Clinical Observation On Sensitive Points Finger Acupuncture In The Treatment Of Chronic Stable Angina Pectoris

Objective:Set chronic stable angina pectoris(CSAP)as the object,and acupressure on the highly sensitized points and non-/lowly sensitized points as the interventions,to investigate whether acupressure on the sensitized points could improve the clinical effect and to analyze the correlation between changes in the degree of point sensitization and disease regression.Methods:This study was a randomized controlled trial in which 123 included CSAP subjects were randomly assigned in a 1:1 ratio to the highly sensitized points group(group A,i.e.,pressing5 highly sensitized points)and the non-/lowly sensitized points group(group B,i.e.,pressing5 non-/lowly sensitized points)using a central randomization method.For a total study period of 12 weeks,with a baseline period of 4 weeks,a treatment period of 4 weeks,and a followup period of 4 weeks.The primary evaluation index was the number of angina attacks in four weeks,and the secondary indexes were the Canadian Cardiovascular Society(CCS)angina severity classification and the Seattle Angina Questionnaire(SAQ)score.In addition,the distribution and changes in pain thresholds of pressure points in each group were observed to analyze the relation between changes in point sensitization degree and disease regression.Results:1.Two groups were comparable in terms of baselines like demographic characteristics and efficacy evaluation indexes,with balanced agreement between the groups(P>0.05).2.The number of angina attacks was significantly reduced in subjects in both groups after treatment and the difference was statistically significant compared to the baseline period(P<0.05),but the difference between groups was not statistically significant(P >0.05).The trend of decrease in the number of angina attacks was the same between the highly sensitized points group and the non-/lowly sensitized points group in the treatment period,but the trend of decrease was more pronounced in the highly sensitized points group than in the non-/lowly sensitized points group in the follow-up period,and the number of angina attack was significantly reduced,and the difference of improvement value of number of attacks was statistically significant(P <0.05).3.The number of subjects with angina CCS grade I increased and the number of subjects with grade II,III and IV decreased after treatment in both groups,which showed that the severity of angina was reduced in both groups after treatment,and the difference was statistically significant(P < 0.05)in the intra-group comparison,but the difference was not statistically significant between groups(P > 0.05).4.All five dimensions of SAQ scores were significantly improved subjects in both groups after treatment,and the differences within the groups were statistically significant(P < 0.05),regarding the comparison between groups,only the difference of angina stable state scores during the treatment period was statistically significant(P < 0.05),and the rest difference was not statistically significant(P > 0.05).5.The pain thresholds of the 12 points in the highly sensitized points group were Shao Hai,Dan Zhong,Shen Men,Qu Ze,Yin Xi,Nei Guan,Xi Men,Ji Quan,Ju Que,Xin Shu,Du Shu and Jue Yin Shu from low to high.The pain thresholds of the 12 points detected in the non-/lowly sensitized points group from low to high were Dan Zhong,Shao Hai,Xi Men,Qu Ze,Nei Guan,Yin Xi,Ji Quan,Shen Men,Ju Que,Du Shu,Xin Shu and Jue Yin Shu.The top 5 points selected for pressure among the 60 subjects in the highly sensitized points group were Shao Hai 70%(42/60),Dan Zhong 58.33%(35/60),Shen Men 56.67%(34/60),Nei Guan 55%(33/60)and Qu Ze 55%(33/60),with the majority of chest and upper limb points,mainly distributed in the Hand Shao Yin Heart Meridian and Pericardium Meridian.The top5 points selected for pressure among the 59 subjects in the non-/lowly sensitized points group were Du Shu 66.10%(39/59),Jue Yin Shu 62.71%(37/59),Xin Shu 61.02%(36/59),Ju Que54.24%(32/59),Shen Men 37.29%(22/59),and Shao Hai 37.29%(22/59),mainly in the back and abdomen and distributed in the Foot Tai Yang Bladder Meridian.6.After pointer pressing therapy,the pain thresholds of the 5 points pressed in the highly sensitized points group were significantly increased.Among them,the difference in pain thresholds of the first 4 points with the lower pain threshold was significantly significant(P<0.05),and only the difference in pain threshold of points with the highest pain threshold was not statistically significant(P >0.05).The pain threshold of the 5 points pressed in the non-/lowly sensitized points group decreased significantly,but only the difference in pain threshold of the point with the highest pain threshold was significantly significant(P <0.05),and the difference in pain thresholds of the other pressed points was not statistically significant.(P >0.05).The difference in pain threshold between pressing points in the highly sensitized points group and in the non-/lowly sensitized points group was significantly reduced.Among them,it was statistically different(P <0.05)between the first 3 points with the lowest pain threshold in the highly sensitized points group and the first 3 points with the highest pain threshold in the non-/lowly sensitized points group,and the pain thresholds of the other two points were not statistically different(P >0.05).Conclusions:1.Acupressure in the highly sensitized points group and the non-/lowly sensitized points group are effective in treating chronic stable angina pectoris.The highly sensitized points group is better than the non-/lowly sensitized points group in improving the number of angina pectoris attack,severity and quality of life.In terms of the improvement value of the number of angina pectoris and the stable state of angina pectoris,the difference was statistically significant,indicating that the highly sensitized points group had better efficacy.2.After acupressure,the pain threshold of pressing points in the highly sensitized points group was significantly increased,and the pain threshold of pressing points in the non-/lowlygroup was decreased.The difference in the pain threshold of the two groups of subjects pressing points was significantly reduced,indicating the sensitivity of acupuncture points will change as the condition changes.