The following has been written by Lawrence A. Herman in response to a list of acupuncture articles which was posted to sci.skepitc in September 2000. In the thread "Re: Skeptics, neurological evidence for Acupuncture!"
Lawrence posted this information in a number of separate postings to the thread and has supplied this combined report which is published on this site with his permission.
A list of studies providing scientific evidence for acupuncture was recently posted to a discussion group. I went on to PubMed and tried to read as many abstracts from the studies on the list as I could, to determine if the evidence presented represented a good case for the effectiveness of acupuncture. Here’s what I found.
The first article was controlled, but not blinded. That means the people who were getting treatment (acupuncture) knew they were getting treatment. The data collected was by patient diary. That means that patients were told they were getting treatment and then asked if it helped. So this particular study didn't try to eliminate the placebo effect and had no objective evaluations. Not very convincing.
The next two, both by Ballegaard, were better. To deal with the problem of blinding, he gave some patients acupuncture and some patients "sham acupuncture," which was treatment at points that are NOT considered by acupuncturists to be effective. Therefore, no one knew who was getting the effective treatment.
The first of these two studies was done on patients with angina pectoris, which is severe recurrent chest pain. Acupuncture did have an effect--but not on the pain. Of the variables tested (the abstract doesn't say how many), all but one showed no effect. One, cardiac work capacity, showed effect for acupuncture but not sham acupuncture. That seems to be a pretty small result. I don't know how well cardiac work capacity correlates with treatment of the condition overall.
The third study also used angina pectoris patients. This is the conclusion, cut and pasted from the abstract: "It is concluded that both genuine and sham acupuncture have a specific effect on some angina pectoris patients in addition to the effect of pharmacological therapy." So there was no effect without drugs (pharmacological therapy) and the acupuncture at sham points worked just as well as the points that were supposed to work.
The next study on the list is also by Ballegaard. He looked at 69 angina patients treated with acupuncture, Shiatsu, and lifestyle adjustments. He compared the results to another study done by others on graft and angioplasty patients. He found no difference in pain, but that fewer of his patients died or had heart attacks. This is one of those studies where reading the abstract probably isn’t enough. The study populations were very different--all of the "other" group had invasive procedures, but only 49 of Dr. Ballegaard’s 60 patients were candidates for that, so it’s hard to compare. But this is the strongest abstract I’ve read so far.
The last study by Ballegaard on the list was controlled, but has this conclusion, cut and pasted here from the abstract: "It is concluded that with the present design it was not possible to demonstrate any significant differences between the effect of genuine and sham acupuncture." So for this one that author is saying that he proved nothing.
The study by Balogun et al was not on clinical treatment, but on a small technical point. He tested two points of acupuncture not by using needles, but by electric stimulation. It’s possible, of course, that electric stimulation doesn’t produce the same effect as needles. In any case, they found that the electrical stimulation had no effect. Here’s the conclusion, again cut and pasted: "Based on our findings we conclude that percutaneously applied HVG stimulation of ST36 and ST37 acupuncture points does not increase peripheral haemodynamic functions in asymptomatic subjects." So again, this study doesn’t come out in favor of acupuncture.
The Ehrlich-Haber tested 36 healthy patients for ability to exercise. There was a control group for sham acupuncture, and one for no treatment. There were good results, but the test was single-blind, not double-blind, which possibly, though not necessarily, allows for bias. This didn’t examine disease, but nonetheless showed benefits for acupuncture.
The Karvelas et al study also tested for exercise capabilities. It was a very small study, though; only ten patients were involved. The authors found that acupuncture did not work. Here are their words: "A single acupuncture treatment has no significant immediate effect on the perceived exertion and physiological responses during submaximal dynamic exercise or upon maximal exercise capacity among healthy individuals."
The next study on the list doesn’t have authors listed and I couldn’t find it in the database. Nor could I find the one by Qingshu C, Shuping C, Zhejing H. Both of these were published in journals with the word ‘Acupuncture’ in their titles, and unfortunately I don’t think these are indexed in PubMed. That’s a shame.
