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Acupuncture

By Lorraine Roberts,2014-07-23 03:06
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AcupunctureAcupun

    Acupuncture

JournalofTraditionalChineseMedicine2008;28(2):8689

    ;AcupunctureTreatmentfor98CasesofVentricularPrematureBeat

    ;HanBaojie韩宝杰&WangFeng王锋

    ;TheFirstAffiliatedHospitalofTianjinCollegeofTraditionalChineseMedicine,Tianjin30

    0193,China

    ;Ventricularprematurebeatisacommonlyenc-- ;ounteredarrhythmia,whichcanoccurinpatients ;withandwithoutcardiacdiseases.InTCM. ;ventricularprematurebeatfalls:intothecategoryof ;palpitationandobstructionofqiinthechest.The ;authorstreateditwithacupunctureandobtained ;satisfactorytherapeuticeffects.Asummaryfollows. ;CLINICALDATA

    ;The98caseswererandomlyselectedfromthe ;inpatientsofthehospital,including56malesand42 ;females,ranginginagefrom37c07Oyears.Ofthem, ;32werecomplicatedwithcoronaryheartdisease.11 ;withchronicmyocarditis,7withrheumaticheart ;disease,9withmyocardialinfarction,and39with ;cardiovascularneurosis.5caseshadoccasional ;ventricularprematurebeat.72hadfrequent ;ventricularprematurebeat,and21hadventricular ;bigeminy/tribigeminy,71monofocalventricular ;prematurebeat,and27multifocalventricular ;prematurebeat.Allthecaseswerediagnosedin ;referringtothediagnosticcriteriadraftedatthe1979 ;NationalSymposiumonthePreventionand

    ;TreatmentofCoronaryHeartDisease,Angina ;Pectoris,andAthmiawiththeCombinedChinese ;dWesternMedici.1

    ;METHoDS

    ;Allthepatientsstoppedtakingtheantiarrhythmics ;for3daysbeforereceivingtheacupuncturetreatment. ;Basedontreatingtheprimarydiseases,acupuncture ;therapywasappliedwiththestrictcriteriaforpoint ;selectionandmanipulation.

    ;Pointselection

    ;Mainpoints:Neiguan(PC6),Shenmen(HT7), ;Baihui(GV20),andXinshu(BLZ5).1]headjunct

    ;points:Sanyi~iao(SP6),Zusanli(ST36),Taichong ;(LR3),Taixi(KI3),Ximen(PC4),Shanzhong(CV ;17),Jueyinshu(BL14),andDaling(PC7). ;Manipulation

    0.28filiformneedleswithalengthof5cm ;No.0.23;

    ;wereused.Neiguan(PC61wasinsertedper- ;pendicularly1.72.6cmindepth,afteramildor

    ;moderateneedlingsensationarrived,thereinforcing ;manipulationbytwirlingtheneedlewithsmall ;amplitudeandhighfrequencywasappliedfor1min, ;andthentheneedlewasretainedfor20min. ;Shenmen(HT71wasinsertedbypenetratingthe ;needletoDaling(PC711.72.6cmandreinforcedby

    ;twirlingtheneedlewithsmallamplitudeandhigh ;frequencyfor1min.BaihuifGV20)wasinserted ;transverselyforward1;1.7cmandreinforcedby

    ;twirlingtheneedlefor1min,andthentheneedlewas ;retainedfor30min.Zusanli(ST36)wasneedled ;perpendicularly2.6——4cmandreinforcedbytwirling ;for1min,andthentheneedlewasretainedfor20 ;min.Sanyinjiao(SP6)andTaixi(KI3)wereneedled ;withthesamemethodasforZusanli(ST36).The ;uniformreinforcementreductionwasappliedfor

    ;Xinshu(BL15),Jueyinshu(BL14),Ximen(PC4) ;andShanzhongfCV17).Thetwirlingreducing ;methodwasappliedforTaichong(LR31andDaling ;(PC7).Theacupuncturewasgivenoncedaily,10 ;sessionsasonecourse.Allthepatientsreceived ;Electrocardiograph(ECG)and24hdynamicECG ;examinationsbeforeandafterthetreatmentfor ;evaluatingthetherapeuticeffects.

    ;Forstatistics,theRiditanalysiswasused. ;

    ;JournalofTraditionalChineseMedicine2008;28(2):86-89 ;RESUIS.

