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Digitalis glycosides, a group of cardiotonic agents for heart failure, have been used for a long time, but may often trigger arrhythmias as a result of digitalis intoxication. It is of great significance in finding a method to reduce their toxicity and improve clinical curative effects simultaneously in the application of digitalis glycosides. It has been well documented that acupuncture has good therapeutic effects in improving cardiac function and inhibiting arrhythmia induced by myocardial ischemia. Acupuncture combined with chemotherapeutics can reduce the adverse effects of chemotherapeutics. Accordingly, acupuncture combined with digitalis is likely to reduce the side effects of digitalis by regulating intracellular Ca2+, improving the function of Ca(2+)-ATPase in the sarcoplasmic reticulum, increasing calcium sensitivity of cardiac troponin, etc. These considerations may provide a novel clue for treatment of heart failure by joint administration of acupuncture and drugs.

Objective: To investigate the functional specificity of acupoint by means of acupoint injection of Dobutamine Hydrochloride (DH)., Methods: Male SD rats were randomized into normal control (NC), EA-Neiguan (PC6) + acupoint injection (AI, EA-PC 6 + AI), EA-Zusanli (ST 36) + AI (EA-ST 36 + AI), and EA-intramuscular injection site (IMIS) + intramuscular injection (EA-IMIS+ IMI) groups,with 8 rats being in each group. EA (2 Hz/15 Hz, 3 mA) was applied to bilateral "Neiguan" (PC 6), "Zusanli "(ST 36) and muscular-injection site for 10 min. DH (a beta1-adrenoceptor agonist) solution (100 microg/kg) was injected intramuscularly into the gluteus maximus after termination of EA intervention. The left ventricular systolic pressure (LVSP), heart rate (HR) and + dp/dt max were recorded before and 2, 5, 15 and 30 min after injection of DH., Results: The values of LVSP, HR and + dp/dt max in EA-PC 6 + AI group were significantly higher than those in NC, EA-ST 36 + AI, and EA-IMIS + IMI groups (P < 0.01) 2 and 5 minutes after EA plus acupoint injection of DH. No significant differences were found between EA-ST 36 + AI and EA-IMIS+ IMI groups in LVSP, HR and +dp/dt max (P > 0.05). After injection of DH for 30 minutes, the values of LVSP, HR and + dp/dt max in EA-PC 6 + AI group were still significantly higher than those in NC group (P < 0.01)., Conclusion: EA-PC 6+ AI DH is significantly superior to EA-ST 36 + AI DH and EA-IMIS+ IMI DH in producing a stronger cardiac excitatory effect and a longer post-effect, showing a relative specificity of the acupoint in upregulating cardiac functional activities.

Acupuncture therapy combined with medication has been widely used in clinic practice in China and proved to be effective in the, treatment of many disorders. The authors of the present paper review researches on the underlying mechanism of joint application of acupuncture therapy and medication in recent decade from (1) neural regulation, (2) endocrine regulation, and (3) immunological regulation. After comprehensive analysis, the authors think that the mechanism underlying the enhanced clinical efficacy of acupuncture therapy combined with drugs may be closely associated with the following factors: (1) acupuncture stimulation of acupoints leads to changes of the drug concentration in the blood and/or in the target organ and, (2) the reactivity or sensitivity of the target organ tissues to the specifically effective drug elements is enhanced.

Objective: To observe the inhibitory effects of acupuncture pretreatment on arrhythmia and intracellular calcium ([Ca2+]i) oscillation in single cardiocyte in rats subjected to myocardial ischemia-reperfusion (MIR)., Methods: Male SD rats were evenly randomized into normal control (NC), MIR and electroacupuncture (EA) groups. MIR was performed by ligation (30 min) and reperfusion (10 min) of the left anterior descending coronary artery in vivo in rats or in the isolated and perfused rat heart subjected to a 40 min global ischemia followed by a 10 min reperfusion. EA pretreatment was applied to bilateral "Neiguan" (PC 6) for 30 min once a day in 3 consecutive days. Arrhythmic score was calculated according to Curtis's and Walker's method, and the count of [Ca2+]i oscillation was measured by using InCytPm 2 intracellular ion detecting system., Results: Both the arrhythmic score and the count of [Ca2+]i oscillation in MIR group were considerably higher than those in NC group (P<0.05). While compared with MIR group, the arrhythmia score and the count of [Ca2+]i oscillation in EA group were decreased significantly (P<0.05)., Conclusion: Pretreatment of EA can effectively resist MIR-induced arrhythmia and intracellular calcium oscillation in the rat.