Clinical Study On The Anti Phlegm Dampness Carotid Atherosclerotic Plaque With The Acupuncture Simplified Scheme Of "Heart-Gallbladder Therapy"

ObjectiveIn this study,a randomized controlled trial was used to objectively evaluate the clinical efficacy of a simplified acupuncture "cardiobiliary treatment”anti-phlegm carotid atherosclerotic plaque by comparing the acupuncture group with the acupuncture group and the drug group.MethodsThe randomized controlled trial method was used to take volunteer patients recruited from the outpatient department of Guangdong Provincial Hospital of Traditional Chinese Medicine as the subject of this experiment.SPSS 20.0 software was used to generate random number numbers.90 subjects who met the study inclusion criteria were 1:1:1.The ratio is divided into 3 groups.79 effective cases were finally included in the 3 groups,26 in the acupuncture group,30 in the acupuncture group,and 23 in the drug group.Grouping:(1)Acupuncture groupAcupoint selection:Baihui,Yintang,Renying(double),Neiguan(double),Yanglingquan(double).Positioning:Refer to the National Standard of the People’s Republic of China(GB/T12346-2006)"Name and Positioning of Acupoints" issued in 2006.Operation:The subject was in a supine position,and acupuncture with φ 0.25×25mm acupuncture needles was used to puncture Baihui,Yintang,bilateral welcoming,bilateral Yanglingquan,bilateral Neiguan,and then in other points than Renying The method of lifting,twisting and twisting produced a sensation of qi.When acupuncture was performed at the acupuncture point,the needle was not used and the degree of seeing the needle body beating with the carotid pulse was maintained.The needle was left for 25 minutes.(2)Acupuncture groupAcupoint:① Acupuncture:Baihui,Yintang,Renying(double),Neiguan(double),Yang lingquan(double)② Intensive moxibustion:qi induction(yuanzhong,xiaqi,qihai,guanyuan),sihua(bilateral shu and bile)③Acupuncture needles:Xinyu(double),Danshu(double)Positioning:Refer to the National Standard of the People’s Republic of China(GB/T12346-2006)"Name and Positioning of Acupoints" issued in 2006.Operation:The operation of acupuncture is the same as that of acupuncture group.The fine moxibustion is operated according to the above corresponding acupuncture points.Each point is placed with a conical fine moxa column with a height of about 3mm and a bottom diameter of 2mm.The moxibustion is ignited with incense.Each moxa column is burned to the remaining 1/3.Moxibustion was performed at 2 acupoints.The acupuncture needles were disinfected with an iodine in accordance with the above points,and then a disposable sterile acupuncture needle was applied to each acupoint for 48 hours.(3)Drug groupThe subjects were given atorvastatin 10 mg/day,and aspirin 100 mg/day.Treatment:The three groups were all treated for 12 weeks.The acupuncture group and the acupuncture group were treated twice a week,with 3 days between each treatment.The treatment plan was the same as above,and 80%and above were required to be regarded as valid cases.Evaluation time and indicators:Two evaluations were performed before and after 12 weeks of treatment.The main indicators are carotid color Doppler ultrasound results,including intra-carotid arterial-media thickness(IMT),plaque thickness(Course score),plaque volume(PV),plaque gray scale value(GSM);secondary indicators are blood lipids,etc.Related results,such as triglycerides(TG),high density lipoprotein(HDL),low density lipoprotein(LDL),and total cholesterol(TC).statistics:Use spss20.0 software for statistical analysis and choose the appropriate statistical method according to the difference in data types.The classification data is tested by exact probability method or chi-square test.The measurement data is first tested for homogeneity of variance and normality test.The t-test is used to compare the mean of samples that meet the normal distribution,and the paired t-test is used to compare before and after the same group.Sample comparisons that satisfy the normal distribution are tested by paired symbol rank sum.Hierarchical data were analyzed using the Wilcoxon rank sum test for sample comparison or the Kruskal-Wallis test for multiple group comparisons.All tests were two-sided,and the significant difference was α=0.05.Results1.Baseline:1.Baseline:The demographic data before treatment of the three groups of subjects include:gender,age,BMI,systolic blood pressure,diastolic blood pressure,smoking status,etc.Baseline statistical analysis is performed.Among them,the person’s chi-square test and measurement data are used for the count data One-way analysis of variance was used.Non-parametric tests were used that did not meet the analysis of variance.There was no significant difference between the three groups.The three groups of subjects can be considered to be comparable in demographic data.Compare the three groups with baselines such as IMT,Crouse points,PV,GSM,TG,TC,HDL-C,and LDL-C before treatment.There was no statistical difference in the indicators before treatment in the three groups(P>0.05).It shows that the three groups are comparable.2.Main indicators:(1)Intra-carotid-medial thickness(IMT):Comparison within the group:In terms of carotid intima-media thickness,the acupuncture group has a significant effect in improving left carotid intima-media thickening in CAS patients;acupuncture group in improving bilateral carotid intima-media thickening in CAS patients It has significant effect;the drug group has no significant effect in improving carotid intima-media thickness in patients with CAS.In terms of comparison between groups,the three different interventions have no statistical difference in improving the carotid intima-media(IMT)thickening of the left and right sides of CAS patients.There may be acupuncture groups>acupuncture groups>drug groups in terms of efficacy.Trend,but no statistical difference.