Observation on therapeutic effect of auricular acupuncture combined with body acupuncture for treatment of cardiac neurosis / 中国针灸

<p><b>OBJECTIVE</b>To find an effective therapy for cardiac neurosis.</p><p><b>METHODS</b>Seventy-two cases were randomly divided into an acupuncture group and a medication group, 36 cases in each group. The acupuncture group were treated with auricular acupuncture combined with body acupuncture, with auricular points Shenmen, Jiaogan (sympathesis), Xin (heart), etc. and body points Xinshu (BL 15), Shenmen (HT 7), Neiguan (PC 6), etc. selected; the medication group were treated with oral administration of Betaloc and Oryzanol. Their therapeutic effects were compared after treatment for 2 months.</p><p><b>RESULTS</b>The cured rate was 77.8% in the acupuncture group and 52.8% in the medication group with very significant differences (P < 0.01), the former being better than the latter.</p><p><b>CONCLUSION</b>Auricular acupuncture combined with body acupuncture is the best method for treatment of cardiac neurosis.</p>

Dor precordial atípica, teste ergométrico e doença do pânico / Atypical chest pain, toadmill exercising test and panic disorder

Os autores avaliaram psiquiatricamente 72 pacientes submetidos ao teste ergométrico. Ciqüenta e três pacientes - grupo diagnóstico - tinham dor precordial atípica e estavam fazendo o teste para esclarecimento diagnóstico, 19 (grupo controle) eram portadores de patologia cardíaca previamente documentada e estavam fazendo o teste para controle da funçäo cardíaca. A freqüência de doença do pânico foi significativamente maior no grupo diagnóstico em relaçäo ao controle (X2 = 3,82; p = 0,05). Trinta e cinco pacientes do grupo diagnóstico tinham teste ergométrico normal e, dentre estes, 16(45,71%) preenchiam os critérios de diagnóstico da doença do pânico. Estes resultados estäo de acordo com as seguintes hipóteses: 1. os pacientes com doença do pânico e dor precordial atípica freqüentemente säo submetidos ao teste ergométrico para esclarecimento diagnóstico; 2. existe uma associaçäo entre a queixa de dor precordial atípica, doença do pânico e o teste ergométrico com resultado normal

O emprego da buspirona na neurose cardíaca / The use of buspirone in cardiac neurosis

Os efeitos de uma nova substância ansiolítica, buspirona, foram estudados em 20 pacientes de cor branca, 13 do sexo feminino, média de 46,4 ñ 12,5 anos, apresentando evidente quadro de ansiedade com manifestaçöes cardiovasculares. Procedeu-se à avaliaçäo da ansiedade pelas escalas de Hamilton e de Covi, e da depressäo pela de Raskin. A dose utilizada foi 5 mg, 3 vezes por dia, em 14 pacientes durante todo o ensaio; 5 receberam 20 mg/dia a partir da 3ª semana e 1 usou 20 mg/dia na 3ª semana e 25 mg/dia na 4ª semana. Pela escala de Hamilton, houve significante reduçäo dos valores da 1ª à 4ª semanas e de cada semana em relaçäo à antecedente (p < 0,05). Os valores obtidos através das escalas de Covi e de Raskin, aplicados na 1ª e na 4ª semanas, mostraram declínio, também com significância estatística (p < 0,05). Em relaçäo aos principais sintomas vinculados à neurose cardíaca, observou-se desaparecimento da dispnéia em 7 dos 18 casos; das palpitaçöes em todos os 17 pacientes e da dor precordial em 14 dos 15. Registrada sonolência em um caso e excitaçäo com insônia em outros dois, em todos com remissäo espontânea, sem interrupçäo da droga. Conclui-se pelo resultado benéfico da buspirona na neurose cardíaca, com efeito ansiolítico e levemente antidepressivo, e boa tolerância

Clinical Study on the Effect of Carteolol in Patients with Cardiac Neurosis

Fiftyeight patients with cardiac neurosis were studied to evaluate the effects of Carteolol 10mg/day. Systolic blood pressure was declined to 122.7+/-17.2mmHg from 137.1+/-23.2mmHg, diastolic blood pressure was declined to 79.6+/-11.1mmHg from 88.2+/-17.5mmHg. Pulse rate was decreased from 83.0+/-10.2 to 73.9+/-6.8per minute. The most frequent subjective symptom was palpitation (74.1%) and effectiveness of therapy for subjective symptom was 91.4%, for usefulness was 93.1%. There was no significant serious side reaction observed. We concluded that Carteolol therapy for the patients with cardiac neurosis could be useful and safe with a small dosage.

