| Objective:According to the theory of where the meridian moves, where the meridian can play an therapeutic role in the body, we aim to discuss the basic law of acupoints effect specificity further through observing the clinic efficacy and influences of vasoactive substances of how selecting acupoints according to meridians treat SAP.Methods:40 SAP patients who matched the inclusion criteria were divided into 4 groups with the Central Randomization System,10 patients as a group. There groups were administered puncturing at different acupoints:Group A:acupoints in Heart meridian and Pericardium meridian (PC6 and HT5), Group B:acupoints in Lung meridian(LU6 and LU9), Group C:Non-acupoints in Non-meridian(two predefined non-acupoints were punctured), and Group D was waiting-list group(only conventional basic medicine in this group). And all of the groups were punctured under the primary drug treatment. Both acupoints and non-acupoints were punctured bilaterally, we have punctured one more needle where was 2mm away from the points (proximal part) after puncturing all the points in order to connect electric acupuncture apparatus (LH200). During the process, according to patients’ tolerance, Monophase fixe was selected,2Hz as the frequency, current intensity was around 0-2mA. Acupuncture treatments were given for every other day,4 weeks as a course,3 times in one week, each acupuncture treatment lasted 30 minutes and all for 12 times in a course. The following outcome measurements were assessed at 0,4,8,12 and 16 weeks after randomization. Seattle Angina Questionnaire scores differences from baseline, VAS score differences from baseline. And the ST-T changes,6 minutes walk test, contents changes of ET-1 and CGRP in the serum were analyzed before and after acupuncture.Results:1. General baseline condition have been compared before treatment in these four groups, including age, gender, process, frequency of angina, VAS scores, Seattle Angina Questionnaire scores (SAQ),6 minutes walk test (6MWT)、ST-T changes, contents of CGRP and ET-1, these factors are no statistical significance (P>0.05), which are comparable.2. VAS scores(1)Intra-group comparison:①Group A, Group C:comparisons among the prior treatment and post-treatment, the first, second, third follow-up, all have extreme statistic significance and outstanding statistic significance (P<0.001, P<0.01).②Group A:comparisons among the post-treatment and the second, third follow-up, all have statistic significance and extreme statistic significance (P<0.05, P<0.001), while comparisons between the first follow-up and the third follow-up have outstanding statistic significance (P<0.01).(2)Intergroup comparison①The first follow-up:comparisons among Group A and Group B, Group C, Group D have statistic significance, outstanding statistic significance and extreme statistic significance (P<0.05, P<0.01, P<0.001), while comparison between Group B and Group D has statistic significance (P<0.05)②The second and third follow-up:comparisons among Group A and Group B, Group C, Group D have extreme statistic significance (P<0.001)3. SAQ scoresThe first dimension of SAQ in physical limitation(1)Intra-group comparison:①Group A, Group B:comparisons among the prior treatment and post-treatment, the first, second, third follow-up, all have outstanding statistic significance and statistic significance (P<0.01, P<0.05).(2) Inter-group comparison:they all have no statistic significance (P>0.05)The second dimension of SAQ in anginal stability(1)Intra-group comparison:① Group A:comparisons among the prior treatment and post-treatment, the first, second, third follow-up, all have extreme statistic significance (P<0.001).② Group B:comparison between the prior treatment and post-treatment have extreme statistic significance (P<0.001), while comparisons among the post-treatment and the first, second, third follow-up, all have outstanding statistic significance(P<0.01).③Group C:comparison among the prior treatment and post-treatment, the first follow-up have outstanding statistic significance and statistic significance (P<0.01, P<0.05), while comparison among the post-treatment and the second, third follow-up have outstanding statistic significance and statistic significance (P<0.01,P<0.05). (2) Inter-group comparison①Post-treatment:comparisons among Group A and Group C, Group D have outstanding statistic significance and extreme statistic significance (P<0.01, P<0.001), while comparisons among Group D and Group B, Group C have extreme statistic significance (P<0.001).②The first follow-up:comparisons among Group A and Group B, Group C, Group D have extreme statistic significance and outstanding statistic significance (P<0.001, P<0.01), while comparison between Group C and Group D has statistic significance (P<0.05)③The second and third follow-up:comparisons among Group A and Group B, Group C, Group D have extreme statistic significance (P<0.001)The third dimension of SAQ in anginal frequency(1)Intra-group comparison:① Group A:comparisons among the prior treatment and post-treatment, the first, second, third follow-up, all have extreme statistic significance (P<0.001). Comparisons among the post-treatment and the second, third follow-up have statistic significance and extreme statistic significance (P<0.05, P<0.001). Comparison between the third and the first follow-up has outstanding statistic significance(P<0.01).(2)Inter-group comparison①Post-treatment:comparisons among Group A and Group C, Group D have statistic significance and outstanding statistic significance (P<0.05, P<0.01).②The first follow-up:comparison between Group A and Group D has outstanding statistic significance (P<0.01), while comparisons among Group B and Group C, Group D have statistic significance (P<0.05).