AP / TCM for coronary arterial occlusion / exercise-induced angina

[Guest guest]

Hi All,

 

It is known that AP can give SYMPTOMATIC relief in CHD.

 

My question to the experts on the list is: Do you know of any studies that

show that AP / TCM can REVERSE the lesions of arterial plaque / CHD /

atherosclerosis? Can you give the references?

 

Based on two angiograms in two days + recent history exercise-induced

severe angina, I was diagnosed last week as having severe coronary arterial

occlusion (plaque) on both sides of my heart. Therefore, I have a definite

personal interest in the applications of AP / TCM in treating / reversing CHD

/ atherosclerosis!

 

I want to start a program of AP / Guasha to reinforce conventional

medication (Aspirin + Plavix + beta-blocker + anticholesterol drug) after

coronary arterial stenting.

 

Richard, have you used Guasha / cupping for this condition in patients on

blood thinners?

 

Below are Medline Abstracts on AP to Tx coronary arterial occlusion / angina

pectoris. Where the acupoints were listed, the main Pts said to be useful

were:

PC06**, ST36**, Ear Pt HT**, BL15, BL20; CV17; HT03, HT05, HT07; LI04,

LI11; SP06, SP08, SP09, SP10; ST40; Ear Pts HT II, HT III, LU, Shenmen

 

As there is a cholesterol component in my case, I presume that acupoints

like LV03, LV14, GB34, BL18 and BL19 would also be relevant.

 

Any comments?

 

Best regards,

 

 

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Medline Abstracts on AP to Tx coronary arterial occlusion / angina pectoris

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

 

(1990) Alliluev IG, Syrkin AL, Pal'tseva IS, Pecherskaia MB, Loshchenov

VB, Ignatov AA, Belkina EM, Kramarenko TA, Radzievskii SA, Fisenko VA,

et al. [Laser AP in the complex treatment of stenocardia] [Article in Russian]

Klin Med (Mosk). Jul;68(7):54-6. AP points were exposed to helium-neon

laser beam in 200 anginal patients. This therapeutic modality yielded good

results: the number of attacks and nitroglycerin intake reduced, exercise

tolerance grew, echocardiographic evidence showed a positive trend,

hemodynamics improved, Spilberger's test values changed for the better.

PMID: 2232649 [PubMed - indexed for MEDLINE]

 

(1990) Ballegaard S, Pedersen F, Pietersen A, Nissen VH, Olsen NV.

Effects of acupuncture in moderate, stable angina pectoris: a controlled

study. J Intern Med. Jan;227(1):25-30. Medical Dept, Rigshospitalet,

University of Copenhagen, Denmark. In order to evaluate the effects of AP

in moderate, stable angina pectoris, 49 patients were randomized to either

genuine or sham AP. In sham AP needles were inserted into points within

the same spinal segment as in genuine AP, but outside the Chinese

meridian system. The effect was evaluated from exercise tests, anginal

attack rate and nitroglycerin consumption. There were no significant

differences between the effects of genuine and sham AP either on exercise

test variables or on subjective variables. In patients receiving genuine AP

there was a significant increase in exercise tolerance (median 9%) and in

delay of onset to pain (median 10%). No significant changes were observed

in patients receiving sham AP. Within both groups there was a median

reduction of 50% in anginal attack rate and nitroglycerin consumption, and

there was no significant difference between the results achieved in the two

groups. It is concluded that with the present design it was not possible to

demonstrate any significant differences between the effect of genuine and

sham AP. PMID: 2105371 [PubMed - indexed for MEDLINE]

 

(1990) Gao C, Meng J, Fu W, Song L. [Change of myocardial glucose and

free fatty acid metabolism and effect of electroacupuncture on them during

experimental myocardial angina] [Article in Chinese] Zhen Ci Yan Jiu.

