Effects of Traditional Acupuncture on Mechanisms of CHD

传统针灸对冠心病机制的影响

• 批准号: 7844244
• 负责人: Cathleen Noel Bairey Merz
• 金额: $ 16.25万
• 依托单位: CEDARS-SINAI MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7844244
• 关键词: Accounting; Acupuncture procedure; Acute; Angina Pectoris; Animal Model; Anxiety; Arrhythmia; Arteries; Autonomic nervous system; Blinded; Blood Pressure; Blood Vessels; C-reactive protein; Cardiac; Cardiac Death; Cardiovascular system; Cause of Death; Cessation of life; Complement; Complementary Medicine; Complementary and alternative medicine; Control Groups; Controlled Study; Coronary heart disease; Data; Disease; Doctor of Medicine; Equipment and supply inventories; Etiology; Event; Frequencies; Functional disorder; Health Care Costs; Hemostatic Agents; Holter Electrocardiography; Hostility; Hyperlipidemia; Hypertension; Infarction; Intervention; Investigation; Measures; Mediating; Medical; Myocardial Infarction; Myocardial Ischemia; Nervous system structure; Nitric Oxide; Outcome; Parasympathetic Nervous System; Patients; Physiological; Prevention; Production; Psyche structure; Psychological Stress; Psychosocial Stress; Quality of life; Questionnaires; Randomized; Randomized Controlled Trials; Recurrence; Research Personnel; Risk Factors; Role; Scandinavian; Simvastatin; Social support; Stress; Sudden Death; Sympathetic Nervous System; Symptoms; System; Techniques; Testing; Tobacco use; Ultrasonography; Vasomotor; Work; alternative treatment; blood lipoprotein; brachial artery; constriction; depression; disability; functional status; heart rate variability; hemodynamics; improved; inflammatory marker; primary outcome; programs; psychologic; secondary outcome; sudden cardiac death; vasomotion

DESCRIPTION (provided by applicant): Coronary heart disease in the leading cause of death, disability, and health care costs in the US. Among patients with established coronary heart disease (CHD), a majority of patients continue to have acute cardiac events, many sudden and unexpected, despite identification and treatment of their disease and traditional risk factors. Substantial evidence indicates that psychosocial stress and the sympathetic nervous system contributes to acute cardiac events. Preliminary evidence suggests that complementary medicine practices, such as traditional acupuncture (TA), may beneficially alter outcomes in patients with CHD, although the mechanisms responsible for the observed benefit are unknown. We propose to conduct a randomized, blinded, controlled study of the effects of the complementary medicine practice of traditional acupuncture (TA) compared to sham TA and waiting control group on the primary outcome of: 1) autonomic nervous system imbalance (heart rate variability); and the secondary outcomes of: 2) an inflammatory marker (high-sensitivity C reactive protein); and 3) psychological stress, depression, hostility, anxiety, social support, and quality of life; and the exploratory variable of arterial vasomotion (brachial artery reactivity testing). We hypothesize that the complementary medicine practice of TA can serve as an additive/alternative treatment for the prevention of acute cardiac events in CHD patients. The results of this randomized controlled trial will: a) yield new data regarding the pathophysiologic mechanisms effected by the complementary medicine practice of TA in CHD patients, and b) provide pilot data for a large multi-center study of the effect of TA on acute CHD events, including sudden cardiac death.

描述（由申请人提供）：冠心病是美国死亡、残疾和医疗费用的主要原因。在已确诊的冠心病 (CHD) 患者中，尽管已识别并治疗了疾病和传统危险因素，但大多数患者仍会出现急性心脏事件，其中许多是突发的和意外的。大量证据表明，社会心理压力和交感神经系统会导致急性心脏事件。初步证据表明，补充医学实践，例如传统针灸 (TA)，可能有益地改变先心病患者的预后，尽管导致所观察到的益处的机制尚不清楚。 我们建议进行一项随机、盲法、对照研究，比较传统针灸 (TA) 的补充医学实践与假 TA 和等待对照组对以下主要结果的影响：1) 自主神经系统失衡（心率变异性） ;次要结果：2) 炎症标志物（高敏 C 反应蛋白）； 3) 心理压力、抑郁、敌意、焦虑、社会支持和生活质量；以及动脉血管舒缩的探索变量（肱动脉反应性测试）。我们假设 TA 的补充医学实践可以作为预防 CHD 患者急性心脏事件的附加/替代治疗。 这项随机对照试验的结果将：a）产生有关 TA 补充医学实践对 CHD 患者的病理生理机制影响的新数据，b）为一项关于 TA 对急性冠心病患者影响的大型多中心研究提供初步数据CHD 事件，包括心源性猝死。

项目成果

ACCF/AHA/ACP 2009 competence and training statement: a curriculum on prevention of cardiovascular disease: a report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Competence and Tra

ACCF/AHA/ACP 2009 年能力和培训声明：心血管疾病预防课程：美国心脏病学会基金会/美国心脏协会/美国医师学会能力和培训工作组的报告

• 发表时间: 2009-09-29
• 影响因子: 24
• 作者: Bairey Merz, C Noel;Alberts, Mark J;Balady, Gary J;Ballantyne, Christie M;Berra, Kathy;Black, Henry R;Blumenthal, Roger S;Davidson, Michael H;Fazio, Sara B;Ferdinand, Keith C;Fine, Lawrence J;Fonseca, Vivian;Franklin, Barry A;McBride, Patrick
• 通讯作者: McBride, Patrick