I found the Richter et al study there, though. It tested 21 patients who had at least 5 angina attacks per weeks. To me, that seems an important group of test subjects. However, the study may have been poorly done--I can’t tell from the abstract. Here’s my problem with it: as far as I can tell, the test used patients who had received "intensive treatment." But it doesn’t say what kind--I assume drug treatment. One group received acupuncture. The control group received "placebo tablet treatment." I think this means that their drug treatment was stopped. If so, then the test could be measuring what happened when the drug treatment stopped just as much as what happened when the acupuncture treatment was started. Without reading the whole article, I can’t tell if this study is valid. For the record, though, the study showed acupuncture to be effective in reducing the number of attacks per week and in the ability to exercise before pain set in.
The study by Steins A, Junger M, Rosch G, et al. is not in the Pub Med database.
The study by Williams T, Mueller K, Cornwall MW was small (10 patients) but controlled with sham acupuncture, and showed significant lowering of diastolic blood pressure at points intended to produce this effect. Results are definitely in favor of acupuncture, although the abstract does not say if the study was blinded.
The next two studies, by Chinese authors, were not in the database. However, a search on the title of the second one revealed another study not in the original list:
Zhou Y, Chen Q, Hou Z, Chen Y. Experimental research on treatment of hypertension with acupuncture. J Tradit Chin Med 1993 Dec;13(4):277-80. It was a study done in rats, and it was controlled. The article does not say if it was blinded, however. It did show significant improvement with acupuncture, but the abstract does not give enough details for an evaluation.
The next Zhou JR study was not in the database, but the study after that, by Zhou XQ, Liu JX was the first study I found originally printed in Chinese for which an abstract was available. It analyzed 40 angina patients (acute heart pain) and tested them for how long they exercised before they had an attack, and how long after the pain appeared it took for the pain to go away. The study found that acupuncture was effective. It was controlled with both sham acupuncture and no acupuncture, however it was only single-blinded, not double-blinded and so it doesn’t carry too much weight.
At this point I’ve searched for all the articles in the Controlled Trials of the Cardiovascular section of the list posted. I guess this is a good time for an initial summary. I looked for 15 articles and found 12. Of these, I consider four to have methodology that is not air-tight. (That doesn’t mean the results are wrong, but they do not carry much weight). I couldn’t tell about 3 of them from the abstracts alone. Of the remaining 5, four showed no effect for acupuncture and one showed positive effect. Clearly, I need to keep looking at more studies.
Now I’m looking at the studies under the heading "Other Data." I think these are all going to be uncontrolled, so they won’t carry the weight of controlled studies, but I will look.
The first study, by Akhmedov TI, Vasil'ev IuM, Masliaeva LV is Russian. The study was done on a big group of patients (360 of them) and the results were very positive but the abstract does not say if it was controlled or blinded, so I can’t evaluate it.
The study by Alekseev VV, Rzhanitsyna NF, Fisenko Lawasn’t about acupuncture. It was a study of "reflex therapy," which I don’t know anything about. Results were again positive, but there is no mention of blinding or controls in the abstract.
The article by Bacchini M, Conci F, Roccia L, Carrossino R is from Italy. Again, results were positive, but there was no mention in the abstract of controls or blinding.
The next two studies were by Ballegaard and others. Ballegaard did two of the controlled studies listed above. In the first, he tried to measure certain physical effects such as heart rate, time to pain attacks, and others to the effects of acupuncture. His results were mixed, but he concluded that acupuncture might help angina pectoris if used along with to drug treatments.
The second Ballegaard study measured the effect of acupuncture on blood flow and heart rate in healthy patients, and concluded that it had positive effects. The study was controlled by comparison to a placebo effect that imitates pills, but wasn’t blinded. Since the data collected didn/t concern disease, there’s no clinical result here.
