| Objective:To demonstrate the efficacy and safety of acupuncture in the treatment of cardiac arrhythmias through meta-analysis,providing literature support for subsequent studies.To observe the effects of transcutaneous acupoint electrical stimulation on patients with palpitations,to provide a trial basis for transcutaneous acupoint electrical stimulation to regulate cardiac function under pathological conditions.To observe the effects of wearable transcutaneous acupoint electrical stimulation on normal human cardiopulmonary endurance and heart rate variability,provide a test basis for wearable transcutaneous acupoint electrical stimulation to improve cardiopulmonary endurance and enhance cardiopulmonary reserve function under physiological conditions,and provide a scientific basis for the application of wearable transcutaneous acupoint electrical stimulation devices in aerospace medicine.Method:Study 1:Four Chinese databases and three English databases were searched by computer,combined with manual searches of the library materials of Tianjin University of Traditional Chinese Medicine,to comprehensively collect the literature on clinical randomised controlled trials of acupuncture for the treatment of cardiac arrhythmias.Data were extracted from the included literature,including information on year of publication,baseline patient data,sample size,arrhythmia type,intervention,acupuncture point protocol,duration of treatment,and observation index,etc.Meta-analysis of the effect of acupuncture treatment was performed using Rev Man 5.3 software.Study 2:Patients with palpitations were studied and 116 patients who met the diagnostic,inclusion and exclusion criteria were subjected to transdermal electrical stimulation at a frequency of 2/10Hz and a duration of 30min/time once a day,with the number of treatments varying according to the patients’hospitalisation cycle.The efficacy of transcutaneous electrical stimulation on patients with palpitations was evaluated before and after the treatment and the TCM symptom score to provide a test basis for transcutaneous electrical stimulation for the treatment of cardiovascular problems in astronauts after entering space.Study 3:A random number table was used to randomly divide 24 healthy subjects who met the inclusion and exclusion criteria into Trial GroupⅠand Trial GroupⅡin a 1:1 ratio.Subjects in both groups were treated with a wearable transcutaneous electrical acupoint stimulation device for 14 consecutive days.The groupⅠwas given one intervention per day and the groupⅡwas given two interventions per day.To explore the effect of the wearable transcutaneous electrical acupoint stimulation device on the cardiopulmonary endurance and heart rate variability of the subjects and the effective stimulation frequency,and to provide evidence of the effectiveness and safety of the wearable transcutaneous electrical acupoint stimulation device in improving the cardiopulmonary reserve function of the astronauts.Results:1 Results of Study 1:（1）In terms of clinical efficacy:statistical differences were observed between the acupuncture group and the control group（P<0.05）.Subgroup analysis showed no statistical difference between the acupuncture group and the herbal group（P>0.05）and the western medicine group（P>0.05）group,and a statistical difference between the placebo group（P<0.05）.（2）In terms of regulating average heart rate,there was statistical difference between the acupuncture group and the control group（P<0.05）.Subgroup analysis showed that there was significant difference in heart rate between bradyarrhythmia（P<0.01）and tachyarrhythmia（P<0.01）before and after acupuncture treatment.（3）In terms of improving TCM symptom score,there was a significant difference between the acupuncture group and the placebo group（P<0.05）.（4）In the treatment of TCM symptoms of arrhythmia:there was significant statistical difference between the acupuncture group and the placebo group（P<0.01）,and there was no statistical difference between the acupuncture group and the traditional Chinese medicine group（P>0.05）.（5）In terms of the number of premature ventricular contractions,there was a significant difference in the number of premature ventricular contractions between the acupuncture group and the placebo group（P<0.05）.（6）In terms of improving the recurrence rate of atrial fibrillation and atrial flutter,there were statistical differences between the acupuncture group,the placebo group and the blank group（P<0.05）.（7）In the aspect of regulating electrophysiological function,there was significant difference between the acupuncture group and the traditional Chinese medicine group（P<0.01）.Subgroup analysis showed that there were significant differences in sinus conduction time（P<0.01）and sinus node recovery time（P<0.01）.（8）In terms of adverse effects:there was no statistically significant difference between the acupuncture and control groups（P>0.05）.2 Results of study 2:（1）In the aspect of curative effect:after the treatment of transcutaneous acupoint electrical stimulation,the curative effect score increased significantly（P<0.01）.（2）In terms of TCM symptom score:after treatment,TCM symptom score decreased significantly（P<0.01）.