Effects of Ten Different Acupuncture Treatments for Angina Pectoris —A Network Meta-Analysis of Randomized Controlled Trials
DOI:
https://doi.org/10.53469/jcmp.2024.06(08).24Keywords:
Acupuncture, Angina pectoris, Network meta-analysisAbstract
Objective: To evaluate the clinical effects of different acupuncture treatments on Angina Pectoris. Design: Five databases (PubMed, Embase, Cochrane Library, Web of Science, and OVID) were searched from the earliest available dates to August 1, 2023, and only randomized controlled trials (RCTs) were included. Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to examine methodological quality, and Stata 15.1, Engauge Digitizer 11.3, and Office 2019 were used to process the data. Results: A total of 26 RCTs with 1747 patients were included. The network meta-analysis showed that acupoint application significantly reduced patients’ Angina Scores (AS) (surface under the cumulative ranking curve [SUCRA]: 74.1%) and improved patients’ Pain Scores (PS) (SUCRA: 100.0%). Cupping significantly improved the patients’ laboratory results and other tests (LOT) (SUCRA: 60.0%). Electroacupuncture significantly improved the patients’ Quality of Life (QoL) (SUCRA: 54.3%). Acupuncture significantly improved patients’ Exercise Tests (ET) (SUCRA: 66.7%) and the Seattle Angina Questionnaire (SAQ) (SUCRA: 93.2%). Auricular acupuncture significantly improved patients’ Anxiety and Depression Scores (ADS) (SUCRA, 79.5%). Conclusion: Different acupuncture treatments offer advantages for different aspects of angina pectoris, according to the Ranking Plot of the Network.
References
Knuuti J, Wijns W, Saraste A, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes[J]. Eur Heart J, 2020, 41(3): 407-477.
Farmakis D, Andrikopoulos G, Giamouzis G, et al. Practical Recommendations for the Diagnosis and Medical Management of Stable Angina: An Expert Panel Consensus[J]. J Cardiovasc Pharmacol, 2019, 74(4): 308-314.
Writing Comm Report Cardiovasc H. Report on Cardiovascular Health and Diseases in China 2021: An Updated Summary[J]. BIOMEDICAL AND ENVIRONMENTAL SCIENCES, 2022, 35(7): 573-603.
Ferrari R, Camici P G, Crea F, et al. Expert consensus document: A 'diamond' approach to personalized treatment of angina[J]. Nat Rev Cardiol, 2018, 15(2): 120-132.
Algoet M, Janssens S, Himmelreich U, et al. Myocardial ischemia-reperfusion injury and the influence of inflammation[J]. Trends Cardiovasc Med, 2023, 33(6): 357-366.
Delmas P, Hao J, Rodat - Despoix L. Molecular mechanisms of mechanotransduction in mammalian sensory neurons[J]. Nat Rev Neurosci, 2011, 12(3): 139-53.
Yamamoto H, Kawada T, Kamiya A, et al. Involvement of the mechanoreceptors in the sensory mechanisms of manual and electrical acupuncture[J]. Auton Neurosci, 2011, 160(1-2): 27-31.
Kagitani F, Uchida S, Hotta H. Afferent nerve fibers and acupuncture[J]. Auton Neurosci, 2010, 157(1-2): 2-8.
Devon H A, Uwizeye G, Cai H Y, et al. Feasibility and preliminary efficacy of acupuncture for angina in an underserved diverse population[J]. Acupunct Med, 2022, 40(2): 152-159.
Lin L, Su Y Y. Acupuncture combined Medicine In the Treatment of Stable Angina Pectoris for 45 Cases[J]. Chinese medicine modern distance education of china [zhong guo zhong yi yao xian dai yuan cheng jiao yu], 2016, 14(13): 85‐87.
Hao Z, Zhang X, Chen P. Effects of Ten Different Exercise Interventions on Motor Function in Parkinson's Disease Patients-A Network Meta-Analysis of Randomized Controlled Trials[J]. Brain Sci, 2022, 12(6).