15(1):66-70. Institute of AP and Moxibustion, China Academy of Traditional

, Beijing. This study was designed to observe the effect of

electroAP applied at PC06 point on myocardial Glucose (GLU) and Free

fatty acid (FFA) metabolism of dogs with experimental myocardial angina,

experimental myocardial angina model was set up in 20 healthy mongrel

dogs with reducing the volume of blood flow of left anterior descending

coronary (LAD) and intracoronary administration of bradykinin. The results

showed that arterial-venous difference of glucose (GLUa-v) was increased

significantly and arterial-venous difference of free fatty acid (FFAa-v) was

decreased significantly after experimental myocardial angina. with

prolongation of the period of myocardial ischemia and increase of the times

of myocardial angina, in control group, GLUa-v was increased lightly and

FFAa-v was markedly decreased (P <0.05), this showed that FFA uptake of

ischemic myocardium was markedly decreased. ElectroAP at bilateral PC06

resulted significant decrease of GLUa-v and slight increase of FFAa-v.

There were statistical significance between the two groups (P <0.05) in

GLUa-v and FFA-v. Aterial blood free fatty acid had not significant change

after experimental myocardial angina and electroAP had not marked effect

on it. The above results indicated that experimental myocardial angina result

in metabolic disorders of myocardial glucose and free fatty acid. ElectroAP

may reduce glucose uptake and increase free fatty acid uptake of ischemic

myocardium. Thus improved metabolic disorder of ischemic myocardium.

PMID: 2118010 [PubMed - indexed for MEDLINE]

 

(1990) Karimova NKh, Odinets ZI, Zavalei EG, Chapala TA, Gzulia IA. [Low-

energy lasers in the combined therapy of patients with stable stenocardia at

a sanatorium] [Article in Russian] Vopr Kurortol Fizioter Lech Fiz Kult. Mar-

Apr;(2):26-9. The use of low-energy laser in combined treatment for angina

of effort (functional class I and II) was found to enhance exercise tolerance,

to reduce symptoms of hypodynamia, to stimulate lipid metabolism, improve

microcirculation and kallikrein-kinin indices. This appears to promote

positive changes in the main links of pathogenesis of CHD. PMID: 2385938

[PubMed - indexed for MEDLINE]

 

(1991) Ballegaard S, Meyer CN, Trojaborg W. Acupuncture in angina

pectoris: does acupuncture have a specific effect? J Intern Med.

Apr;229(4):357-62. Dept of Internal Medicine P, Rigshospitalet, University

Hospital of Copenhagen, Denmark. To overcome the methodological

problems of blinding the patients and the acupuncturist in AP trials, 33

patients with stable angina pectoris, who were randomized to either genuine

or sham AP, received electroAP by another acupuncturist, and the change in

skin temperature was recorded. It was found that the change in skin

temperature correlated significantly with the degree of improvement

following both genuine and sham AP. Fourteen patients with no decrease in

skin temperature exhibited a significantly better response to AP than 19

patients who showed a decrease in skin temperature (G II). In the former

group, there was a 15% median improvement in exercise tolerance (G II

0%), a 67% improvement in anginal attack rate (G II 38%), and an 84%

improvement in nitroglycerine consumption (G II 50%). A significant

correlation was found between the duration of disease and the effect of AP.

It is concluded that both genuine and sham AP have a specific effect on

some angina pectoris patients in addition to the effect of pharmacological

therapy. PMID: 2026989 [PubMed - indexed for MEDLINE]

 

(1991) Richter A, Herlitz J, Hjalmarson A. Effect of acupuncture in patients

with angina pectoris. Eur Heart J. Feb;12(2):175-8. Wallenberg Laboratory

for Cardiovascular Research, Sahlgren's Hospital, University of Gothenburg,

Sweden. 21 patients with stable effort angina pectoris were randomized in a

crossover study to 4 weeks traditional Chinese AP or placebo tablet

treatment. The patients had at least five anginal attacks per week in spite of

intensive treatment. AP was given three times per week at main points

PC06, HT05, BL15, BL20 and ST36. Previous antianginal treatment

remained unchanged during the whole study. During the AP period, the

number of anginal attacks per week was reduced from 10.6 to 6.1 compared

with placebo (P <0.01). Accordingly, the performance before onset of pain

during exercise test increased from 82 W to 94 W (P <0.05). However,

maximal performance did not increase after AP. Intensity of pain at maximal

workload decreased from 1.4 to 0.8 (scale 0-4, P <0.01). Further, ST-

segment depressions at maximal comparable load decreased from 1.03 to

0.71 mm after AP (P <0.01). A life quality questionnaire confirmed improved

feeling of well-being. Thus, AP showed an additional beneficial effect in

patients with severe, intensively treated angina pectoris. PMID: 2044550

[PubMed - indexed for MEDLINE]

