| ObjectiveBy using the method of evidence-based medicine,the effectiveness of acupuncture and moxibustion in the treatment of unstable angina pectoris and blood stasis syndrome of coronary heart disease and the related molecular indicators were analyzed by meta-analysis,and the clinical efficacy of acupuncture and moxibustion in the treatment of unstable angina pectoris and blood stasis syndrome of coronary heart disease was objectively evaluated,so as to provide new ideas and reference basis for the prevention and treatment of acupuncture intervention in unstable angina pectoris and blood stasis syndrome and the improvement of clinical trials.MethodAccording to the method of Cochrane collaborative network and the characteristics of each database,the corresponding retrieval strategy is formulated.We searched CNKI,VIP,WF,CBM,Pub Med,Cochrane Library and EMBASE respectively.The retrieval time is limited from the beginning of the database to December 1,2019,and the language is limited to Chinese and English documents.After the completion of literature retrieval,two evaluators screened and extracted the literature according to the inclusion and exclusion criteria formulated in advance,and completed the literature extraction table.Finally,according to the quality evaluation table recommended in Cochrane Handbook 5.1.0 of Cochrane Collaboration Network,the quality evaluation of all the literature included in this study is carried out.The type and number of adverse reactions included in the literature were used as the outcome indicators of the safety evaluation of this study.In this study,Revman 5.3 software was used for meta analysis.Statistical treatment group including acupuncture and moxibustion therapy literature,and its collection of information and data analysis.The clinical efficiency,electrocardiographic efficiency,attack frequency,duration,EF(ejection fraction),SV(output per stroke),ambulatory electrocardiographic mean ischemic time,TC(cholesterol),TG(triglyceride),fibrinogen,plasma viscosity,hematocrit,TCM syndrome and blood stasis syndrome,acupuncture and moxibustion acupoint selection were systematically studied Evaluation and meta-analysis.The clinical efficacy and safety were compared.ResultA total of 160 documents were retrieved in this study,all of which were in Chinese and 0 in English.Among them,there are 84 CNKI,19 VIP,46 WF and 11 CBM.95 articles were obtained after eliminating duplicate articles.After excluding 13 articles of review,conference paper,systematic evaluation,animal experiment and cell group research,82 articles were obtained.By reading the abstract,58 articles were excluded which were inconsistent in research content,intervention measures,control measures or data could not be extracted.Three papers were excluded,which were not RCT and were not rigorous in experimental design.21 articles were included after full text browsing.Four papers were excluded.Finally,a total of 17 articles were included,with 1341 patients.Meta analysis showed that:(1)the effective rate of acupuncture treatment was significantly higher than that of conventional western medicine and traditional Chinese medicine treatment(P<0.05),the difference was statistically significant;(2)acupuncture treatment could significantly reduce the frequency of angina attack(P<0.05)and duration of angina pectoris(P <0.05),the difference was statistically significant;(3)acupuncture treatment could significantly improve ECG of patients(P<0.05),and the mean time of ambulatory electrocardiographic ischemia(P<0.05),the difference was statistically significant;(3)acupuncture therapy could significantly improve the hemorheology indexes,reduce the plasma viscosity(P<0.05),fibrinogen(P<0.05),hematocrit(P<0.05),the difference was statistically significant;(4)acupuncture therapy could improve the heart function of patients,and the difference was statistically significant The difference was statistically significant.(5)acupuncture therapy couldsignificantly reduce the levels of TC(cholesterol)(P<0.05)and TG(triglyceride)(P<0.05)in patients with unstable angina pectoris and blood stasis syndrome.(6)Acupuncture and moxibustion can obviously improve the symptoms and signs of patients,reduce the TCM syndrome score of patients(P<0.05),the difference is statistically significant.(7)The main acupuncture points are Neiguan,Xinshu and Tanzhong,which are combined with other acupuncture points according to dialectics.ConclusionUnder the support of current evidence,the effective rate of acupuncture treatment is significantly higher than that of conventional western medicine and traditional Chinese medicine treatment;it can significantly reduce the frequency of angina attack and duration of angina;improve the ECG,hemorheology index and the average time of blood deficiency of dynamic ECG;improve the hemorheology index,reduce the plasma viscosity,fibrinogen and Hematocrit,improvement of cardiac function,increase of cardiac output and ejection fraction,and decrease of TC(cholesterol)and TG(triglyceride)in patients with unstable angina and blood stasis syndrome.According to syndrome differentiation,Neiguan,Xinshu and Tanzhong points can be selected as the main points and other acupuncture points can be used to treat unstable angina pectoris of coronary heart disease.The therapeutic effect of acupuncture and moxibustion on unstable angina pectoris of coronary heart disease is better than that of traditional Chinese medicine,western medicine or combination of Chinese and Western medicine,that is to say,acupuncture and moxibustion has a definite therapeutic effect on unstable angina pectoris of coronary heart disease,which is worthy of clinical reference and promotion. |
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