Jing Shi1, Jian Wang2, Yuan Wang3, Kun Liu4, Yong Fu5, Jian-Hua Sun6, Ji-Ping Zhao7, Xiao-Mei Shao8, Si-Feng Feng1, You-Wei Yang2, Jie Li3, Qian-An Cao5, Xun He4, Mei-Fang Liu1, Lu Chen6, Xiang Cui4, Jiang-Yun Wu7, Yuan-Yuan Wu8, Xin-Yan Gao4, Bing Zhu4. 1. Department of Acupuncture and Moxibustion, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming 650000, China. 2. Institution of Acupuncture-moxibustion and Massage, Shandong University of Traditional Chinese Medicine, Jinan 250355. 3. The Innovation Research Center for Combination of Acupuncture and Chinese Materia Medica, Shaanxi University of Traditional Chinese Medicine, Xianyang 712046, Shaanxi Province. 4. Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700. 5. The First Department of Acupuncture and Moxibustion, the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006. 6. Department of Acupuncture-moxibustion and Rehabilitation, Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing 210029. 7. Department of Acupuncture and Moxibustion, Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing 100700. 8. The Third Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, Hangzhou 310053.
Abstract
OBJECTIVE: To observe the correlation between the referred pain regions of stable angina pectoris (SAP) and the acupoints in coronary heart disease (CHD) patients and to investigate the rule of regional sensitized point distribution in rats. METHODS: A total of 1 046 CHD patients with SAP from 8 hospitals in China were recruited in the present study. The tenderness was palpated along the left and right chest, back, shoulder, upper limb, etc. by a specially-assigned researcher in each hospital. Among them, 77 patients accepted pain threshold (PT) measurement by using a hand-held esthesiometer. In animal experiments, 14 SD rats were subjected to occlusion of the left anterior descending branch of the left coronary artery for 4 h for establishing myocardial ischemia (MI) model, and other 4 normal rats were used as the sham-operation control group. Four hours after MI, all the rats accepted tail venous injection of 5% Evans blue (50 mg/kg) for examining the distribution of the blue dye exudation spots at the body surface where the mechanical PT was also detected by a von Frey. RESULTS: In 1 046 CHD patients, 987 (94.36%) were found to have at least one tenderness spot. The tenderness spots were found at the left chest (87.47%), right chest (13.67%), left arm (ulnar side, 41.30%), right upper limb (4.68%), left shoulder back (30.21%), right shoulder back (7.07%), etc., accompanied with rash or pigmentation, subcutaneous induration, cord-like tissue contracture, skin sag, etc. The mechanical PT level was significantly lower at the tenderness spots of the left upper limb than at non-tender points of the right upper limb in CHD patients (P<0.001). Tenderness and cutaneous abnormal changes in angor pectoris patients distributed mostly on the left chest, back, shoulder and upper limb, and some also on the right. Tender points scattered on, near or outside acupoints. A similar distribution of the blue exudation spots and lower mechanical PT spots were found in MI rats, but not in sham-MI rats. CONCLUSION: In the case of MI, a regular "referred sensitization" response frequently occurs in the dermatomere area innervated by the corresponding segments (T 1－T 5) in both CHD patients and MI rats, which may be closely associated with the formation of acupoints in ancient China.
OBJECTIVE: To observe the correlation between the referred pain regions of stable angina pectoris (SAP) and the acupoints in coronary heart disease (CHD) patients and to investigate the rule of regional sensitized point distribution in rats. METHODS: A total of 1 046 CHD patients with SAP from 8 hospitals in China were recruited in the present study. The tenderness was palpated along the left and right chest, back, shoulder, upper limb, etc. by a specially-assigned researcher in each hospital. Among them, 77 patients accepted pain threshold (PT) measurement by using a hand-held esthesiometer. In animal experiments, 14 SD rats were subjected to occlusion of the left anterior descending branch of the left coronary artery for 4 h for establishing myocardial ischemia (MI) model, and other 4 normal rats were used as the sham-operation control group. Four hours after MI, all the rats accepted tail venous injection of 5% Evans blue (50 mg/kg) for examining the distribution of the blue dye exudation spots at the body surface where the mechanical PT was also detected by a von Frey. RESULTS: In 1 046 CHD patients, 987 (94.36%) were found to have at least one tenderness spot. The tenderness spots were found at the left chest (87.47%), right chest (13.67%), left arm (ulnar side, 41.30%), right upper limb (4.68%), left shoulder back (30.21%), right shoulder back (7.07%), etc., accompanied with rash or pigmentation, subcutaneous induration, cord-like tissue contracture, skin sag, etc. The mechanical PT level was significantly lower at the tenderness spots of the left upper limb than at non-tender points of the right upper limb in CHD patients (P<0.001). Tenderness and cutaneous abnormal changes in angor pectoris patients distributed mostly on the left chest, back, shoulder and upper limb, and some also on the right. Tender points scattered on, near or outside acupoints. A similar distribution of the blue exudation spots and lower mechanical PT spots were found in MI rats, but not in sham-MI rats. CONCLUSION: In the case of MI, a regular "referred sensitization" response frequently occurs in the dermatomere area innervated by the corresponding segments (T 1－T 5) in both CHD patients and MI rats, which may be closely associated with the formation of acupoints in ancient China.
Entities:
Keywords:
Acupoint sensitization; Angina pectoris; Mechanical pain threshold; Referred pain
Authors: Sheng Li; Xiao Ning Chai; Chuan Yi Zuo; Peng Lv; Yong Tang; Hui Juan Tan; Li Zhou Liu; Hai Yan Yin; Shu Guang Yu Journal: Medicine (Baltimore) Date: 2019-11 Impact factor: 1.817