The studies by Bao JZ, another from acupuncture journal in China, do not have translations available.
The study by Bobkova AS, Gaponiuk PIa, Korovkina EG, Sherkovina TIu, Leonova MV is Russian. It shows positive effects for acupuncture on lowering blood pressure in 35 patients, but was neither controlled nor blinded.
The study by Celoria R, Bachini M, Bouzin A, Martello L, Roccia L is Italian. It study oxygen consumption by the heart in both acupuncture and with drugs. It found effects for both, but more effects for acupuncture. There are no details about controlling or blinding.
The study by Celoria R, Conci F, Bonelli T also gave no indication of blinding or controls. It studied effects in patients with Reynaud’s syndrome. It found no clinical effects for acupuncture, although there was some vasodilatation, which suggests acupuncture might have some use if used along with other therapy.
Chen KZ is another Chinese study not available in translation. The same for Chen LB, Li SX. I couldn’t find any reference to Chen S, Ye F. The study by Cochran WM is American but not indexed by PubMed. The same for Danciu A, Ionescu Tirgoviste C, Georgescu M, Cheta D, Stamoran M. It appears that a number of these studies are unavailable. Whether this is because there is a prejudice against acupuncture studies or because these trials are uncontrolled and unblinded, which makes them difficult to publish in mainstream journals, is impossible to tell.
The study by Dovgiallo OG, Rabkin MS, Tkachenko Gia was Russian. It tested acupuncture versus acupuncture and exercise, and so it wasn’t really a test of acupuncture, but more of exercise.
Eyb R, Trnavsky G, a German study, was unavailable. Fraser PH is a book, not a journal, so I have no handy resources for finding it.
Gaponiuk PIa, Leonova MV was available in abstract. It tested 98 patients who had high blood pressure and found that between 57% and 66% had reduced blood pressure by acupuncture. Apparently, though, these patients were taking drugs at the same time, so without reading further it’s hard to tell if it says much.
Gaponjuk PJa, Sherkovina TJu, Leonova MV and Guan X, Zhang J, Shi B, Chen Y, Ouyang X, from Russia and China respectively, are not in the database.
Hollinger I, Richter JA, Pongratz W, Baum M is an interesting study. It was large, 800 patients, and it concerned a severe and important test--anaesthesia for open heart surgery. It was uncontrolled, and it involved a combination of acupuncture and drugs, though. The authors conclusions are a bit confusing. They find that this form of combination pain killing is very effective (I have no quibble with that). But they say "There is a certain advantage of using acupuncture anesthesia when compared with chemical anesthesia, as the pharmacological agents are not used and hence post no metabolic load for the patients." I don’t know how they got to that in this study, since they also say "This article reports the utilization of acupuncture in combination with chemical anesthesia..."
The next two studies are Chinese. No abstract is available for Huang DJ, Cheng DT, Das SK, Buda AJ, Pitt B, Lee F, but there is one for Huang H, Liang S. It studied 30 cases oh patients with high blood pressure. It was controlled by sham acupuncture, that is, acupuncture at a point that is supposed to affect the stomach. Not the heart. It tested for cardiac effects and found excellent results. The abstract does not mention blinding. Nonetheless, I think these are the best positive results in this category so far.
There are no abstracts for the studies by Ionescu Tirgoviste C.
The study by Itaya K, Manaka Y, Ohkubo C, Asano M was on a technical point--whether acupuncture helped increase blood flow in rabbits’ er chambers. A gradual increase was observed. No controls, no blinding and the abstract doesn’t say how large the study was.
I couldn’t find Izzo V, Mariconti P, Orefice A, Pinelli M, Grasso R; Jiaen W, Chuanjie L, Bojun Z; Jianhua M, Yongjian X, Ningning Z, Jin Q, Moxun D; or Jiao X, Yin K, Zhang W, Lei Z, Gao Y, Chen Z. But the next study, from Shanghai, China, had an abstract available.