 

(1992) Gao C, Meng J, Fu W, Song L. [Effect of electroacupuncture on

myocardial oxygen metabolism and pH of coronary sinus blood during

experimental angina pectoris] [Article in Chinese] Zhen Ci Yan Jiu. 17(1):28-

32. Institute of AP and Moxibustion, China Academy of Traditional Chinese

Medicine, Beijing. The experiments were performed on 30 healthy mongrel

dogs, intubation was taken in the left anterior descending coronary (LAD),

the blood in carotid was transported to LAD through a peristalic pump, the

blood flow was reduced to 3-5 ml/min, thus acute myocardial ischemia was

produced. Basing on this condition, 0.1-0.16 ml bradykinin (2 ug/ml) was

given into LAD coronary before recording to produce angina pectoris. The

effects of electroAP (EA) at PC06 on myocardial oxygen metabolism, pH of

coronary sinus blood and myocardial contractile force were observed (EA

intensity 5 volts, frequency 1-20 Hz). The results are as follows: 1. EA could

reduce obviously A-V difference of blood oxygen capacity (Ca-vO2) and the

rate of myocardium extracting oxygen (O2E), thus reduced obviously oxygen

consumption of ischemic myocardium. 2. EA could reduce V-A difference of

carbon dioxide partial pressure (Pv-aCO2), prevent the decrease of pH of

coronary sinus blood (PHv), this indicated that EA could prevent

accumulation of acidic metabolic products. 3. EA could increase myocardial

developed tension (DT) of ischemic area, strengthen myocardial contractile

force of ischemic area. Above results indicated that EA could reduce oxygen

consumption of ischemic myocardium, prevent the decrease of pH of

coronary sinus blood, thus myocardial cell acidosis was prevented,

myocardial contractile force was strengthened. It might be the mechanism of

AP treating CHD. PMID: 1394952 [PubMed - indexed for MEDLINE]

 

(1993) Saku K, Mukaino Y, Ying H, Arakawa K. Characteristics of reactive

electropermeable points on the auricles of CHD patients. Clin Cardiol.

May;16(5):415-9. Dept of Internal Medicine, Fukuoka University School of

Medicine, Japan. In oriental medicine there is a hypothesis related to AP that

the auricle is a projection of the functional anatomy of the whole human

body. In this study reactive electropermeable points (REPP), that is, points

on the skin with low electrical resistance, on the auricle were measured on

patients with CHD using a neurometer LC-M. Our findings correlated

positively with the particular points--HT I (shin) and HT II (shinzo)*--named

by the Chinese group as being related to the functional anatomy of the HT.

The incidence of positive REPP test results at the shin and shinzo points for

subjects with acute myocardial infarction (AMI) were extremely high, and

positive test results for patients with old myocardial infarction (OMI) and

angina pectoris (AP) were also significant. There was no significant

difference in the incidence rates of REPP at the shin and shinzo points

between the OMI and AP groups. High incidence of positive REPP test

results at the lung and HT III (shinyu) points occurred only in the AMI group,

and this was significantly high when compared with the control group. PMID:

8504576 [PubMed - indexed for MEDLINE

 

(1993) Zhou XQ, Liu JX. [Metrological analysis for efficacy of acupuncture

on angina pectoris] [Article in Chinese] Zhongguo Zhong Xi Yi Jie He Za Zhi.

Apr;13(4):212-4, 196. Human College of Traditional ,

Changsha. AP (Acupoints: PC06, HT07, HT03 or auriculo-points: HT,

Shenmen) was administrated once or 7 times in a week on 40 patients with

stable type of angina pectoris. The effect was assessed quantitatively or

semi-quantitatively according to the extent, area, frequency, duration of

attack, the time of attack during exercise, and the vanishing of suffering after

exercise. Just after one performance of AP, 15 patients' angina pectoris

were significantly alleviated (P < 0.001) both in degree and area. After 7

times of AP 10 patients' angina pectoris were not only significantly alleviated

both in extent and area, but also in frequency and duration of attack. 15

patients were randomized to an AP, non-AP or AP at non-acupoints (ANA) in

a single blind design. The time from the beginning of exercise to the anginal

attack in active AP group was longer than that in non-AP or ANA group (P <

0.01), but they were similar (P > 0.05) in both non-AP group and ANA group.