    ;nIecriteriafortherapeuticeffects:TheBasesr ;ClinicalDiagnosisandCriria.forCureand ;ImprovementofDiseaseswastakenasthereference. ;Cured:Afterthetreatment.thedynamicECG ;examinationshoweddisappearanceofventricular

    ;prematurebeatandtheECGfindingsrestorednorma1. ;Improved:Afterthetreatment.thedynamicECG ;examinationshowedmorethan50%decreasein ;ventricularprematurebeat.Ineffective:Afterthe

    ;treatment,thereshowednodecreaseinventricular ;premature-l_beat.andnoimprovementofthe ;symptoms?

    ;Thetherapeuticresults:Ofthe98cases,39were ;cured,56wereimproved,and3wereineffective, ;withatotaleffectiverateof96.9%.

    ;Theanalysesontherapeuticeffects:Forrelation ;betweentheeffectandprimarydiseases,SeeTable1. ;Forrelationbetweentheeffectanddiseaseduration. ;SeeTable2.Forrelationbetweentheeffectand ;treatmentCOurse.SeeTable3.

    ;TableI.Comparisonofeffectfordifferentprimarydiseasescasesl%)

    ;Primary.

    ;disease.nCuredImprovedIneffective

    ;CoronaryVPB

    ;RheumaticVPB

    ;MyocarditicVPB

    ;Cardio.neurcsalVPB

    ;Cardiacinfar,:tionVPB

    ;32

    ;7

    ;l1

    ;39

    ;9

    ;12(37.50)

    ;1(14.28)

    ;4(36.36)

    ;36(92.3o)

    ;4r44.40)

    ;18r56.25)

    ;3(42.85)

    ;7(63.63)

    ;3(7.69)

    ;3(33.3o)

    ;2f6.25)

    ;3(42.85)

    ;0(0)

    ;0(0)

    ;2(22.21

    ;Note:compa,3(1withothergroupsP<0.05 ;Table2.Comparisonofeffectfordifferentdiseasedurationscasesr%J

    ;Table3.Comparisonofeffectfordifferenttreatmentcoursescasesr%J

    ;Note:comparisonofcurativeratebetween(2)(3)groupand(1)(4)groupP<0.05

    ;Acupuncturegavedifferenteffectsforventricular

    ;prematurebeatcausedbydifferentdiseases.The ;effectfortheventricularprematurebeatdueto ;cardiacneurosiswasthebest,showingasignificant ;differenceascomparedwiththatcausedbyother ;diseases(P<0.05).

    ;Table2showedthatthedifferenceincurativerates ;betweenthepatientswithdiseasedurationwithinand ;over3monthswasverysignificant<O.01).Among ;the98casesreceivingacupuncturetreatment,the ;curativerateWasfirstplaceinthepatientswith ;diseasedurationwithin1month,secondinthe ;patientswithdiseasedurationwithin3months,and ;noneofthosewiththedurationoverhalfayearWas ;cured,suggestingthatthetherapeuticeffectof ;acupunctureWascloselyrelatedtothedisease ;

    ;JournalofTraditionalChineseMedicine2008;28(2):8689

    ;duration,andtheeffectattheearlystagewasfar ;superiortothatoftheprolonged.,

    ;Table3showedthatall98caseshadtherapeutic ;effectaftertakingonecourseoftreatment,butthe ;curativeratewashighestinthecasesreceiving2-3 ;coursesoftreatment,over5coursesdidnotshowthe ;highestcurativerate,suggestingthatcourseof ;treatmentwasnotnecessarilyindirectproportionto ;thetherapeuticeffect.

    ;DISCUSSIU

    ;TCMholdsthatthenormalheartbeatreliesonthe ;heart-qi.Ampleheartqimaintainsnormalcardiac

    ;rhythm.Insufficiencyoftheheartqicanmake

    ;malnutritionoftheheart,leadingtopalpitationand ;intermittentpulse,i.e.ventricularprematurebeat. ;Therefore,theacupuncturetreatingprincipleshould ;begivingfirstplacetostrengthenthebodyresistance ;andgiveconsiderationtoeliminatethepathogenic ;factors,treatingtheprimaryaspectandthesecondary ;aspectofthediseaseatthesametime,replenishing ;theheart-qLactivatingtheheart-yang,nourishingthe ;heartblood,anddredgingtheheartchannels.Inthe ;acupuncturetreatment,sourcepointofthe ;PericardiumChannel,Daling(PC7)andsourcepoint ;oftheHeartChannel,Shenmen(HT7),connecting ;pointofPericardiumChannel,Neiguan(PC6),and ;cleftpointofthePericardiumChannel,Ximen(PC4)

