Acupuncture And Moxibustion Treatment Based On ’Heart And Gallbladder’ Theory For Carotid Atherosclerosis On Arterial Stiffness

ObjectiveApplying the ultra-fast pulse wave velocity technology to evaluate the effect of the "heart and gut theory" acupuncture integration program on the vascular elasticity of atherosclerosis patients.By the observation of blood indexes such as blood lipids and platelets,the effect of acupuncture on blood lipid and platelet aggregation function in patients with atherosclerosis can be evaluated.MethodRandom method using SPSS20.0 software to generate random number,90 cases of subjects in line with the inclusion of the standard according to the ratio of 1:1,divided into acupuncture group,control group,blank group 3 groups,and finally included in 52 cases which combined with acupuncture group 22 cases,control group 20 cases and blank group 10 cases.1.Acupoints selection:Acupuncture:NEIGUAN(PC6),RENYING(ST9),BAIHUI(DU20),YINGTANG(EX-HN3),YANGLINGQUAN(GB34)Moxibustion:YINQIGUIYUAN,SIHUAInner needle:XINSHU,DANSHU2.Acupuncture group operation:Patients lying on back,the operator inject needle through the double-sided stab and surface of skin.The depth of insertion is flexible and depends on the location of the acupoints and the figure of the patient.Keep the needle in for about 25min;then place a 3mm*2mm conical aciculum on the surface of the acupoints until burns to half when the pinch is extinguished,each acupoints give twice;the inner needle operates as usual and last for 48-72 hours.3.Control group operationAcupoints and body position are the same as acupuncture group,the choice of improved disposable stacking needle,dip hand-held custom blunt needle into the base,let the needle tip touch the patient’ s skin which can cause sensation of pain;the inner needle is placed flat on the skin when the needle is operated,and the needle tip is secured with adhesive cloth,leaving the needle 48h-72 hours.4.Blank GroupThe blank group does not perform any clinical intervention.5.Course of treatmentThe course of treatment is 3 months with every 72 hours a intervention,2 treatments a week,a total of 24 treatments,the completion of 80 percent is effective.6.Evaluation timepoint and outcome indicatorsSelecting the 0,4,8,and 12 week as the evaluation time point,measure the thickness of the mid-membrane in the two-sided carotid artery before joining the group as the diagnostic criterion,and detect two-sided BS,ES value,TG,total cholesterol(TC),low-density lipoprotein(LDL),high-density lipoprotein(HDL),lipoprotein A and platelet count detection.7.Statistical methodsAnalyzing the results of the ITT principle,the continuous variable baseline data analysis uses single-factor ANOVA(any group of data is non-normally distributed or inconsistently varied by using the K independent sample non-parametric test-Kruskal Walls Test);Comparison syllable ANOVA analysis within the continuous variable group before and after treatment(the non-parametric test of K independent sample-Kruskal Walls Test is used in any group of data that is not normal liberated or inconsistent),and the main outcome indicator uses variance analysis of repeated measurements Correlation analysis of two continuous variables uses Pearson correlation(non-compliance with normal distribution is spearman rank correlation).Using a two-sided test,the baseline comparative test level is alpha=0.10,the therapeutic test level is alpha=0.05,and the two groups are compared with alpha=0.0167.ResultsIn terms of demographic data,there was no significant difference between the three groups of demography data(P>0.05),and the baselines of demography data were consistently comparable.In terms of the main outcome indicators,the results of the inter-group comparison suggested that there was no significant difference between the first three groups of BS(P=0.289),the right-hand ES(P=0.347)and the left-hand BS(P=0.196),and the left-hand ES(P=0.244)groups.There was no significant difference in vascular elasticity in patients with atherosclerosis in the first two groups of treatment,and the baseline was consistently comparable.In-group comparison:The two-sided BS and ES values of acupuncture group showed no significant difference(P>0.05)after 1 month of treatment compared to pre-treatment,and there were significant differences(P<0.05)after treatment 2 months and 3 months after treatment compared with pre-treatment,and showed a downward trend;The ES values showed no significant differences(P>0.05)at all points after treatment compared to pre-treatment,there was no significant difference in the blank group’s two-sided BS at any point before and after treatment(P>0.05),and there was a significant difference(P<0.05)after 3 months of left ES treatment compared to pre-treatment,and there was an upward trend.Through-group comparison:After 1 month of treatment,there was no significant difference in the values of acupuncture group,false needle group,blank group two-sided BS and ES(P>0.05).There was no significant difference in arterial vascular elasticity in the three groups.After 2 months of treatment,there was no significant difference between the three groups of right BS difference(P=0.054),the right-hand ES difference(P=0.004)and the left BS difference(P=0.038),There was a significant difference between the left ES difference(P=0.035)group,and there was a significant difference(P<0.05)between the acupuncture group and the blank group 2 months after treatment,and the left ES difference(P=0.047).After 3 months of treatment,there were significant differences between the three groups of BS difference(P=0.032),the right-hand ES difference(P=0.036),the left-hand BS difference(P=0.007)and the left-hand ES difference(P=0.000)group.Two comparisons were obtained by using Tamhane test:there were significant differences between the two-sided BS difference and the ES difference(P<0.05)between the acupuncture group and the blank group after 3 months of treatment(P<0.05),while there was a significant difference between the acupuncture group and the fake acupuncture group in the left BS difference(P=0.043)and the left ES difference(P=0.008).Repeated measurements suggest that there is no interaction between the time point and the two-sided BS value BS value and the ES value,there is no significant difference between the PWV value and the difference between the points(P=0.008)there is an interaction effect.There is a significant difference in the movement of the Left BS value,the left ES value,and the right ES value at different points in time(P<0.05).In terms of secondary indicators,there was no significant difference(P>0.05)between groups of triglycerides,cholesterol,HDL,LDL,Lipoprotein a and platelet counts.ConclusionAcupuncture therapy can improve the atherosclerosis of the cetotheriids of the carotid,and the change of atherosclerosis elasticity is more significant than the change of arterial elasticity in the early stage of contraction,but the mechanism of acupuncture anti-arteriosclerosis and the incidence of long-term cardiovascular risk and complications in patients are still needed in the later researches.