Efficacy and safety of acupoint stimulation in the treatment of angina pectoris caused by coronary heart disease: A meta-analysis

GAO He; WU Peixiang; XIAO Liyun; LI Jing; YIN Juan; ZHANG Huiyuan

doi:10.16766/j.cnki.issn.1674-4152.002963

Volume 21 Issue 4

Apr. 2023

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Article Navigation > Chinese Journal of General Practice > 2023 > 21(4): 698-703

GAO He, WU Peixiang, XIAO Liyun, LI Jing, YIN Juan, ZHANG Huiyuan. Efficacy and safety of acupoint stimulation in the treatment of angina pectoris caused by coronary heart disease: A meta-analysis[J]. Chinese Journal of General Practice, 2023, 21(4): 698-703. doi: 10.16766/j.cnki.issn.1674-4152.002963

Citation:

GAO He, WU Peixiang, XIAO Liyun, LI Jing, YIN Juan, ZHANG Huiyuan. Efficacy and safety of acupoint stimulation in the treatment of angina pectoris caused by coronary heart disease: A meta-analysis[J]. Chinese Journal of General Practice, 2023, 21(4): 698-703. doi: 10.16766/j.cnki.issn.1674-4152.002963

Citation:

GAO He, WU Peixiang, XIAO Liyun, LI Jing, YIN Juan, ZHANG Huiyuan. Efficacy and safety of acupoint stimulation in the treatment of angina pectoris caused by coronary heart disease: A meta-analysis[J]. Chinese Journal of General Practice, 2023, 21(4): 698-703. doi: 10.16766/j.cnki.issn.1674-4152.002963

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Efficacy and safety of acupoint stimulation in the treatment of angina pectoris caused by coronary heart disease: A meta-analysis

doi: 10.16766/j.cnki.issn.1674-4152.002963

GAO He¹
, WU Peixiang^{2
,
,}
, XIAO Liyun³
, LI Jing³
, YIN Juan³
, ZHANG Huiyuan³

1.
Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250011, China

Funds:

2019-0235

Received Date: 2022-02-15
Available Online: 2023-05-31

Abstract

Abstract

Objective The treatment of coronary heart disease and angina pectoris with acupoint stimulation therapy based on routine treatment have been increasingly reported, but no systematic evaluation of acupoint stimulation on coronary heart disease and angina pectoris has been conducted. At present, the effectiveness and safety of acupoint stimulation therapy in the treatment of coronary heart disease and angina pectoris are evaluated on the basis of the meta method of evidence-based medicine. Methods A systematic literature search was performed in the following databases: PubMed, the Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Database, VIP and Wanfang Database. Randomised controlled trials (RCTs) on the effects of acupoint stimulation applied on patients with angina pectoris caused by coronary heart disease were collected in accordance with the pre-established inclusion and exclusion criteria. Chinese and English literatures published from the establishment of each database to March 31, 2021, were retrieved by combining subject headings and free terms. Two researchers independently screened out the literatures, extracted the data and evaluated the quality. RevMan 5.4 was used for data synthesis and meta-regression analysis. Results Finally, 25 RCTs with 2 095 patients were included, and the quality of the included literatures were all Grade B. Meta-analysis showed the efficacy of angina pectoris (RR=3.89, 95% CI: 2.66-5.70, P < 0.001), ECG efficacy (RR=2.96, 95% CI: 1.93-4.55, P < 0.001), TCM syndrome (RR=3.04, 95% CI: 2.12-4.36, P < 0.001), level of NO after treatment (RR=9.94, 95% CI: 5.69-14.19, P < 0.001) and hs-CRP level (RR=-4.70, 95% CI: -5.27 to -4.13, P < 0.001). Conclusion Acupoint stimulation can effectively improve the clinical efficacy of angina pectoris of coronary heart disease, and the occurrence of adverse events is less, with better safety and effectiveness.
- Acupoint stimulation,
- Angina pectoris,
- Chest pain,
- Meta-analysis

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References(40)

