Huang Shourui, Li Ling, Liu Jiali, Li Xiujuan, Shi Qingyang, Li Ying, Liu Yanping, Li Mingxiu, Ma Li, Ning Liang, Liao Xiaoyang, Ying Xihui, Cai Weiye, Yang Fuyu, Wang Tengfei, Guo Ru, Ma Weijie, Chen Wenzhu, Chen Jin, Sun Xin
Chinese Evidence-based Medicine Centre, West China Hospital, Sichuan University, Chengdu 610041, China.
School of Acupuncture and Massage, The Third Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China.
Evid Based Complement Alternat Med. 2021 Nov 2;2021:7228033. doi: 10.1155/2021/7228033. eCollection 2021.
Acupoint sensitization is considered an important factor in the efficacy of acupoint therapy. This study aimed to evaluate the efficacy of acupressure in the prevention of stable angina pectoris using acupoints with different pressure-pain sensitivities.
A total of 202 patients were enrolled and randomly assigned to a high-sensitivity group (HSG) ( = 109) in which patients received acupressure at the five acupoints with the highest sensitivity to pain and a low-sensitivity group (LSG) ( = 93) in which patients received acupressure at the five acupoints with the lowest sensitivity to pain. The duration of acupressure treatment was 4 weeks, and the patients were evaluated at baseline, week 4, and week 8. The primary outcome was a change in the frequency of angina attacks from baseline. The secondary outcomes included nitroglycerin consumption, the Canadian Cardiovascular Society classification, and the Seattle Angina Questionnaire score. Adverse events such as bleeding and subcutaneous haemorrhage were recorded in both groups.
The effect of acupressure compared with baseline on the prevention of angina pectoris in HSG was better than that in LSG at week 4 (incidence rate ratio (IRR): 0.691 and 95% confidence interval (CI): [0.569, 0.839]) and week 8 (IRR: 0.692 and 95% CI: [0.569, 0.839]). No significant difference between groups was found in the frequency of nitroglycerin consumption at week 4 (odds ratio (OR) = 0.863 and 95% CI: [0.147, 5.077]) or week 8 (OR = 1.426 and 95% CI: [0.211, 9.661]). Two themes in the questionnaire showed significantly different changes from baseline between the two groups. Scores on the angina frequency (AF) subscale had changed more from the baseline in the HSG at week 8 than in the LSG (mean difference (MD) = 3.807 and 95% CI: [0.673, 6.942]). Scores on the treatment satisfaction (TS) subscale had also changed more in the HSG than in the LSG at week 4 (MD = 3.651 and 95% CI: [0.327, 7.327]) and week 8 (MD = 4.220 and 95% CI: [0.347, 7.346]). One patient in the LSG reported bruising at the acupoint. No unexpected safety problems arose.
This study showed that acupressure at acupoints with high sensitivity to pain may effectively reduce the frequency of stable angina pectoris episodes. This trial is registered with NCT03975140.
穴位敏化被认为是穴位疗法疗效的一个重要因素。本研究旨在评估使用不同压痛敏感度穴位进行指压预防稳定型心绞痛的疗效。
共纳入202例患者，随机分为高敏组（HSG）（n = 109），该组患者在五个对疼痛敏感度最高的穴位接受指压，以及低敏组（LSG）（n = 93），该组患者在五个对疼痛敏感度最低的穴位接受指压。指压治疗持续4周，在基线、第4周和第8周对患者进行评估。主要结局是心绞痛发作频率相对于基线的变化。次要结局包括硝酸甘油消耗量、加拿大心血管学会分级和西雅图心绞痛问卷评分。记录两组的出血和皮下出血等不良事件。
在第4周（发病率比（IRR）：0.691，95%置信区间（CI）：[0.569，0.839]）和第8周（IRR：0.692，95%CI：[0.569，0.839]）时，与基线相比，高敏组指压预防心绞痛的效果优于低敏组。在第4周（优势比（OR） = 0.863，95%CI：[0.147，5.077]）或第8周（OR = 1.426，95%CI：[0.211，9.661]）时，两组硝酸甘油消耗量频率无显著差异。问卷中的两个主题显示两组间相对于基线有显著不同的变化。在第8周时，高敏组心绞痛频率（AF）子量表的得分相对于基线的变化大于低敏组（平均差（MD） = 3.807，95%CI：[0.673，6.942]）。在第4周（MD = 3.651，95%CI：[0.327，7.327]）和第8周（MD = 4.220，95%CI：[0.347，7.346]）时，高敏组治疗满意度（TS）子量表的得分变化也大于低敏组。低敏组有1例患者报告穴位处有瘀伤。未出现意外的安全问题。
本研究表明，在对疼痛敏感度高的穴位进行指压可有效降低稳定型心绞痛发作的频率。本试验已在ClinicalTrials.gov注册，注册号为NCT03975140。