Interpretation of 201Tl Myocardial Scan in Ischemic Heart Disease

This study was performed to evaluate the method of quantification of exercise thallium-201(201Tl) myocardial perfusion imaginges(M.P.I.) for the detection of coronary artery disease. Exercise 201 Tl MPI were interpreted objectively, reproducibly, quantitatively and easily by a computer assisted technique-Circumferential profile method. Exercise 201Tl MPI and redistribution images were taken in 32 patients(9 cases of post infarction angina, 13 cases of angina pectoris, 8 cases of atypical chest pain, 1 case of arrhythmial and 1 case of caridac neurosis). The results obtained were as follows: 1) Exercise 201Tl MPI of 3 cases of angina pectoris demonstrated transient perfusion defect in 5 cases, persistent perfusion defect in 2 cases, transient and persistent perfusion defect in 1 cases and no perfusion defect in 5 cases. Exercise 201Tl MPI of 9 case of post-infarction angina revealed persistent perfusion defect in 7 cases and transient and persistent perfusion defect in 2 cases. 201Tl MPI of 8 cases of atypical chest pain showed transient perfusion defect in 1 case and no perfusion defect in 7 cases. There was no perfusion defect in 1 case of arrhythmia and another case of cardiac neurosis. 2) The location of persistent perfusion defects in several views of 201Tl MPI in 9 case of postinfarction angina were consistent with those of infarction area in the electrocardiogram. 3) While visual analysis interpreted three cases to have no perfusion defect and one case to have transient perfusion defect respectively, objective analysis revealed that one of them had transient perfusion defect, another of them had persistent perfusion defect and the other had transient and persistent perfusion defect. 201Tl MPI of three cases could be done easily by circumferential profile method, which were difficult to interprete by subjective visual analysis. The results indicate that Exercise 201Tl MPI interpreted by circumferential profile analysis would be an objective, quantitative and noninvasive method for the detection of ischemic change and location in coronary artery disease.

Clinical Studies on Arrhythmias

A clinical study was made on 189 cases of various types of arrhythmia diagnosed among 1,100 patients. Incidence of arrhythmia was 17.2% of the total cases (male 58.2%, female 41.8%). Of 189 cases of arrhythmias, 78(41.3%) had bundle branch block, 42(22.2%) atrial fibrillation, 18(9.5%) atrioventricular block, 15(8%) premature ventricular contraction, 6(3.2%) sinus arrhythmia, 6(3.2%) W.P.W. syndrome, 4(2%) premature atrial contraction, 3(1.6%) atrial flutter-fibrillation, 3(1.6%) ventricular bigeminy, 3(1.6%) intraventricular conduction defect, 2(1.1%) atrial flutter, 2(1.1%) nodal bigeminy, 2(1.1%) ventricular bigeminy, 1(0.5%) paroxysmal atrial contraction and 1(0.5%) A-V nodal rhythm, 1(0.5%) nodla premature contraction, 1(0.5%) paroxysmal atrial contraction and 1(0.5%) sinus arrest. Etiological diagnoses of patients with arrhythmia were rheumatic heart disease (21.7%), hypertensive heart disease (12.7%), arteriosclerotic heart disease (12.7%), thyrotoxic heart disease (1.6%), anemic heart disease(1.6%) congenital heart disease (2.6%), cerebral vascular accident (1.6%), essential hypertension (9%) cerebral arteriosclerosis (0.53%), cor pulmonale (2.1%). chronic myocarditis (1.6%), anemia (1.6%), chronic nephritis (1.6%), acute glomerulonephritis (0.53%) chronic hepatitis (1.1%), tuberculosis (4.2%), bronchiectasis (1.1%), leprosy (0.53%), epilepsy (0.53%) intoxication (2.6%) cardiac neurosis (11.6%) and unknown (8%). The cardinal symptoms consisted of palpitation, dyspnea, headache, edema, dizziness, cough, left chest pain. gastrointestinal complaints, chest discomfort (thightness), weakness and fatigability. The incidence of arrhythmia was highest in the 4 th decade.

Treatment of Cardiac Neurosis with Propranolol (Inderal(R))

Thirty-seven cases of cardiac neurosis were treated with propranolol (Inderal(R)) and following results were obtained. 1) Symptoms, such as palpitation, dyspnea, chest tightness and chest pain were disappeared or improved in all cases. 2) Heart rate reduced significantly after treatment from 99.8 per minutes to 74.8 per minutes. 3) Systolic blood pressure reduced significantly after treatment from 147.6 mmHg to 131.4 mmHg. but diastolic blood pressure were not reduced significantly. These results indicated that propranolol is recommendable medicine for improving cardiac symptoms and tachycardia in cardiac neurosis.