Complementary Alternative Cardiovascular Medicine
Complementary Alternative Cardiovascular Medicine
Complementary Alternative Cardiovascular Medicine
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178 <strong>Alternative</strong> <strong>Cardiovascular</strong> <strong>Medicine</strong><br />
rather than exact choice of Chinese acupuncture points. The combined<br />
study suggests a mutual mechanism underlying the acupuncture-induced<br />
improvement in pressure-rate-product during exercise and an increase in<br />
local skin temperature; a decrease in sympathetic tone, induced by segmental<br />
nerve stimulation is a possible explanation.<br />
Level A Scientific Studies. Several experiments on animals support<br />
the clinical findings in patients with angina pectoris.<br />
In one study, experimental myocardial ischemia was produced in 30<br />
rabbits by ligation of the ventricular branch of the left coronary artery.<br />
The rabbits were randomly allocated to electroacupuncture at Per. 5<br />
(acupoint Jianshi) (60 Hz for 10 min) or no treatment. Using ST depression<br />
as a measurement of myocardial ischemia, the acupuncture group<br />
showed a decrease in ST depression after release of the ligation, when<br />
compared to the control group (p < 0.05), and a normal ST amplitude<br />
was obtained after 50 min in the acupuncture group only (26). In another<br />
study with the same design, 48 rabbits were randomly allocated to (1)<br />
control, (2) acupuncture, (3) electrolytic destruction of the hypothalamus<br />
without acupuncture, and (4) electrolytic destruction of the hypothalamus<br />
with acupuncture. Again, when compared to the control group,<br />
the acupuncture group showed improved recovery after release of the<br />
ligation, measured as ST depression (p < 0.05). Although lesion of the<br />
hypothalamus did not affect the recovery, the effect of acupuncture in<br />
the group with a destroyed hypothalamus was no longer significant when<br />
compared to the control group (27).<br />
A Chinese American group of scientists have conducted a series of<br />
impressive experiments on anesthetized cats, elucidating the effects of<br />
acupuncture on bradykinin stimulated, reflex-induced myocardial ischemia<br />
(28–30). To produce a controlled reduction in regional coronary blood flow<br />
(CBF), the left anterior ascending artery was totally (5 cats) or partially<br />
occluded (7 cats). Regional wall movement measured by Doppler was<br />
used to assess myocardial function in response to the induced ischemia.<br />
Electroacupuncture at the median nerve (corresponding to acupoint Per.<br />
6: Neiguan) significantly improved wall function when compared to<br />
controls (p < 0.05). The improvement in regional function with stimulation<br />
of the median nerve was accompanied by a diminished pressor<br />
response, as indicated by significantly reduced increments in blood pressure<br />
and pressure-rate-product (p < 0.05). The inhibitory effect of acupuncture<br />
on the reflex-induced myocardial ischemia was blocked by<br />
naloxone, administrated either intravenously or directly into the cardiovascular<br />
reflux center of the medulla spinalis, suggesting that the decrease<br />
in myocardial oxygen demand was mediated by stimulation of<br />
opioid receptors in the medulla spinalis exercising an inhibitory effect on<br />
cardiovascular sympathetic reflexes (29).