Savovic J, Page M, Elbers R, et al. A revised tool for assessing risk of bias in randomized trials (RoB 2.0) [J]. Trials, 2017, 18.
Li D, Chen P. Effects of Aquatic Exercise and Land-Based Exercise on Cardiorespiratory Fitness, Motor Function, Balance, and Functional Independence in Stroke Patients-A Meta-Analysis of Randomized Controlled Trials[J]. Brain Sci, 2021, 11(8).
Jackson D, Riley R, White I R. Multivariate meta-analysis: potential and promise[J]. Stat Med, 2011, 30(20): 2481-98.
Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement[J]. Syst Rev, 2015, 4(1): 1.
Vats D, Flegal J M, Jones G L. Multivariate output analysis for Markov chain Monte Carlo[J]. Biometrika, 2019, 106(2): 321-337.
Salanti G, Ades A E, Ioannidis J P. Graphical methods and numerical summaries for presenting results from multiple-treatment meta-analysis: an overview and tutorial[J]. J Clin Epidemiol, 2011, 64(2): 163-71.
Chaimani A, Higgins J P, Mavridis D, et al. Graphical tools for network meta-analysis in STATA[J]. PLoS One, 2013, 8(10): e76654.
Marotta N, Demeco A, Moggio L, et al. Comparative effectiveness of breathing exercises in patients with chronic obstructive pulmonary disease[J]. Complement Ther Clin Pract, 2020, 41: 101260.
Khera R, Murad M H, Chandar A K, et al. Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events: A Systematic Review and Meta-analysis[J]. JAMA, 2016, 315(22): 2424-34.
Bao K J, Ma T Y. Clinical observation of acupoint application with Xiong Bi Tie for unstable angina pectoris[J]. Shanghai journal of acupuncture and moxibustion [shang hai zheng jiu za zhi], 2016, 35(6): 653‐655.
Dai J Y, Wang Z F L. Clinical research of the treatment of angina pectoris by point application[J]. Shanghai journal of acupuncture and moxibustion, 1997, 16(5): 2‐3.
Li D H, Xie J, Ren Y L, et al. Effectiveness and Safety of Acupoint Application of Guan Xin Su He Pill (冠心苏合丸) for Patients with Chronic Stable Angina Pectoris: a Multi-Center, Randomized Controlled Trial[J]. Chinese journal of integrative medicine, 2021.
Wang Y M, Wang Q Y, Zhang J, et al. [Comparative study on acupoint pressing and medication for angina pectoris due to coronary heart disease] [J]. Zhongguo Zhen Jiu, 2011, 31(7): 595-8.
Huang S, Li L, Liu J, et al. The Preventive Value of Acupoint Sensitization for Patients with Stable Angina Pectoris: a Randomized, Double-Blind, Positive - Controlled, Multicentre Trial[J]. Evidence-based complementary and alternative medicine: eCAM, 2021, 2021: 7228033.
Zhao L, Li D, Zheng H, et al. Acupuncture as Adjunctive Therapy for Chronic Stable Angina: a Randomized Clinical Trial[J]. JAMA internal medicine, 2019, 179(10): 1388‐1397.
Ballegaard S, Jensen G, Pedersen F, et al. Acupuncture in severe, stable angina pectoris: a randomized trial[J]. Acta Med Scand, 1986, 220(4): 307-13.
Lan L, Yin T, Tian Z, et al. Acupuncture Modulates the Spontaneous Activity and Functional Connectivity of Calcarine in Patients With Chronic Stable Angina Pectoris[J]. Front Mol Neurosci, 2022, 15: 842674.
Devon H A, Uwizeye G, Briller J, et al. Acupuncture shows early efficacy for pain reduction in stable angina[J]. Circulation, 2021, 144(SUPPL 1).
Li X, Cao J, Jiang A. [Clinical observation and dynamic electrocardiogram of unstable angina pectoris treated with acupuncture combined with western medication] [J]. Zhongguo Zhen Jiu, 2015, 35(9): 895-6.
