Wednesday, May 28, 2008

Effects Of Acupuncture On Angina Pectoris In Patients With Coronary Heart Disease

Meng Jingbi, Liu Ruiting, Xu Huiren (Institute of Acupuncture and Moxibustion, Academy of Traditional Chinese Medicine)

Acupuncture has been used for angina pectoris. Not only the clinical symptoms can be relieved but also the ischemic electrocardiogram of the patients can be partially improved. In order to further confirm this effect, synchronous recordings of ECG, PCG, CARO and ACG were made using a paper speed of 100 mm/second. Calculations were done manually and the four parameters were recorded with a recorder, and then put into a medical computer. The cardiac diastolic and systolic intervals and A wave per cent in the ACG were measured by means of the light-spot illuminating method, and then observations were made.


Patients studied: 123 patients were selected according to the diagnostic criteria specified at the National Conference for Coronary Heart Disease held in 1974. They all had typical clinical symptoms and recent electrocardiograms showing changes in the ST-T wave and were treated by needling point Neiguan. 35 patients served as controls. 68 were males and 55 were females. They were between 33-75 years of age. In addition, acupuncture was given to 30 normal subjects without cardiovascular disease. Before withdrawal, the needle was rotated for 2 minutes and retained for 15 minutes. Three successive recordings were made and compared. The results are summarized as follows:


(1) The heart rates and the cardiac diastolic and systolic intervals of normal subjects were analyzed using a regression equation and the concordance test. The electric systolic interval (QA[2])=483.29-1.49 HR, r=-0.58, the mechanical systolic interval (MS)=395.57-0.90 HR, r=-0.36, the ejection time (ET)=386.57-1.41 HR, r=-0.60, and the slow filling interval (SF)=1135.55-12.59 HR, r=-0.89. These four parameters showed a linear negative concordance with the heart rate. However, no linear relationship existed between the four parameters and the prolonged electric systole (QS[1]), pre-ejection period (PEP), isovolumetric contraction time (ICT), isovolumetric relaxation period (IRP), rapid filling period (RF), PEP/ET and ET/ICT. There was no significant difference in the abovementioned parameters in normal subjects before and after acupuncture.


(2) When comparisons were made between patients suffering from angina pectoris and normal subject, the heart rate was found to be increased, QA[2], MS, PEP, ICT and IRP were markedly prolonged, ET and SF were markedly shortened, PEP/ET was definitely increased ET/ICT was definitely decreased, and the A wave per cent in ACG was significantly raised. These results indicate that the function of the left ventricle of the patient was relatively poor, the force of myocardial contraction was weak and the left ventricular end diastolic pressure raised. After lying down quietly for 15 min. no marked differences were observed in these parameters, except that the heart rate slowed slightly, and QA[2], MS and SF were somewhat prolonged.


(3) Acupuncture could slow down the heart rate markedly in patients suffering from angina pectoris, significantly prolong QA[2], MS and SF, definitely shorten PEP and decrease PEP/ET, indicating that acupuncture may improve the function of the left ventricle of the patient. ICT was significantly shortened, ET prolonged, and ET/ICT increased, indicating that the force of myocardial contraction was stronger after acupuncture. The decrease in A wave per cent in ACG indicates that the left ventricular end-diastolic pressure was decreased by acupuncture.


(4) By comparing with the corrected value of the ejection interval, 69.12% of the patients, 14.28% of the controls, and 30% of normal subjects had a prolonged ejection interval. The differences between the groups were statistically significant. The results demonstrate that the function of the left ventricle of most patients after acupuncture could be improved, and that acupuncture could relieve the clinical symptoms.

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