（3）In terms of safety:there was no significant difference in equipment score before and after treatment（P>0.05）.3 Results of Study 3:3.1 Main outcomes（1）In terms of maximum oxygen uptake:the VO2max of the groupⅠincreased before and after the intervention,and the difference was statistically significant（P<0.05）.There was no significant difference in the VO2max of the groupⅡbefore and after the intervention（P>0.05）,The change range of VO2max in groupⅠwas higher than that in groupⅡ,and the difference was statistically significant（P<0.05）.（2）In terms of heart rate variability LF,no statistical difference was found between the LF indexes in the pre-and post-intervention groups（P>0.05）,and no statistical difference was found between the LF indexes in the post-intervention groups（P>0.05）.（3）In terms of heart rate variability LF/HF indexes:no statistically significant LF/HF ratio within the group before and after the intervention（P>0.05）,and no statistically significant LF/HF ratio between the groups after the intervention（P>0.05）.3.2 Secondary outcomes（1）In terms of maximum kilogram oxygen uptake:Before and after the intervention,the maximum oxygen uptake per kilogram in the two groups increased and the difference was statistically significant（P<0.01 in groupⅠ,P<0.05 in groupⅡ）.After the intervention,there was no significant difference in the maximum oxygen uptake per kilogram between the two groups（P>0.05）.The change range of the maximum oxygen uptake per kilogram in the groupⅠwas greater than that in the groupⅡand the difference was statistically significant（P<0.05）.（2）In terms of anaerobic threshold,there was no statistically significant difference in anaerobic threshold within the group before and after the intervention（P>0.05）,and no statistically significant difference in anaerobic threshold between the groups after the intervention（P>0.05）,but the magnitude of change in the groupⅠwas higher than that in the groupⅡand the difference was statistically significant（P<0.05）.（3）In terms of lung ventilation:before and after the intervention,the level of lung ventilation in the group increased and the difference was statistically significant（P<0.01）.After the intervention,there was no statistical difference in lung ventilation between the groups（P>0.05）.The change of lung ventilation in groupⅠwas slightly higher than that in groupⅡ,but the difference was not statistically significant（P>0.05）.（4）In terms of exercise duration:before and after the intervention,the exercise duration was prolonged with significant statistical significance（P<0.01）.After the intervention,there was no statistical difference in the exercise duration between the two groups（P>0.05）.The change range of the groupⅡwas slightly higher than that of the groupⅠ,but the difference was not statistically significant（P>0.05）.（5）In terms of metabolic equivalents:the metabolic equivalents increased in both groups before and after the intervention and the difference was statistically significant（P<0.01）,and the metabolic equivalents were not statistically different between the groups after the intervention（P>0.05）,the magnitude of change in metabolic equivalents was higher in the groupⅠthan in the groupⅡand the difference was statistically significant（P<0.05）.（6）In the aspect of maximum exercise heart rate:the maximum exercise heart rate of the two groups showed a downward trend.The maximum exercise heart rate of the groupⅠbefore and after the intervention had no statistical significance（P>0.05）,but the difference of the groupⅡbefore and after the intervention was statistically significant（P<0.01）,and there was no statistical difference between the groups after the intervention（P>0.05）,There was no significant difference between the two groups（P>0.05）.（7）In terms of NRS scores:during the intervention period of the wearable transcutaneous electrical acupoint stimulation device,the NRS scores of the upper and lower extremities of the subjects in both groups were between 3 and 4.The difference in NRS scores between the upper and lower extremities of the subjects was not statistically significant（P>0.05）,and the difference in NRS scores of the upper and lower extremities at different stimulation frequencies was not statistically different（P>0.05）.（8）In terms of safety:the grade 1 score was 66.7%and the grade 2 score was 33.3%in the groupⅠ,and the grade 1 score was 58.3%and the grade 2 score was 41.7%in the groupⅡ.The safety grading scores of the subjects in both groups were high and not statistically different（P>0.05）,and there were no adverse reactions.Conclusion:1 Acupuncture is safe and effective in the treatment of cardiac dysrhythmias and can be a complementary therapy in the treatment of cardiac dysrhythmias.2 Transcutaneous electrical acupoint stimulation can effectively treat palpitations and significantly reduce the patients’TCM symptom score,and patients acceptance of this treatment is high,safe and feasible.3 Wearable Transcutaneous Electrical Acupoint Stimulation can improve cardiopulmonary reserve function in normal subjects and is more effective once a day for 14 days;the wearable Transcutaneous Electrical Acupoint Stimulation device is safe,effective and implementable. |