Tan X H, Zhou Q, Chen Z T, et al. Clinical observation of plasma TXB2 and 6-k-PGF1 in patients with coronary heart disease and angina pectoris treated with acupuncture and medicine[J]. Chinese journal of ethnomedicine and ethnopharmacy [zhong guo min zu min jian yi yao], 2016, 25(13): 66‐68.
Richter A, Herlitz J, Hjalmarson A. Effect of acupuncture in patients with angina pectoris[J]. Eur Heart J, 1991, 12(2): 175-8.
Kurono Y, Egawa M, Yano T, et al. The effect of acupuncture on the coronary arteries as evaluated by coronary angiography: a preliminary report[J]. Am J Chin Med, 2002, 30(2-3): 387-96.
Lan T, Lv L, Gao Q. Effect of Ticagrelor Combined with Acupuncture on Myocardial Infarction and its Effect on Levels of Serum Myocardial Enzymes, Cytokines and T Lymphocytes[J]. Indian Journal of Pharmaceutical Sciences, 2022, 84: 81-86.
Ballegaard S, Pedersen F, Pietersen A, et al. Effects of Acupuncture in Moderate, Stable Angina Pectoris: A Controlled Study[J]. Surv. anesthesiol., 1990, 34(6): 402.
Mao X. Effects of acupuncture on angina pectoris, ecg and blood lipids of patients with coronary heart disease[J]. [world journal of acupuncture-moxibustion]: world j acup-moxi: shi jie zhen jiu za zhi, 1993, 3(4): 15‐19.
Liu W P, Xing Z H, Tan H Y, et al. Efficacy of acupuncture treatment on patients with variant angina pectoris and its effect on the function of vascular endothelial system[J]. Chinese Journal of Clinical Rehabilitation, 2004, 8(15): 2874-2875.
Yin L, Miao B, Chen J, et al. Clinical study about acupuncture combined with cupping therapy for treating stable exertional angina pectoris in the middle-age or old patients[J]. Chinese journal of clinical healthcare, 2009, 12(5): 465‐467.
Dai J, Liang S. A clinical observation on coronary heart disease treated by otopuncture at heart otopoint[J]. J Tradit Chin Med, 1998, 18(1): 43-6.
Zhang J Z, Wu H L, Chang P F, et al. Therapeutic effect of auriculotherapy with miniature bian needle on anxiety in the patients after percutaneous coronary intervention[J]. Zhen ci yan jiu = Acupuncture research, 2021, 46(10): 880-884.
Abazari M, Yousefi M, Rahimi V B, et al. Interactive Effects of Nutrition Modification and Wet Cupping on Male Patients with Refractory Stable Angina[J]. J Pharmacopuncture, 2022, 25(3): 224-232.
Wang M, Chen H, Lu S, et al. [Impacts on neutrophil to lymphocyte ratio in patients of chronic stable angina pectoris treated with acupuncture at Neiguan (PC 6)] [J]. Zhongguo Zhen Jiu, 2015, 35(5): 417-21.
Tang X, Yang J, Feng Z, et al. Study of Scraping with Copper Stone Based on Theory of Midnight-Noon Ebb-Flow in Angina Pectoris with Coronary Heart Disease of Qi Stagnation and Blood Stasis[J]. Evid Based Complement Alternat Med, 2021, 2021: 2677696.
Deng J, Fei L, Zhou J, et al. Needle-embedding therapy combined with basic treatment for stable angina pectoris[J]. World Journal of Acupuncture - Moxibustion, 2018, 28(2): 81-85.
Wallace B C, Schmid C H, Lau J, et al. Meta-Analyst: software for meta-analysis of binary, continuous and diagnostic data[J]. BMC Med Res Methodol, 2009, 9: 80.
Wang X Y, Li X L, Hong S Q, et al. Electroacupuncture induced spinal plasticity is linked to multiple gene expressions in dorsal root deafferented rats[J]. J Mol Neurosci, 2009, 37(2): 97-110.
Wang K, Zhang R, Xiang X, et al. Differences in neural-immune gene expression response in rat spinal dorsal horn correlates with variations in electroacupuncture analgesia[J]. PLoS One, 2012, 7(8): e42331.
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