The time from the end of exercise to the disappearance of angina pectoris in

AP group was shorter than that in the other two groups (P < 0.05). PMID:

8400769 [PubMed - indexed for MEDLINE]

 

(1995) Ballegaard S, Karpatschoff B, Holck JA, Meyer CN, Trojaborg W.

Acupuncture in angina pectoris: do psycho-social and neurophysiological

factors relate to the effect? Acupunct Electrother Res. Apr-Jul;20(2):101-16.

Dept of Internal Medicine P, Rigshospitalet, Denmark. We studied the effect

of AP in 49 patients with angina pectoris with focus on its relationship to

psycho-social factors and changes in skin temperature, pain thresholds, and

pain tolerance thresholds. No significant influence from patient expectation,

social stress (strain) or profiles of the Minnesota Multiphasic Personality

Inventory (MMPI) was found (all p > 0.1). AP slightly increased exercise

tolerance (median 7%), the difference in Systolic Blood Pressure-HT Rate

Product between rest and maximal exercise (delta PRP) (median 3%), and

the time to onset of pain (median 10%); decreased nitroglycerin

consumption (median 58%) and anginal attack rate (median 38%).

Improvement in exercise tolerance was significantly correlated to an

improvement in delta PRP (correlation coefficient = 0.7; p < 0.0001) but not

to time of myocardial ischemia (correlation coefficient = 0.1; p = 0.1).

Compared with 28 patients with a less pronounced anti-anginal effect, the 21

patients with a pronounced effect had a significant increase in local skin

temperature, but had no significant change in distant skin temperature and

pain thresholds. It is concluded that AP, due to hemodynamic alterations,

might have a specific effect on angina pectoris in addition to drug

treatments. PMID: 7491848 [PubMed - indexed for MEDLINE]

 

(1996) Ballegaard S, Nørrelund S, Smith DF. Cost-benefit of combined use

of acupuncture, Shiatsu and lifestyle adjustment for treatment of patients

with severe angina pectoris. Acupunct Electrother Res. Jul-Dec;21(3-4):187-

97. AP Center, Klampenborg, Denmark. ballegaard

Sixty-nine patients with severe angina pectoris were treated with AP, Shiatsu

and lifestyle adjustments, and were followed for 2 years. Forty-nine patients

were candidates for coronary-artery bypass grafting (CABG), whereas

bypass grafting was rejected in the remaining 20 patients. We compared our

endpoint findings with those of a large prospective, randomized trial

comparing CABG with percutaneous transluminal coronary angioplasty

(PTCA). The incidence of death and myocardial infarction was 21% among

the patients undergoing CABG, 15% among the patients undergoing PTCA

and 7% among our patients. No significant difference was found concerning

pain relief between the three groups. Invasive treatment was postponed in

61% of our patients due to clinical improvement, and the annual number of

in-hospital days was reduced by 90%, bringing about an estimated economic

saving of 12,000 US $ for each of our patients. Despite the fact that the men

in the present study, had significantly less positive expectations towards the

outcome of the treatment, when compared to the women, there was no

significant difference concerning the effect. The study suggests that the

combined treatment with AP, Shiatsu and lifestyle adjustment may be highly

cost effective for patients with advanced angina products. PMID: 9051166

[PubMed - indexed for MEDLINE]

 

(1999) Ballegaard S, Johannessen A, Karpatschof B, Nyboe J. Addition of

acupuncture and self-care education in the treatment of patients with severe

angina pectoris may be cost beneficial: an open, prospective study. J Altern

Complement Med. Oct;5(5):405-13. AP Centre, Hellerup, Denmark.

ballegaard OBJECTIVES: A cost-benefit analysis of AP and

self-care education in the treatment of patients with angina pectoris.