(2)Carotid plaque thickness(Crouse score):Comparison within the group:In terms of carotid plaque thickness,the acupuncture group has a significant effect on improving the total plaque thickness in the carotid arteries of CAS patients;the acupuncture group has significant effects on improving the total plaque thickness on the left and carotid arteries of CAS patients Efficacy;the drug has a significant effect in improving plaque thickness in the right carotid artery of CAS patients.In the results of comparison between groups,three different interventions were equivalent in improving plaque thickness and total plaque thickness in the left and right carotid arteries of CAS patients.(3)Carotid plaque volume(PV)Intra-group comparison:Acupuncture group and acupuncture group have significant effects in improving the total volume of carotid plaques in CAS patients;drug group has no significant effect in improving the total volume of carotid plaques in CAS patients.In terms of comparison between groups,there are no statistical differences in the three different inter ventions in improving the carotid plaque volume in CAS patients.With reference to the bar chart,it can be known that according to the comparison of the average of the three groups’total volume differences,the acupuncture group and the acupuncture group The curative effect is equivalent,and there is a trend that is better than the drug group,but no statistical difference is formed.(4)Gray scale value of carotid plaque(GSM)Comparison within the group:The acupuncture group has a significant effect only in improving the left carotid artery plaque grayscale value,the acupuncture group has a significant effect in improving the bilateral carotid plaque grayscale value,and the drug group is only improving the right side Carotid plaque grayscale values have significant effects.In terms of comparison between groups,there was no statistical difference between the three groups before and after treatment in improving the gray value of the left carotid plaque.According to the chart,there was a trend in the efficacy of acupuncture group>acupuncture group>drug group,but no statistical difference was formed.;There was no statistical difference between the three groups before and after treatment in improving the gray value of the right carotid plaque,but there was a trend in the.efficacy of the drug group)acupuncture group>acupuncture group,but no statistical difference was formed.(5)blood indexIn terms of triglyceride(TG),comparison within each group showed that the three groups of acupuncture,acupuncture,and medicine had no significant improvement in triglyceride(TG).Comparison between groups showed that the three groups were improving triglyceride.There is no difference in efficacy.In terms of total cholesterol(TC),comparisons in each group showed that there was no significant improvement in total cholesterol before and after treatment in the acupuncture group and acupuncture group,and the drug group had significant effects in improving total cholesterol.In terms of comparison between groups,the drug group was better than the acupuncture group and the acupuncture group in improving total cholesterol,and the acupuncture group and the acupuncture group were equally effective in this respect.In terms of high-density lipoprotein(HDL),comparison within each group shows that the acupuncture group has a certain effect in improving high-density lipoprotein,while the acupuncture group and the drug group have no significant effect in improving high-density lipoprotein.In terms of comparison between groups,the three groups did not form a statistical difference in improving HDL.In terms of low-density lipoprotein(LDL),comparisons within each group showed that the acupuncture group and the drug group had a certain effect in improving the low-density lipoprotein level;the acupuncture group had no significant effect in improving the low-density lipoprotein;comparison between groups It is suggested that the efficacy of the drug group is better than that of the acupuncture group and the acupuncture group in improving the low density lipoprotein,and the effect of the acupuncture group and the acupuncture group is equivalent.ConclusionThe acupuncture simplified scheme of "Heart-Gallbladder Therapy" can effectively reduce the carotid plaque volume and improve the stability of plaque patients with carotid atherosclerosis,and the curative effect is the same as the acupuncture scheme of "Heart-Gallbladder Therapy" and better than the western medicine plan,but the operation is easier.