Jin Y, Fu Q, Guo X studied the effects of electroacupuncture on rats. Again, no controls, no blinding, and no population size was mentioned. Results were somewhat positive.
The piece by Kaada B is in Norwegian. It is not a study, but an article concerning the possibility that the Chinese used acupuncture to help their female runners in the 1993 Olympics. It sounds like an interesting article, but it isn’t a study and so doesn’t need any comment.
I couldn’t find Kespi JM or Kiener E, both from a French acupuncture journal
The study by Landry MD, Scudds RA looked at skin temperature in hands. It had been reported that electroacupuncture effected temperatures. This study attempted to find out whether high-frequency or low-frequency electroacupuncture did this. It found out that both did. But the study did not test acupuncture itself, and was not controlled against no acupuncture, so it can’t really be used to prove acupuncture itself.
The study by Lee DC, Lee MO, Clifford DH was on acupuncture in dogs that had been giving anaesthetic. It found that acupuncture had cardiovascular effects similar to other neurological cardiovascular effects. Again, no mention of blinding, controls, or study size.
The next three studies are by Li and colleagues. The first two (Li CJ, Bi LG, Zhu BJ, Qi MZ, Zhao CX, Xu YF, Yao ZL, Lu ZS, Sun SM, Dong H, et al.; and Li P) are untranslated, but the third (Li P, Sun FY, Zhang AZ) is available. It wasn’t measuring the effect of acupuncture, but a possible pathway for acupuncture, and so the results don’t help me one way or the other.
The study by Litscher G, Schwarz G, Sandner-Kiesling A, Hadolt I didn’t directly test the effectiveness of acupuncture but tried to measure blow flow before, during, and after acupuncture to see if acupuncture caused a physiological response. They found that it did. No controls, no blinding.
Liu R, Yang X, Zhao C, Wang Y, Wen B, Li Y, Tang W, Zhao X, Li M, Liu R, another Chinese study, wasn’t int he database.
Liu Z, Sun F, Li J, Shi X, Hu L, Wang Y, Qian Z was in the database, but the abstract was rather vague and I couldn’t figure out exactly what was done. It was a test to study the effects of acupuncture and moxibustion (which is a counterirritation procedure) and found positive results.
Loubser PG, Cardus D, Pickard L, McTaggart W wasn’t available. Nor were Ma XP; Meerson FZ, Beloshitskii PV, Radzievskii SA, Vorontsova FY, Didenko VE; Meng JB, Fu WX, Cai JH, Qi YZ, Yao SZ; Mori H, Tukayama H, Nishijo K, Takeda T was not available.
Nishimoto T, Ishikawa T, Matsumoto K, Fujioka A was, though. This study looked at a possible pathway for acupuncture to work. It found a specific possibility in autonomic nerve function. They derived their data from electrocardiograms. The study was small (17 female and 4 male patients). I don’t really understand the technical info given, but the results were positive. The authors think that acupuncture might help regulate nerve function. No blinding, no controls.
Nissel H, Schiner E, an Italian study, wasn’t available.
The first Odud AM, Potapenko Pistudy was a Russian study that tested "laser puncture" (I don’t k now what that is) on acupuncture points in patients with low blood pressure who were on medication. They found that acupuncture allowed the dose of medicine to be reduced. The abstract doesn’t say how many patients. No blinding, no controls.
The second study by Odud AM, Potapenko PI was more laser puncture, and the abstract did not mention acupuncture at all..
The abstract for Ohsawa H, Okada K, Nishijo K, Sato Y was very technical, but seems to show results that don’t support acupuncture. The study was done on anesthetized rats and tested an "acupuncture-like stimulation" of skin versus muscle. It found that blood pressure affect was a reflex response of the muscle. I may be misinterpreting this--it’s a complex abstract.
Okamoto Y, Yano T, Yamada N, Hiro M, Watanabe I, Asada T, a Japanese study, was not available.
The studies by Omura Y aren’t available either.