DESIGN: An open prospective study on an unselected group of patients. For

comparison of risk three control groups were used: (1) published data

concerning medical and invasive treatments; (2) an age- and sex matched

group obtained from a randomly selected Danish population of 14,000

people; and (3) the 211 patients in this group with angina pectoris

symptoms. SETTING: The treatment was carried out on a outpatient basis in

a private research clinic. SUBJECTS: 105 patients with angina pectoris, 73

candidates for invasive treatment, and 32 for whom this was rejected.

INTERVENTIONS: AP and self-care education was added to the

pharmaceutical treatment. OUTCOME MEASURES: Healthcare expenses,

a satisfactory medical status defined as New York Heart Association (NYHA)

classification 0-I and/or no use of antianginal medication, and risk measured

as cardiac death or myocardial infarction. RESULTS: The estimated cost

savings during 5 years were $32,000 (U.S.) per patient, mainly due to a 90%

reduction in hospitalization and 70% reduction in needed surgery. Compared

to 8% before treatment, 53% of the patients achieved a life without

limitations (NYHA 0-I) 1 year after treatment, as did 69% after 5 years. No

increased risk for myocardial infarction or cardiac death was observed.

CONCLUSIONS: The addition of AP and self-care education was found to

be cost beneficial in patients with advanced angina pectoris. The results

invite further testing in a randomized controlled trial. PMID: 10537240

[PubMed - indexed for MEDLINE]

 

(2001) Syuu Y, Matsubara H, Kiyooka T, Hosogi S, Mohri S, Araki J, Ohe T,

Suga H. Cardiovascular beneficial effects of electroacupuncture at PC06

acupoint in anesthetized open-chest dog. Jpn J Physiol. Apr;51(2):231-8.

Oriental Medicine Laboratory, School of Social Welfare, Kyushu University of

Health and Welfare, Nobeoka, 882-8508 Japan. syuuy PC06

is a traditional acupoint in the bilateral forearms, overlying the median nerve

trunk. PC06 electroAP (EA) has been believed to affect cardiovascular

function and used in traditional Chinese medicine to improve or treat a wide

range of health conditions and diseases, including angina pectoris,

myocardial infarction, hypertension, and hypotension. However, few

physiological studies have assessed the beneficial effects of PC06 EA on

the cardiovascular function. In the present study, we investigated its effects

on the cardiovascular function in normal open-chest dogs under

pentobarbital and fentanyl anesthesia. We also obtained left ventricular (LV)

pressure-volume (P-V) data with a micromanometer catheter and a

volumetric conductance catheter. Mean arterial pressure, end-diastolic

volume, HR, stroke volume, cardiac output, and end-systolic pressure

gradually decreased by 5 to 10% over 1.5 h without PC06 EA. PC06 EA at

40 Hz, however, increased these cardiovascular variables by 10 to 15%,

especially end-systolic elastance (Ees) by 40% (p<0.05) over 15 to 60 min.

After PC06 EA was stopped at 1 h, these facilitated cardiovascular variables

decreased below the pre-EA level. This beneficial effect of electroAP may

contribute to the effectiveness of the AP in Chinese medicine. PMID:

11405917 [PubMed - indexed for MEDLINE]

 

(2002) Kurono Y, Egawa M, Yano T, Shimoo K. The effect of acupuncture

on the coronary arteries as evaluated by coronary angiography: a

preliminary report. Am J Chin Med. 30(2-3):387-96. Graduate School of AP

and Moxibustion, Meiji University of Oriental Medicine, Kyoto, Japan.

y_kurono PC06 AP point is often used for circulatory

disorders. To clarify this effect, we measured coronary diameters in patients

with angina pectoris following AP stimulation using cardioangiography. Two

kinds of AP stimulation, the leaving needle (LN) and the sparrow pecking

method (SPM), were employed for this study. No significant differences were

found between LN and SPM. Concerning the pattern of coronary reaction,

coronary constriction following AP showed a relationship to patients with

vasospastic angina. Coronary dilation following AP showed a relationship to

patients with Syndrome X. The mean dilatation with AP was 68.8% of that

caused by isosorbide dinitrate. These findings may help to clarify the

mechanism of AP treatment. PMID: 12230027 [PubMed - indexed for

MEDLINE]

 

