Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
Heart. 2010 Sep;96(17):1396-400. doi: 10.1136/hrt.2009.187930. Epub 2010 Jun 15.
Congestive heart failure (CHF) is a complex clinical syndrome with autonomic dysbalance and increased plasma levels of inflammatory cytokines, which further worsen the syndrome. Experimental data have shown that stimulation of certain acupoints decreases autonomic dysbalance.
To test the therapeutic potential of acupuncture for life-threatening diseases such as CHF.
17 stable patients with CHF (New York Heart Association class II-III, ejection fraction <40%) receiving optimised heart failure medication were randomised into a verum acupuncture (VA) and placebo acupuncture (PA) group. Cardiopulmonary function, heart rate variability and quality of life were explored.
No improvements of the cardiac ejection fraction or peak oxygen uptake were observed, but the ambulated 6 min walk distance was remarkably increased in the VA group (+32+/-7 m) but not the PA group (-1+/-11 m; p<0.01). Accordingly, post-exercise recovery after maximal exercise and the VE/VCO(2) slope, a marker of ventilatory efficiency, were improved after VA but not PA. Furthermore, heart rate variability increased after VA, but decreased after PA. The 'general health' score and 'body pain' score of the quality-of-life questionnaire SF-36 tended to be improved after VA.
Acupuncture may become an additional therapeutic strategy to improve the exercise tolerance of patients with CHF, potentially by improving skeletal muscle function.
充血性心力衰竭(CHF)是一种复杂的临床综合征,伴有自主神经失衡和炎症细胞因子的血浆水平升高,这进一步加重了该综合征。实验数据表明,刺激某些穴位可以减少自主神经失衡。
测试针刺治疗充血性心力衰竭等危及生命疾病的潜力。
17 例稳定的充血性心力衰竭患者(纽约心脏协会分级 II-III,射血分数<40%)接受优化的心力衰竭药物治疗,随机分为真针刺(VA)和假针刺(PA)组。探讨心肺功能、心率变异性和生活质量。
心脏射血分数或峰值摄氧量没有改善,但 VA 组的步行 6 分钟距离明显增加(+32+/-7 m),而 PA 组没有增加(-1+/-11 m;p<0.01)。因此,VA 后最大运动后的运动后恢复和 VE/VCO(2)斜率(通气效率的标志物)得到改善,但 PA 后则没有改善。此外,VA 后心率变异性增加,而 PA 后心率变异性降低。SF-36 生活质量问卷的“一般健康”评分和“身体疼痛”评分也倾向于 VA 后改善。
针刺可能成为改善充血性心力衰竭患者运动耐量的一种附加治疗策略,可能通过改善骨骼肌功能。