Qi LY, Hu JK, Fang DR, Le Y is another Chinese study, but the abstract apparently hasn’t been translated.
The Russian study by Radzievskii SA, Fisenko LA, Lebedeva OD was good-sized, 124 patients. It tested some effects on heart function when chemotherapy was stopped and acupuncture was started. The abstract reports positive results with 3 variables, but doesn’t mention if others were tested. There were no mention of controls or blinding, but this is one of the more positive uncontrolled studies.
The next study, also Russian, by Radzievskii SA, Vorontsova Eia, was done on rats. It tested acupuncture with and without electrostimulation. It found that with electrostimulation reduced duration of arrhythmias and no electrostimulation didn’t do that but reduced the severity of reperfusion. This wasn’t clinical and had more to do with possible pathways for the effects than the effects themselves. No mention of study size, controls, or blinding.
Raut C was not available, which is too bad because it looks like a clinical trial. Two more Chinese studies, Shaomin X, Chuanjie L, Lige B; and Shi XM, Wang CX, Zhang CS, Han JX, Lu FC, Zheng YH, weren’t available.
Shinohara M did a study in Japan that tested technical points. It showed that two different kinds of nerve stimulation could be generated at the same time by acupuncture. This was done in healthy patients, so it wasn’t intended to say much about how much acupuncture might help patients.
The paper by Smith FW Jr isn’t a study, it’s a review of other studies. It concludes that acupuncture should be considered as possible treatment, but there is no way to tell how valid the studies were from this abstract.
The study by Solun MN, Liaifer AI was done in Russia and involved 55 patients with diabetes. It found that 78% of them were helped by acupuncture. This was directly clinical and very positive, but again there was no blinding and no controls.
Song X, Tang Z, Hou Z, Zhu S is a study from China done on rabbits to see if acupuncture had an effect on certain physiological responses. It found acupuncture "could raise blood pressure, protect cardiac pump function, correct the disturbance of secretion and metabolism of humoral factors, reduce blood adhesion to normal level." That seems positive, although again it isn’t clinical, and there was no mention of controls or blinding.
The two studies by Sternfeld and others are not available.
Still J, Konrad J did a study on rescusitating animals. They used 243 cases, a pretty big study. They induced narcosis (numbing of nerves) by medicine. They found that healthy patients could be rescusitated, but that most by not all diseased patients could be. Without knowing the methods, though, this is impossible to evaluate. It would depend on when the medicines would be expected to wear off anyway. Without controls, this doesn’t say much.
The title of the article by Sugioka K, Mao W, Woods J, Mueller RA is "An unsuccessful attempt to treat hypertension with acupuncture." The conclusions: "Because of the poor patient acceptance of acupuncture and in the absence of a beneficial response, we feel acupuncture as employed in this study is of limited value in the management of patients with essential hypertension."
The study by Tabeeva DM, Shagieva LK tested the effectiveness of corporal acupuncture vs corporal-auricular acupuncture, but didn’t measure general effectiveness of acupuncture. The abstract doesn’t have anything in it to show one way or the other about the general effectiveness of acupuncture as a whole.
Unfortunately, I couldn’t get a whole bunch of the remaining studies. I think this is because alphabetically a number of Chinese names come up next and, as I’ve noted before, Chinese studies are not generally available. The ones I can’t look at include
Tung LC, Haering R, Stallkamp B;
Wang WT, Wei WL;
Wang XT, Wang XM, Liu HL, Li CW, Wang LP, Liu RX;
both studies by Wu CC;
Yan J, Wang JJ, Yi SX, Li WL, Wang LH, Yao XX
Yang SM, Xu SQ, Huang YH, Luo CJ, Lan FR
Yanli J
Yao T was available, but it appears to be a review. The abstract concludes that acupuncture is effective, but no mention of any new study or data is there.
Yin K, Jia C; and You Z, Hu X, Wu B, Zhang W, Liang D were also not available.
