Investigation On The Current Condition Of Chronic Stable Angina Pectoris And A Randomized Controlled Trial Of Acupuncture For Treatment With Selecting Acupoints Along Meridian

Objective:In this study, with the research vehicle of chronic stable angina, we exploit a clinical research programs on the basis of the clinical investigation, and then by standard clinical randomized controlled trials, we evaluated the differences of point selection along meridians, point selection on other meridians and non-acupoint on the clinical effects. Thereby, we further clarify the proposed "course of meridian is the foundation of the specific of acupoint effect" hypothesis on the basis of preliminary studies and evaluate the clinical effects of acupuncture of chronic stable angina.Methods:1、Using the questionnaire method, we investigate angina patients with onset of symptoms in cardiology clinics and wards of Affiliated Hospital of Chengdu University of TCM, Chengdu Military Region General Hospital and the Hospital of Chengdu chronic, and finally acquire128valid survey questionnaires. Research content includes age, course of the disease, patients’angina frequency, duration, the way to ease, the dosage of nitroglycerin, treatment condition, acupuncture willingness, acupuncture frequency, etc., and its reliability and validity is verified. By analyzing the survey result, we demonstrate the feasibility and confirm dtudy protocol of acupuncture treatment of chronic stable angina pectoris.2、Through a multi-center, randomized, controlled method, we recruit subjects from five clinical centers in Chengdu, Hunan, Yunnan, Guizhou, and Shaanxi,172patients with chronic stable angina of which meeting the inclusion criteria are randomly divided into point selection along meridians group (group A), point selection on other meridians group (group B) and non-acupoint group (group C) through the central stochastic systems.Group A:Acupuncture on Neiguan of the Pericardium Channel of Hand-Jueyin and Tongli of the Heart Channel of Hand-Shaoyin;Group B:Acupuncture on Taiyuan and Kongzui of the Lung Meridian; Group C:Acupuncture on two non-acupoints.The same basic treatments are given to all groups. The above acupuncture points are bilateral selection, and acupunctured by HANS-LH200acupuncture instrument with monophase fixe, wave frequency2Hz and the current strength in the0-2mA. Treatment time and frequency is30min and3times a week at intervals of one day respectively and the treatment lasts4weeks. The entire study period lasts20weeks, including4weeks of baseline period,4weeks of treatment period and12weeks of follow-up period. We conduct an evaluation on week0,4,8,12and16respectively. Evaluation criteria include attack time of angina patients before and after treatment, the VAS score of pain extent, angina severity classification, the Seattle Angina Questionnaire, six-minute walk test and incidence of cardiovascular events.Results:1、The findings show that the average age of128angina patients having onset of symptoms is68years, and these angina patients are with an average duration of four years,62.5%patients of which show symptoms of precordial pain or chest discomfort mainly. The percentage of patient with attack of1to2times weekly is45.3%, and the onset with no less than3times weekly is40.6%.86.7%of patients with onset in less than5minutes, The angina of65.6%patients is induced by overwork.97.7%of patients share with similar symptoms of each attack, and when attacked,28.9%of the patients would take nitroglycerin.90%of patients undergone one or more kind of the comorbidities.56.3%of patients had been diagnosed with angina and accepted drug treatment, and meanwhile13.3%of patients diagnosed and treated by surgery.31.3%of patients are willing to accept the acupuncture treatment of angina.2、After acupuncture intervention, three groups of angina attacks, pain VAS score, angina severity classification, the Seattle Angina Questionnaire, six-minute walk test results are significantly improved (P<0.05) compared with that before treatment, and during study there is no adverse events and cardiovascular events.3、From the4th week, group A of angina attacks and the Seattle Angina Questionnaire evaluation is significantly better than group C; compared with group B, group A of attacks frequency is significant decrease but no statistical differences; group B compared with group C shares the same case with group A and B.4. The clinical effects of group A are continuously effective in the entire study period. Episodes of angina patients, VAS score, Seattle Angina Scale, and angina severity grading has continued to improve. But such effects of tgroup B start to tend towards stability or gradually disappear on the8th week after treatment and the group C shares the same case on the4th week.Conclusion:(1) According to the survey result, we confirm the feasibility with chronic stable angina as the research object, and develop the study subjects, therapeutic regimen, and the index of treatment efficacy observed.(2) Acupuncture treatment of chronic stable angina is safe and effective. Acupuncture treatment of patients with angina make theirs attack frequency, pain severity, Seattle angina scores, exercise tolerance evaluation and classification of angina severity constitute significantly improve, and meanwhile no adverse events and cardiovascular events come up.(3) The efficacy through acupoints along meridians treatment of angina is superior to non-acupoint; the group with acupoints along meridians is no significant difference in efficacy compared with that with acupoints on other meridians, but the effect of acupoints along meridians group is faster onset and persistence better. And the group with acupoints on other meridians is no significant difference in efficacy compared with non-acupoints group, but its efficacy is more lasting.(4) The efficacy is most obvious in the acupuncture treatment phase. What’s more, it can be sustainable to eight weeks after the end of treatment, and then will diminish or disappear.