Acupuncture as Adjunctive Therapy for Chronic Stable Angina

Abstract

The effects of acupuncture as adjunctive treatment to antianginal therapies for patients with chronic stable angina are uncertain. OBJECTIVE To investigate the efficacy and safety of acupuncture as adjunctive therapy to antianginal therapies in reducing frequency of angina attacks in patients with chronic stable angina. DESIGN, SETTING, AND PARTICIPANTS In this 20-week randomized clinical trial conducted in outpatient and inpatient settings at 5 clinical centers in China from October 10, 2012, to September 19, 2015, 404 participants were randomly assigned to receive acupuncture on the acupoints on the disease-affected meridian (DAM), receive acupuncture on the acupoints on the nonaffected meridian (NAM), receive sham acupuncture (SA), and receive no acupuncture (wait list [WL] group). Participants were 35 to 80 years of age with chronic stable angina based on the criteria of the American College of Cardiology and the American Heart Association, with angina occurring at least twice weekly. Statistical analysis was conducted from December 1, 2015, to July 30, 2016. INTERVENTIONS All participants in the 4 groups received antianginal therapies as recommended by the guidelines. Participants in the DAM, NAM, and SA groups received acupuncture treatment 3 times weekly for 4 weeks for a total of 12 sessions. Participants in the WL group did not receive acupuncture during the 16-week study period. MAIN OUTCOMES AND MEASURES Participants used diaries to record angina attacks. The primary outcome was the change in frequency of angina attacks every 4 weeks from baseline to week 16. RESULTS A total of 398 participants (253 women and 145 men; mean [SD] age, 62.6 [9.7] years) were included in the intention-to-treat analyses. Baseline characteristics were comparable across the 4 groups. Mean changes in frequency of angina attacks differed significantly among the 4 groups at 16 weeks: a greater reduction of angina attacks was observed in the DAM group vs the NAM group (difference, 4.07; 95% CI, 2.43-5.71; P < .001), in the DAM group vs the SA group (difference, 5.18; 95% CI, 3.54-6.81; P < .001), and in the DAM group vs the WL group (difference, 5.63 attacks; 95% CI, 3.99-7.27; P < .001). CONCLUSIONS AND RELEVANCE Compared with acupuncture on the NAM, SA, or no acupuncture (WL), acupuncture on the DAM as adjunctive treatment to antianginal therapy showed superior benefits in alleviating angina. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01686230

Akupunktur bei Schmerzerkrankungen und Allergien – von der klinischen Erfahrung zur Evidenz

“…Zu diesem Zweck wertete sie insbesondere systematische Reviews mit Metaanalysen aus, darunter insgesamt 159 qualitativ hochwertige Cochrane-Reviews [49]. Im letzten Jahrzehnt wurden in China zunehmend hochwertige RCT-Studien zur Wirksamkeit von Akupunktur bei großen Patientenpopulationen mit unterschiedlichen Erkrankungen durchgeführt, u. a. eine negative Studie beim polyzystischen Ovarsyndrom [50], eine positive Studie bei schwerer funktionaler Obstipation [51], eine positive Studie bei Stressharninkontinenz [52], eine positive Studie bei klimakterischen Beschwerden mit einem klinisch nicht relevanten Effekt [53] und eine positive Studie bei stabiler Angina-Pectoris-Symptomatik [54].…”

The Cerebral Mechanism of Acupuncture for Chronic Insomnia with Gastrointestinal Disorder: Protocol for a Randomized Controlled Trial

“…The blinding of acupuncturists is quite di cult to achieve. [41] Therefore, only patients, outcome assessors, and statisticians will be fully blind in this study.…”

STAT3 but not STAT5 contributes to the protective effect of electro-acupuncture against myocardial ischemia/reperfusion injury

“…Increasing experimental and clinical evidences have confirmed EA's effectiveness on cardiovascular diseases Ji et al, 2018;Huang et al, 2014;Fu et al, 2014;Zeng et al, 2018;Lu et al, 2016). A very recent article (Zhao et al, 2019) collected a total of 1651 patients with chronic stable angina and performed a clinical trial with acupuncture treatment. This study has shown that acupuncture as an auxiliary treatment method can alleviate clinical pain in patients with chronic stable angina, reduce the patient's anxiety and depression, and eventually improve the quality of life for these patients.…”