OBSERVATIONS EFFECTS INDUCED BY NEEDLING POINTS QUCHI AND FENGLONG IN PATIENTS WITH ESSENTIAL HYPERTENSION

Chen Daozhi, Wu Zihui, Liao Binfu, Xie Xuyun

(Chengdu Institute of TCM, Sichuan)

In our attempts in the summarization of the experience of famous senior doctors of Chinese medicine and in the development of an approach to the treatment and prophylaxis of disorders of high blood pressure, we have been engaged in the undertaking of monitoring 74 patients with hypertension since 1981. After having been treated with acupuncture, all of them showed favorable changes in Blood pressure. Out of this group, 35 patients were treated solely with acupuncture. We made specific observations on the efficacy relative to the application of acupuncture to these points in patient who were formerly refractory to other treatments and therefore it lasted a long course of therapy.

Patients' effective response observed:

Patients were recruited as subjects out of their own accord; the selection of recruits was based on a principle in accordance with the national standards for diagnosis of patients with hypertension. Thirty patients with stage 2 symptoms of hypertension were chosen; only five were with stage III. The insertion of needle into points Quchi and Fenglong was performed collaterally. Manipulation method of Xie (reducing) was intended as a means for the initial therapy. Not until the fall of blood pressure of the patient to the normal was seen did we use the method of even movements reinforcing and reducing for a change. Initial administration: one session of acupuncture per day; fortnight afterwards, 2-3 sessions were given weekly, if patient's condition of blood pressure permitting. Further observations on the subjects were made upon the completion of a 8 week course of treatment.

Results:

78.9% of the patients occurred a fall in systolic pressure 30 minutes after the performance of acupuncture; diastolic fall occurred in 77.3% of the population under consideration. 82.2% of them were subjects with average lowered arterial pressure. Average systolic pressure dropped by 34.2 mmHg; average diastolic fall by 19.4 mmHg; the lowered arterial pressure averaged by 23.6 mmHg. A 3-6 month follow-up was conducted immediately after a 8-week course of acupuncture-therapy. Patients with their blood pressure returned to normal after having been given this modality of therapy totaled 80%; the effective results were noticed in particular in those who were afflicted with stage II symptoms.

Hemodynamic observations:

With fixed members engaged in the research undertaken and with room temperature conditioned at 20°C (+2°C), through the use of instrumentation, a device for multipurpose recordings of electrophysiological indices on a multi-lead system, the authors of this paper were able to obtain a series of the following data:

Electrocardiograms relating the synchronous descriptions of subjects' conditions, by way of Lead II, to their response to acupuncture-therapy were obtained before or after the treatment. Such materials as references to data involving phonocardiograms differential impedance diagrams, charts of pulse rate of arteriae radialis, records of peripheral circulation at finger-tip areas, left ventricular ejection lime (LVET), prior to ejection period (P.E.P), systolic time interval (STI), function index of left ventricular contraction (Q-Z), stroke volume (SV), cardiac out-put per minute (C.O), cardiac index (C.I.), average arterial pressure, peripheral vascular resistance, pulse wave propagation time (B-P Time), diagrams showing amplitude of peripheral circulation, all were gathered in due course of time. Comparison of observations was made before or after acupuncture on the hemodynamic changes, with indexes obligatory to this study included. An examination of 57 normal subjects with hemodynamic changes was also made in order to ensure the validity of this modality of treatment.

All findings of the hemodynamic changes of the patients showed an elevation in peripheral vascular resistance in comparison with those of normal subjects. They also showed an increase in STI value, and a shortening of B-P time. Although no abnormality in Q-Z time was found; yet the respective values of S.V, C.O, C.I were smaller than those of normal subjects. After having received the therapy with acupuncture, the patients' amplitude charts concerning peripheral circulation in the digital part appeared an out-look of enlargement, but there was an obvious decrease in peripheral vasoresistance, as well as a shortening of P.E.P, there also seemed a prolongation in LVET and a reduction in STI value: the Q-Z time remained unchanged as ever; there was, however, an evident increase in values of S.V, S.O and C.I; the effects resulted from the fact that it was the needling of these points in patients with hypertension that they showed improvement in their disease. The preliminary interpretation of the mechanisms is indicated in the peripheral vasodilatation brought about by the therapy with acupuncture, which removes the cramping state of the vasoconstriction in the periphery and, at the same time, lowers the peripheral vasoresistance; thus alleviates the cardiac work-load, in addition to an improvement of the left ventricular functions. After the fall of blood pressure, there is an increase in cardiac stroke volume as well as the volume of general perfusion of blood. All these objectively reflect the therapeutic effects on the subjects suffering from hypertension by the employment of this mode of treatment.