Complementary Alternative Cardiovascular Medicine

174 Alternative Cardiovascular Medicine
ish studies on skin flap survival, have been conducted (see Ischemic Skin
Flaps section). This is in contrast to the industry-supported development
of transcutaneous electrical nerve stimulation (TENS) and spinal cord
stimulation (SCS).
The use of acupuncture, acupressure combined with numerous other
remedies, all supporting the same aim—to help the body to heal itself
and the person to live in balance with nature—has produced encouraging
results in the treatment for angina pectoris. The results of one such
treatment complex, called integrated rehabilitation, are presented later
in this chapter (see Evidence Level B Observational Studies section).
Safety
In an English study of 34,000 acupuncture treatments, no serious side
effects were encountered. Accordingly, it was concluded that when
compared with medical treatment, acupuncture must be seen as a relatively
gentle treatment (7). However, in treating heart disease, the locations
of the acupoints are close to vital organs, and the risk of serious
complications, such as cardiac tamponade or pneumothorax, does exist
(8–10) although such incidences are extremely rare.
CLINICAL AND SCIENTIFIC STUDIES AND EVIDENCE
REGARDING USE OF ACUPUNCTURE
INTRODUCTION
Methodological Considerations
The double-blind randomized trial is the hallmark of the Western
scientific world when assessing the effects of a new treatment. The
purpose of the randomization is to ensure a balanced distribution of
baseline variables between the treatment groups. The double-blinding
eliminates patient and investigator biases. However, in acupuncture trials,
it is not possible that the treatments being compared are identical to
the patient and the practitioner. The consequences of this are discussed
below and more comprehensively elsewhere (11).
PATIENT BIAS
Genuine acupuncture entails the penetration of the skin at specific
sites related to the condition of the patient, repeated physical contact
between the hands of the acupuncturist and patient’s skin, and a unique
physical sensation when the needle affects the acupuncture point. This
sensation is described as a soreness, an aching, or a burning and is different
from the sensation related to penetration of the skin. Consequently,
a truly nonactive control treatment, which feels like genuine acupuncture
is not possible, and therefore patient bias cannot be eliminated.