;arepuncturedforreplenishingtheheartqi,

    ;nourishingtheheart-blood,andcalmingthe ;heart-mind;reductioninacupunctureatShanzhong ;(cv17),influentialpointofqi,canpromoteqi ;circulationtoremoveobstructioninthechanneland ;activateyangqiinthechest;acupunctureatXinshu ;(BL15)andJueyinshu(13L14)havetheactionof

    qiofzang-fuorgans;and ;regulatingtheessential

    ;reinforcementinacupunctureatGeshu(BL17), ;influentialpointofblood,canproducetheeffectof ;nourishingbloodandactivatingbloodflow,and ;dredgingthechannelstonourishtheheart.e ;acupunctureattheabovepointscanjointlyexertthe ;effectsofregulatingblood,ymandyangofthe

    ;heart,soastomaketheminbalance.Ithasbees ;provedbyclinicalexperimentsthattheamplitudeof ;leftventricularposteriorwallmotionandstroke ;volumebeforeandafteracupunctureatNeiguan(PC ;6)showsignificantdifferences,suggestingthat ;acupuncturecanimprovethefunctionofleftventricle, ;soastotreatventricularprematurebeat.Acupuncture ;canstrengthenthemyocardialcontractivepowerand ;lowerdownleftventricularenddiastolicpressureso ;astoimprovethefunctionofheart,anddecreasethe ;cardiacoutputsoastoreducetheheartrateor ;decreasethefrequencyofventricularprematurebeat. ;Acupuncturecanalsohelpdecreasingmyocardial ;oxygenconsumptionsoastomakesmallveins ;expandandbloodflowspeedup.Somescholarspoint ;outthatitisbymeansofregulatingtheadrenergic ;andcholinergicvegetativenervoussystemsand ;affectingtheelectrophysiologyofheartthat ;acupuncturecantreatventricularprematurebeat. ;Throughinhibitingtheexcitabilityoftheectopic ;excitationpointandprolongingthetimeofthe ;cardiacactionpotential,acupuncturecanactivateNa+, ;K~-ATPtomakemyocardialrepolarizationhomo

    ;geneousandremovereciprocalexcitation.Some ;researcheshaveprovedthatacupuncturecanprolong ;theventricularandauriculareffectiveandfunctional ;refractoryperiod,soastodelaytherestoringtimeof ;themyocardialexcitabilityandavoidprematurebeat. ;AcupuncturecanlowerdownVmaxofaction

    ;potentialofcardiacmusclecell,andslowdownthe

    ;impulseconductionVelocitytomakesome ;unidirectionalblockproducedundercertain ;pathologicconditionchangeintobidirectionalblock, ;soastobreakoffreciprocalexcitation.Besides, ;acupuncturecanpromotetheincreaseincalciumion ;influxofmyocardialcells,andstrengthenthe

    arrhythmiaabilityandmyocardialcontractility, ;anti

    ;soastopreventtheoccurrenceofventricular ;prematurebeat.Tosumup.acupunctureatdifferent ;pointscanproduceactionontheheartthrough ;

    ;JournalofTraditionalChineseMedicine2008;28(2):8689

    ;differentmechanisms.

    ;Theantiarrhythmicdrugsinwesternmedicinecan ;inhibitthemyocardialcellularexcitability,auto

    ;maticityandconductivity,andmyocardialcon

    ;tractilityinvaryingdegrees.Ithasbeenshownby ;recentelectrophysiologicalresearchesthatallthe ;antiarrhythmicdrugshavebeenassociated,with ;proarrhythmia.Thesedrugscanexertuntoward ;effectsoncardiacfunctionandelectrolyte.ereas. ;acupuncturedoesnothavetheabovementionedside

    ;effects,suggestingthatacupuncturetreatmenthas ;broadprospects,andisworthypopularizing. ;Moreover,treatingtheprimarydiseasescanneverbe ;ignoredinthetreatmentofstubbom,multifocaland ;multipleventricularprematurebeat.

    ;REFERENCES

    ;1.罗陆一.普乐林治疗冠心病临床观察.实用中西医结合

    ;杂志1995;8(7):439.

    ;2.中国人民解放军总后勤部卫生部.临床疾病诊断依据治

    ;愈好转标准第2.北京:人民军医出版社2002;551.

    ;(TranslatedbyWangXinzhong王新中)

    ;

    ;

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