Acupuncture effects on heart failure: How to create objective study designs

摘要

根据对针刺机制的现代理解, 针刺可以引起植物神经反射, 可能是影响与心力衰竭(其特征之一是6 分钟步行实验得分较低)症状有关的系统植物神经调节异常。 笔者进行了一个初步的前瞻性随机、 单盲、 交叉临床试验, 比较符合海德尔堡中医模型诊断(i-ACU)和不符合这一模型(u-ACU)的两种针刺治疗。 重复测量分析提示: 与不符合海德尔堡中医模型的针灸治疗相比, 符合这一模型的针灸治疗更有效(F =7.2, df =1.37, P=0.011)。 这一研究结果表明针刺可延长6 分钟行走距离这一心力衰竭的重要指标。

Abstract

According to a modern understanding of acupuncture mechanisms, acupuncture may elicit vegetative reflexes, presumably influencing the systemwide vegetative dysregulation associated with the heart failure syndrome, a feature of which is low performance in the 6 min walk test. The author performed a preliminary prospective, randomized, single-blinded clinical trial (n=21) in a cross-over design comparing acupuncture treatment, which was either compatible with individual Chinese diagnosis according to the Heidelberg Model of TCM (i-ACU) or a standardized treatment on acupoints with no specific relation to TCM diagnosis (u-ACU). The repeated measures analysis revealed a significant effect for i-ACU vs. u-ACU (F =7.2, df =1.37, P=0.011). The study revealed first evidence that acupuncture may prolong 6 min walk distance as a key parameter of heart failure.