③The second follow-up:comparisons among Group A and Group B, Group C, Group D have extreme statistic significance and outstanding statistic significance (P<0.001, P<0.01)④The third follow-up:comparisons among Group A and Group B, Group C, Group D all have extreme statistic significance (P<0.001)The fourth dimension of SAQ in the degree of angina’s treatment satisfaction(1)Intra-group comparison:① Group A:comparisons among the prior treatment and post- treatment, the first, second, third follow-up, all have extreme statistic significance (P<0.001). Comparisons among the post-treatment and the second, third follow-up have statistic significance and outstanding statistic significance (P<0.05, P<0.01).②Group B:comparisons among the prior treatment and post-treatment, the second follow-up, all have outstanding statistic significance (P<0.01). Comparisons among the prior treatment and the first, third follow-up have extreme statistic significance (P<0.001).③Group C:comparison between the prior treatment and the post-treatment has statistic significance (P<0.05), while comparisons among the prior treatment and the first, second, third follow-up, all have extreme statistic significance (P<0.01).(2) Inter-group comparison①Post-treatment:comparisons among Group A and Group C, Group D have statistic significance and extreme statistic significance (P<0.05, P<0.001), while comparison between Group B and Group D has outstanding statistic significance (P<0.01)②The first follow-up:comparisons among Group A and Group B, Group C, Group D have statistic significance, outstanding statistic significance and extreme statistic significance (P<0.05, P<0.01, P<0.001).③The second follow-up:comparisons among Group A and Group B, Group C, Group D have outstanding statistic significance and extreme statistic significance (P<0.01, P<0.001)④The third follow-up:comparisons among Group A and Group B, Group C, Group D all have statistic significance, outstanding statistic significance and extreme statistic significance (P<0.05, P<0.01, P<0.001), while comparisons among Group B and Group C, Group D all have outstanding statistic significance and statistic significance (P<0.01, P<0.05),The fifth dimension of SAQ in the cognitive degree of angina(1)Intra-group comparison:①roup C:comparisons among the prior treatment and the first, second follow-up, all have statistic significance (P<0.05), while comparison between the prior treatment and the third follow-up have outstanding statistic significance (P<0.01).(2)Inter-group comparison:①they all have no statistic significance (P>0.05).4.6 minutes walk test before and after treatment in the four groups(1)Intra-group comparison:①Group A, Group B:comparison between prior treatment and post-treatment has outstanding statistic significance and has statistic significance (P<0.01,P<0.05)(2)Intergroup comparison:①There is a trend of:Group A> Group B> Group C> Group D, but they all have no statistic significance(P>0.05).5. Minutes and range of ST-segment depression in 24h Dynamic Electrocardiogram before and after treatment in the four groups Minutes of ST-segment depression in 24h Dynamic Electrocardiogram:(1)Intra-group comparison:①Group A, Group B:comparison between prior treatment and post-treatment has outstanding statistic significance and has statistic significance (P<0.01,P<0.05)(2)Intergroup comparison:①There is a trend of:Group A> Group B> Group C> Group D, but they all have no statistic significance(P>0.05). Range of ST-segment depression in 24h Dynamic Electrocardiogram(2)Intra-group comparison:①Group A; comparison between prior treatment and post-treatment has outstanding statistic significance (P<0.01).②Group B, Group C:comparisons between prior treatment and post-treatment has statistic significance (P<0.05).(2)Intergroup comparison:①There is a trend of:Group A> Group B> Group C> Group D, but they all have no statistic significance(P>0.05).6. Contents of ET-1 and CGRP in four groups before and after treatment(1)Intra-group comparison of ET-1:Group A, Group B:comparisons between prior treatment and post-treatment has extreme statistic significance and statistic significance (P<0.001,P<0.05). (2)Intra-group comparison of CGRP:Group A:comparisons between prior treatment and post-treatment has statistic significance (P<0.05).(3)Inter-group comparison of ET-1, CGRP:①Contents of ET-1:There is a trend of:Group A> Group C> Group B> Group D, but they all have no statistic significance(P>0.05).②Contents of CGRP:There is a trend of:Group A> Group B> Group C> Group D, but they all have no statistic significance(P>0.05).7. Clinic curative effect in four groups:the total effective rate of Group A is 100%, Group B is 40%, Group C is 10% and Group D is 0%. There is a rank in Group A> Group B> Group C> Group D, they all have extreme statistic significance (P<0.001).Conclusion:1. After acupoints selecting heart and pericardium meridians can relieve the pain degree of SAP after treatment and follow-ups, and Group A and Group B are better than Group C and Group D, which can prove the existence of acupoints effect specificity.2. Acupuncture treatment can improve the life quality of SAP patients, Group A has a better effect on the physical limitation, anginal stability, anginal frequency and the degree of angina’s treatment satisfaction than the other groups. But on the cognitive degree of angina, Group C has better effect on the other groups.3. Group A and Group B can improve the myocardium ischemia situation of SAP and exercise tolerance, while Group C and Group D have little effects on the myocardium ischemia situation of SAP and exercise tolerance.4. Group A can reduce the contents of ET-1 in the serum and enhance the contents of CGRP. |
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