in the effects of acupuncture at "Point" and "Non-Point" compared with ultrasonic cardiograph and rheoencephalograph were found, P<0.001, indicating a specificity of the points used in the treatment of this disease.


6. Acupuncture at Neiguan in 123 cases of coronary heart disease resulted in a slowing of the heart rate, prolongation of the electric mechanical contraction period (QA[2]), mechanical systolic (MS) and slow filling (SF), shortening of the Pre-ejection period (PEP) and reduction of PEP/ET, indicating certain improvement in the left ventricular function after acupuncture. The shortening of isovolume contraction time (ICT), marked increase of ET/ICT, elongation of left ventricular ejection time (LVET), the increase of the contraction of the myocardium, the marked decrease in the percentage of A wave of ACG indicated an effect of reduction of the left-ventricular end-diastolic pressure. For the controls without receiving acupuncture, there were some slowing of the heart rate after lying down for 15 minutes, a prolongation of QA[2], MS, SF but for parameters of other findings no statistically significant difference were found.


Basing on the above statement, it might be shown that acupuncture therapy had the advantages of being rapid effect, economical, easily available and without side-effect after long period of application. It deserves further study in the future.

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