Yu P, Li F, Wei X, Wu R, Fu C is a Chinese study that’s available. It
tested acupressure (not acupuncture) controlled against drug treatment and
concluded that they were about equally effective. Although there is no mention
of blinding, this is one of the better uncontrolled experiments I’ve seen.
The last 4 abstracts, also Chinese, are not available either:
Zhang HL, Cao QS, Zhuang D;
Zhao XW, Li SX, Shan XF, Chen LB, Wang XZ.
Zhou YM.
Zhu BJ, Bi L, Liang SY, Pang L, Wang SL, Liu JF, Jiang AP, Li CJ, Ye ZJ, Yang H, et al.
A list of the papers follows.
Lawrence A. Herman
martin3k@my-Deja.com
ACUPUNCTURE USAGE - CARDIOVASCULAR SYSTEM
------------------------------------------------------------------------
Selected Controlled Trials
Appiah R, Hiller S, Caspary L, Alexander K, Creutzig A. Treatment of primary Raynaud's syndrome with traditional Chinese acupuncture. J Intern Med 1997 Feb;241(2):119-24.
Ballegaard S, Jensen G, Pedersen F, Nissen VH. Acupuncture in severe, stable angina pectoris: a randomized trial. Acta Med Scand
1986;220(4):307-13.
Ballegaard S, Meyer CN, Trojaborg W. Acupuncture in angina pectoris: does acupuncture have a specific effect? J Intern Med 1991
Apr;229(4):357-62.
Ballegaard S, Norrelund S, Smith DF. Cost-benefit of combined use of acupuncture, Shiatsu and lifestyle adjustment for treatment of patients with severe angina pectoris. Acupunct Electrother Res 1996
Jul-Dec;21(3-4):187-97.
Ballegaard S, Pedersen F, Pietersen A, Nissen VH, Olsen NV. Effects of acupuncture in moderate, stable angina pectoris: a controlled study. J Intern Med 1990 Jan;227(1):25-30.
Balogun JA, Tang S, He Y, Hsieh JM, Katz JS. Effects of high-voltage galvanic stimulation of ST36 and ST37 acupuncture points on peripheral blood flow and skin temperature. Disabil Rehabil 1996 Oct;18(10):523-8.
Ehrlich D, Haber P. Influence of acupuncture on physical performance capacity and haemodynamic parameters. Int J Sports Med 1992
Aug;13(6):486-91.
Karvelas BR, Hoffman MD, Zeni AI. Acute effects of acupuncture on physiological and psychological responses to cycle ergometry. Arch Phys Med Rehabil 1996 Dec;77(12):1256-9.
A quantitative study of the effects of needle manipulations in treating coronary heart disease using electrocardiograms. Wash Update Acupunct 1997 Jan 26;2(1):4-5.
Qingshu C, Shuping C, Zhejing H. Effect of electroacupuncture on the phase of repolarization of ischemic myocardium in the rabbit. World J Acupunct Moxibustion 1992 Dec;2(4):46-50.
Richter A, Herlitz J, Hjalmarson A. Effect of acupuncture in patients with angina pectoris. Eur Heart J 1991 Feb;12(2):175-8.
Steins A, Junger M, Rosch G, Mohrle M, Blum A, Lorenz F, Klyscz T, Hahn M. [Efficiency of acupuncture in acral circulatory disturbances]. Phlebologie 1996;25(4):139-43. (Ger).
Williams T, Mueller K, Cornwall MW. Effect of acupuncture-point stimulation on diastolic blood pressure in hypertensive subjects: a preliminary study. Phys Ther 1991 Jul;71(7):523-9.
Yiping Z, Qiong C, Zhengming H, Yilong C. Experimental research on treating hypertension with acupuncture. World J Acupunct Moxibustion 1992 Mar;2(1):33-7.
Zhou JR. [Effect of auriculo-acupuncture plus needle embedding in heart point on left cardiac, humoral and endocrine function]. Chung Kuo Chung Hsi I Chieh Ho Tsa Chih 1993 Mar;13(3):153-4, 132. (Chi).