(2004) Meng J. The effects of acupuncture in treatment of CHDs. J Tradit

Chin Med. Mar;24(1):16-9. Institute of AP and Moxibustion, China Academy

of TCM, Beijing 100700. A clinical study on AP at point PC06 was conducted

on the basis of successful treatment of patients with angina pectoris and

acute myocardial infarct. The effective rate (91.3%) was found to be far

superior to isosorbide dinitrate and nifedipine (P < 0.01). The experimental

studies in animal models demonstrated that electro-AP could decrease the

elevated ST segments in ECGs and reduce the infarct areas induced by

coronary ligation. PMID: 15119162 [PubMed - indexed for MEDLINE]

 

(2005) Xu FH, Wang JM. [Clinical observation on acupuncture combined

with medication for intractable angina pectoris] [Article in Chinese].

Zhongguo Zhen Jiu. Feb;25(2):89-91. Liaocheng Hospital of TCM,

Shandong 252000, China. fhuaxu1968 OBJECTIVE: To

compare clinical effects of AP combined with medication and simple

medication on intractable angina pectoris (IAP). METHODS: Seventy cases

of IAP were randomly divided into two groups, a control group and a

treatment group, 35 cases in each group. The control group were treated

with nitric acid ester, beta-receptor blocking agent, calcium antagonist,

aspirin and hypo-molecular heparin, and the treatment group were treated

with AP at CV17 and PC06 and others, once daily for 10 consecutive days

on the basis of the above treatment. RESULTS: The total effective rates for

symptoms and electrocardiogram were 88.6% and 62.9% in the treatment

group and 60.0% and 31.4% in the control group, respectively, with a

significant difference between the two groups; the incidence of acute HT

attack and sudden death of 5.7% in the treatment group was lower than

20.0% in the control group, with no serious adverse effect. CONCLUSION:

AP combined with medication is safe and effective for intractable angina

pectoris and it can improve short-term prognosis. PMID: 16312887 [PubMed

- in process]

 

(2008) Zhang ZL, Ji XQ, Zhao SH, Zhang JJ, Kang T, Yang XJ.

[Randomized controlled study on effects of the needling method for

regulating SP-ST on CHD complicated by type 2 diabetes mellitus

complicated] [Article in Chinese] Zhongguo Zhen Jiu. Sep;28(9):629-33.

Dept of AP and Moxibustion, Tianjin City Hospital of TCM, Tianjin 300140,

China zhangzhilongtj OBJECTIVE: To probe into the clinical

therapeutic effect of AP on CHD complicated by type 2 diabetes mellitus

(CDM) and the mechanism. METHODS: Using multi-central, randomized,

controlled and blind methods, 120 cases of CDM were divided into an

observation group and a control group, 60 cases in each group. They were

treated by routine therapy for diabetes mellitus, and in the observation

group, AP at LI11, LI04, SP10, ST36, SP09, ST40, SP08, SP06, etc. were

added with the needling method for regulating SP-ST; while in the control

group, AP was given at Weiwanxiashu (EX-B3), BL13, BL20, BL23, GB34,

etc. The treatment was given twice a day in the two groups. Clinical

therapeutic effects were assessed according to clinical symptoms and signs,

frequency and lasting time of angina pectoris, quantity of taking Glycerol

Trinitrate, blood sugar, blood lipids, urinary albumin excretion rate, urinary

beta2-microglobulin, urinary monocyte chemotactic protein-1 (MCP-1), ECG,

HT color Doppler, etc. RESULTS: The needling method for regulating SP-

ST not only could improve the symptoms and signs of the patient, but also

could improve the degree of ST segment moving down and the function of

left artrium relaxation, and had benign regulative effect on glycometabolism,

lipids metabolism and urinary albumin level, with significant differences as

compared with the control group (P < 0.05 or P < 0.01). The markedly

effective rate for improvement of ECG was 50% in the observation group

and 13.79% in the control group. CONCLUSION: The needling method for

regulating SP-ST can improve the damage of HT and blood vessels induced

by abnormal sugar and lipids, decrease the level of urinary protein, inhibit

MCP-1 excessive expression, relieve myocardial load and raise cardiac

output in the patient of CHD complicated by type 2 diabetes mellitus. PMID:

18822974 [PubMed - indexed for MEDLINE