Philip A.M. Rogers MRCVS

AP and the Cardiovascular System


Alliluev_IG; Syrkin AL; Pal'tseva IS; Pecherskaia MB; Loshchenov VB; Ignatov AA; Belkina EM; Kramarenko TA; Radzievskii SA; Fisenko VA et al (1990) [Laser-AP in the complex treatment of stenocardia]. Klin Med (Mosk) Jul 68(7):54-56. Laser-AP (helium-neon) was used in 200 anginal patients. Therapeutic results were good: the number of attacks and nitroglycerin intake reduced, exercise tolerance grew, echocardiographic evidence showed a positive trend, haemodynamics improved, Spilberger's test values changed for the better.

Ballegaard_S; Karpatschoff B; Holck JA; Meyer CN; Trojaborg W (1995) AP in angina pectoris: do psychosocial and neurophysiological factors relate to the effect?. AETRIJ Apr-Jul 20(2):101-116. Dept of Int Med P, Rigshospitalet, Denmark. We studied the effect of AP in 49 patients with angina pectoris with focus on its relationship to psychosocial 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-Heart 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 (r=.7; p <.0001) but not to time of myocardial ischemia (r=.1; p=.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. Due to haemodynamic alterations, AP may have a specific effect on angina pectoris in addition to drug treatments.

Ballegaard_S; Pedersen F; Pietersen A; Nissen VH; Olsen NV (1990) Effects of AP in moderate, stable angina pectoris: a controlled study. J Intern Med Jan 227(1):25-30. Med Dept, Rigshospitalet, Univ 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 Channel 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 2 groups. The present design failed to show any significant differences between the effect of genuine and sham AP.

Ballegaard_S1; Meyer CN; Trojaborg W (1991) AP in angina pectoris: does AP have a specific effect?. J of Internal Med Apr 229(4):357-362. 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 EAP by another acupuncturist, and the change in skin temperature was recorded. The change in skin temperature correlated significantly with the degree of improvement after both genuine and sham AP. 14 patients with no decrease in skin temperature had 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 Ir 50%). The duration of disease and the effect of AP correlated significantly. Both real and sham AP had a specific effect on some angina pectoris patients in addition to the effect of drug-therapy.

Colquhoun-DM (1993) AP and TENS: where east meets west [comment]: Electrical neurostimulation for angina pectoris. Med-J-Aust 5 Apr 158(7):440-442. and 488-489.

Kraemer_ES; Cardoso M de F; Yamamura Y (1991) AP in angina pectoris [letter; see comments]. J Intern Med Apr 229(4):384-385. J Intern Med Apr 229(4):383.

Richter_A; Herlitz J; Hjalmarson A (1991) Effect of AP in patients with angina pectoris. European Heart J Feb 12(2):175-178. Wallenberg Lab for Cardiovascular Research, Sahlgren's Hospital, Univ of Gothenburg, Sweden. 21 patients with stable effort angina pectoris were randomized in a crossover study to 4 wk traditional Chinese AP or placebo tablet treatment. The patients had at least 5 anginal attacks/wk in spite of intensive treatment. AP was given 3 times/wk at main points PC06, HT05, BL15, BL20 and ST36. Previous antianginal treatment remained unchanged during the whole study. Compared with placebo, the number of anginal attacks during the AP period fell from 10.6-6.1/wk (p<.01). The performance before onset of pain during exercise test increased from 82 W to 94 W (p<.05). However, maximal performance did not increase after AP. Intensity of pain at maximal workload decreased from 1.4-0.8 (scale 0-4, p<.01). Further, ST-segment depressions at maximal comparable load decreased from 1.03-0.71 mm after AP (p<.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.

You_Z (1992) [Preliminary observation on the relationships between needling sensation of AP at PC06, Propagated Channel Sensation (PCS) and clinical AP effect in angina]. Chen Tzu Yen Chiu 17(1):75-78. Fujian Inst of TCM and Pharmacol, Fujian, PRC. This paper reports the different needling sensations (mainly distension), when AP was given at PC06 by the same doctor with the same manipulation in 300 CHD-patients with angina. Patients who reported a compound sensation (such as sourness-distension and distension-numbness) reported a higher rate of PCS and a better AP effect on angina. The AP effect was poor in all patients who did not report PCS. Other needling sensations gave an intermediate rate of PCS appearance and intermediate effects of AP effect on angina. The kind of needling sensation induced by AP was closely related to the appearance of PCS and the clinical AP effect in angina.

You_Z; Hu X; Wu B; Zhang W; Liang D (1993) [Differences in the time of appearance of AP effects between subjects with and without PCS during AP of PC06]. Chen Tzu Yen Chiu 18(2):149-153, 148. Fujian Inst of TCM Fuzhou, People's Hospital, Fujian Coll of TCM Fuzhou, PRC. Some work showed that AP at PC06 improved markedly the ECG of CHD-patients when Propagated Channel Sensation (PCS) was achieved. In contrast, patients without PCS gave a response to AP which was significantly less. Other work showed that the presence or absence of PCS did not influence significantly the beneficial clinical effects of AP. We found marked ECG changes in patients during AP of PC06, and some patients without PCS had marked changes as the duration of AP was prolonged. Thus, this trial was designed to observe any differences in the development of AP-induced EEG changes between patients with and without PCS. Patients with CHD (total 170; 86 M, 84 F; aged 35-83 yr) were observed. ECG was recorded with polygraph (model SJ-42) before AP. Then the PC06 AP point of the left forearm was punctured by slow twisting for 5 min and the presence or absence of PCS was observed carefully. PCS appeared to a varying degree in 80 patients, but not in the remaining 90. Another ECG was recorded after retaining the needle for 10 min. Retaining needle lasted for 30 min in some patients and the needle was manipulated every 16 min in order to keep the needling sensation. (ABSTRACT TRUNCATED AT 250 WORDS).

Zhou_XP4; Liu JX (1993) Metrological analysis for efficacy of AP on Angina Pectoris. Chung-Kuo Chung Hsi i Chieh Ho Tsa Chih Apr 13(4):212-214. 40 patients with stable angina pectoris got AP once or 7 times in 1 wk at PC06, HT07, HT03 or Earpoints HT, Shenmen. 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. After just one session of AP, angina was significantly alleviated (p<.05). The time from the end of exercise to the disappearance of angina in the AP group was shorter than that in the other 2 groups.

Zhou_XQ; Liu JX (1993) [Metrological analysis for efficacy of AP on angina pectoris]. Chung Kuo Chung Hsi I Chieh Ho Tsa Chih Apr 13(4):212-214, 196. Human Coll of TCM, Changsha, PRC. AP (AP points: PC06, HT07, HT03 or Ear-points: Heart, Shenmen) was administrated once or 7 times in 1 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 <.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-AP points (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 <.01), but they were similar (p >.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 2 groups (p <.05).