Zhou XQ, Liu JX. [Metrological analysis for efficacy of acupuncture on angina pectoris]. Chung Kuo Chung Hsi I Chieh Ho Tsa Chih 1993
Apr;13(4):212-4, 196. (Chi).
Zhou Y, Wang Y, Fang Z, Xia C, Liu B, Chen Q, Zhang F. [Influence of acupuncture on blood pressure, contents of NE, DA and 5-HT of SHR and the interrelation between blood pressure and whole blood viscosity]. Chen Tzu Yen Chiu 1995;20(3):55-61. (Chi).
Other Data
Akhmedov TI, Vasil'ev IuM, Masliaeva LV. [The hemodynamic and
neurohumoral correlates of the changes in the status of hypertension patients under the influence of acupuncture]. Ter Arkh 1993;65(12):22-4. (Rus).
Alekseev VV, Rzhanitsyna NF, Fisenko LA. [Changes in central and periferal hemodynamics in patients with hypertensive conditions treated by reflexotherapy]. Kardiologiia 1986 Mar;26(3):52-5. (Rus).
Bacchini M, Conci F, Roccia L, Carrossino R. [Circulatory disorders and acupuncture]. Minerva Med 1979 May 19;70(24):1755-7. (Ita).
Ballegaard S, Karpatschoff B, Holck JA, Meyer CN, Trojaborg W.
Acupuncture in angina pectoris: do psycho-social and neurophysiological factors relate to the effect? Acupunct Electrother Res 1995
Apr-Jul;20(2):101-16.
Ballegaard S, Muteki T, Harada H, Ueda N, Tsuda H, Tayama F, Ohishi K. Modulatory effect of acupuncture on the cardiovascular system: a cross-over study. Acupunct Electrother Res 1993 Apr-Jun;18(2):103-15.
Bao JZ. Acupuncture treatment of Raynaud's disease--a report of 43 cases. J Tradit Chin Med 1988 Dec;8(4):257-9.
Bao YX, Yu GR, Lu HH, Zhen DS, Cheng BH, Pan CQ. Acupuncture in acute myocardial infarction. Chin Med J (Engl) 1982;95(11):824-8.
Bobkova AS, Gaponiuk PIa, Korovkina EG, Sherkovina TIu, Leonova MV. [The effect of acupuncture on endocrine regulation in hypertensive patients]. Vopr Kurortol Fizioter Lech Fiz Kult 1991 Jan-Feb;(1):29-32. (Rus).
Celoria R, Bachini M, Bouzin A, Martello L, Roccia L. [Comparative evaluation of local 02 consumption in lumbar sympathetic infiltration as compared with acupuncture]. Minerva Med 1976 Jun 9;67(29):1902-12. (Ita).
Celoria R, Conci F, Bonelli T. [Changes in the angiographic pictures in Raynaud's disease following acupuncture treatment]. Minerva Med 1977 Mar 3;68(11):693-702. (Ita).
Chen KZ. [Observations on changes in intracranial pressure during craniotomy under acupuncture and general anesthesia]. Chung Hua Shen Ching Ching Shen Ko Tsa Chih 1984 Jun;17(3):153-4. (Chi).
Chen LB, Li SX. The effects of electrical acupuncture of Neiguan on the PO2 of the border zone between ischemic and non-ischemic myocardium in dogs. J Tradit Chin Med 1983 Jun;3(2):83-8.
Chen S, Ye F. Immediate effects of needling Lingdao on functions of left ventricle in patients with coronary heart disease. Int J Clin Acupunct 1993;4(3):249-51.
Cochran WM. The role of acupuncture in treating hypertension. Pac J Orient Med 1994 Spring;(3):20-5.
Danciu A, Ionescu Tirgoviste C, Georgescu M, Cheta D, Stamoran M. The treatment of hyperlipoproteinemias by acupuncture. Am J Acupunct 1976;4(4):337-43.
Dovgiallo OG, Rabkin MS, Tkachenko GIa. [Results of using acupuncture and therapeutic physical exercise for preventing the development of arterial hypertension in persons with borderline arterial pressure]. Ter Arkh 1987;59(9):16-9. (Rus).
Eyb R, Trnavsky G. [Effect of percutaneous electrical stimulation of acupuncture points on blood flow in the leg]. Therapiewoche
1981;31(4):442-6. (Ger).
Fraser PH. A handbook of modern clinical acupuncture for heart and vascular disease. Tathra (NSW, Australia): P.H. Fraser; c1991. 86 leaves.
Gaponiuk PIa, Leonova MV. [The clinical efficacy of auricular
electroacupuncture in treating hypertension patients]. Vopr Kurortol Fizioter Lech Fiz Kult 1990 Jan-Feb;(1):13-5. (Rus).
Gaponjuk PJa, Sherkovina TJu, Leonova MV. Clinical effectiveness of auricular acupuncture treatment of patients with hypertensive disease. Acupunct Med 1993 May;11(1):29-31.
Guan X, Zhang J, Shi B, Chen Y, Ouyang X. Acupuncture in prevention of ventricular fibrillation secondary to myocardial infarction: animal experiment to explore its mechanism. Int J Clin Acupunct
1993;4(3):235-42.
Hollinger I, Richter JA, Pongratz W, Baum M. Acupuncture anesthesia for open heart surgery: a report of 800 cases. Am J Chin Med
1979;7(1):77-90.
Huang DJ, Cheng DT, Das SK, Buda AJ, Pitt B, Lee F. Effect of
acupuncture on left ventricular size and function assessed by
echocardiography in patients with stable dilated cardiomyopathy. J Tradit Chin Med 1985 Dec;5(4):243-5.
Huang H, Liang S. Acupuncture at otoacupoint heart for treatment of vascular hypertension. J Tradit Chin Med 1992 Jun;12(2):133-6.
Ionescu Tirgoviste C, Bigu V, Danciu A, Cheta D. Results of acupuncture in the treatment of essential arterial hypertension. Am J Acupunct 1978;6(3):185-90.
Ionescu-Tirgoviste C, Matei M. The place of acupuncture in the treatment of chronic peripheral arteriopathies. Am J Acupunct 1979;7(3):235-40.
Itaya K, Manaka Y, Ohkubo C, Asano M. Effects of acupuncture needle application upon cutaneous microcirculation of rabbit ear lobe. Acupunct Electrother Res 1987;12(1):45-51.
Izzo V, Mariconti P, Orefice A, Pinelli M, Grasso R. Usefulness of paravertebral lumbar electroacupuncture for obliterative arteriopathy of the legs. Schmerz Pain Douleur 1988;9(3A):288-33.
Jiaen W, Chuanjie L, Bojun Z. Clinical study on the coronary heart disease treated by acupuncture. Chin J Acupunct Moxibustion
1990;3(1):1-6.
Jianhua M, Yongjian X, Ningning Z, Jin Q, Moxun D. The effect of electroacupuncture at auricular heart area on the eletrocardiogram [electrocardiogram] and the cardiac function. World J Acupunct
Moxibustion 1992 Dec;2(4):19-22.
Jiao X, Yin K, Zhang W, Lei Z, Gao Y, Chen Z. Clinical and experimental study of acupuncture treatment of hyperlipemia. Int J Clin Acupunct 1993;4(4):351-60.
Jin Y, Fu Q, Guo X. Effects of electroacupuncture of 'Zusanli' acupoint on high blood pressure and blood hyperviscosity in stress rats. J Tongji Med Univ 1992;12(4):209-15.
Kaada B. [The Chinese runners' revolution]. Tidsskr Nor Laegeforen 1993 Dec 10;113(30):3799-801. (Nor).
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