References

[1]	WANG K H, WU J R, DUAN X J, et al. Comparative efficacy of Chinese herbal injections for angina pectoris: a Bayesian network meta-analysis of randomized controlled trials[J]. Complement Ther Med, 2019, 43: 208-217. doi: 10.1016/j.ctim.2019.01.019
[2]	李海燕, 左瑶瑶, 陈守强. 中医护理对冠心病兼焦虑抑郁患者疗效的Meta分析[J]. 中华全科医学, 2020, 18(3): 492-495. doi: 10.16766/j.cnki.issn.1674-4152.001281 LI H Y, ZUO Y Y, CHEN S Q. Meta-analysis of the efficacy of Chinese medicine care in patients with coronary heart disease and anxiety and depression[J]. Chinese Journal of General Practice, 2020, 18(3): 492-495. doi: 10.16766/j.cnki.issn.1674-4152.001281
[3]	JANUARY C T, WANN L S, CALKINS H, et al. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American college of cardiology/American heart association task force on clinical practice guidelines and the heart rhythm society in collaboration with the society of thoracic surgeons[J]. Circulation, 2019, 140(2): e125-e151.
[4]	黄春雨, 周果, 李刚, 等. 复方丹参滴丸联合耳穴埋豆及穴位按摩对稳定性心绞痛的干预[J]. 中国实验方剂学杂志, 2017, 23(2): 175-180. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSFX201702031.htm HUANG C Y, ZHOU G, LI G, et al. Effect of Compound Danshen Dripping Pills Combined with Auricular Point Sticking and Acupoint Massage on Stable Angina Pectoris[J]. Chinese Journal of Experimental Traditional Medical Formulae, 2017, 23(2): 175-180. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSFX201702031.htm
[5]	张秋英, 邹继红. 胸痹膏穴位贴敷联合中频脉冲穴位刺激治疗不稳定性心绞痛临床研究[J]. 河北中医, 2018, 40(12): 1869-1873. doi: 10.3969/j.issn.1002-2619.2018.12.024 ZHANG Q Y, ZOU J H. Clinical study on the treatment of unstable angina pectoris with Xiongbi ointment acupoint application combined with mid-frequency pulse acupoint stimulation[J]. Hebei Journal of Traditional Chinese Medicine, 2018, 40(12): 1869-1873. doi: 10.3969/j.issn.1002-2619.2018.12.024
[6]	宋婷婷, 武跃华, 刘颐, 等. 冬病夏治穴位贴敷治疗冠心病心绞痛的疗效观察[J]. 中西医结合心脑血管病杂志, 2014, 12(7): 816-817. doi: 10.3969/j.issn.16721349.2014.07.019 SONG T T, WU Y H, LIU Y, et al. Observation on the effect of acupoint application of winter disease and summer treatment on angina pectoris of coronary heart disease[J]. Chinese Journal of Integrative Medicine on Cardio-/Cerebrovascular Disease, 2014, 12(7): 816-817. doi: 10.3969/j.issn.16721349.2014.07.019
[7]	中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 慢性稳定性心绞痛诊断与治疗指南[J]. 中华心血管病杂志, 2007, 35(3): 195-206. doi: 10.3760/j.issn:0253-3758.2007.03.002 Chinese Society of Cardiology, editorial Board of Chinese Journal of Cardiology. Guidelines for the diagnosis and treatment of chronic stable angina pectoris[J]. Chinese Journal of Cardiology, 2007, 35(3): 195-206. doi: 10.3760/j.issn:0253-3758.2007.03.002
[8]	柯元南, 陈纪林. 不稳定性心绞痛和非ST段抬高心肌梗死诊断与治疗指南[J]. 中华心血管病杂志, 2007, 35(4): 295-304. doi: 10.3760/j.issn:0253-3758.2007.04.003 KE Y N, CHEN J L. Guidelines for Diagnosis and treatment of unstable angina pectoris and non-ST-segment elevation myocardial infarction[J]Chinese Journal of Cardiology, 2007, 35(4): 295-304. doi: 10.3760/j.issn:0253-3758.2007.04.003
[9]	卫生部心血管系统药物临床药理基地. 心血管系统药物临床研究指导原则[J]. 中国临床药理学杂志, 1988, 4(4): 245-255. https://www.cnki.com.cn/Article/CJFDTOTAL-GLYZ198804016.htm Clinical Pharmacology Base of Cardiovascular System Drugs Ministry of Health. Guidelines for clinical research on cardiovascular drugs[J]. The Chinese Journal of Clinical Pharmacology, 1988, 4(4): 245-255. https://www.cnki.com.cn/Article/CJFDTOTAL-GLYZ198804016.htm
[10]	郑筱萸. 中药新药临床研究指导原则(试行)[M]. 北京: 中国医药科技出版社, 2002: 68-73. ZHENG X Y. Guidelines for Clinical Research of New Chinese Medicine (Trial)[M]. Beijing: China Medical Science Press, 2002: 68-73.
[11]	王晶, 陈苏宁. 隔药艾灸加刺血虚里穴治疗冠心病心绞痛的临床疗效[J]. 中西医结合心脑血管病杂志, 2015, 13(5): 669-670. doi: 10.3969/j.issn.16721349.2015.05.041 WANG J, CHEN S N. Clinical effect of herbal moxibustion plus acupoint Xuexuli on angina pectoris of coronary heart disease[J]. hinese Journal of Integrative Medicine on Cardio-/Cerebrovascular Disease, 2015, 13(5): 669-670. doi: 10.3969/j.issn.16721349.2015.05.041
[12]	李智, 蔡凤思, 蓝鹏. 针刺配合推拿治疗冠心病稳定型心绞痛的心电图效果分析[J]. 心电图杂志(电子版), 2019, 8(1): 9-10. https://www.cnki.com.cn/Article/CJFDTOTAL-XDTZ201901009.htm LI Z, CAI F S, LAN P. Analysis of electrocardiogram effect of acupuncture combined with massage on stable angina pectoris of coronary heart disease[J]. Journal of Electrocardiogram, 2019, 8(1): 9-10. https://www.cnki.com.cn/Article/CJFDTOTAL-XDTZ201901009.htm
[13]	王忠良, 刘敏, 梁田, 等. 心脉通贴散穴位贴敷联合西药治疗冠心病不稳定型心绞痛40例临床观察[J]. 中医杂志, 2018, 59(11): 952-955. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201811013.htm WANG Z L, LIU M, LIANG T, et al. Clinical Observation on Acupoint Sticking Xinmaitong Plaster Combined with Western Medicine Treating Unstable Angina Pectoris of Coronary Heart Disease Patients[J]. Journal of Traditional Chinese Medicine, 2018, 59(11): 952-955. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201811013.htm
[14]	王建明, 刘宁. 穴位敷贴对不稳定型心绞痛患者高敏C反应蛋白的影响[J]. 世界中西医结合杂志, 2017, 12(2): 245-248. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZX201702029.htm WANG J M, LIU N. Impacts of Acupoint Plaster on High Sensitive C-Reactive Protein in the Patients of Unstable Angina Pectoris[J]. World Journal of Integrated Traditional and Western Medicine, 2017, 12(2): 245-248. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZX201702029.htm
[15]	宋柏奇, 齐锋. 针刺治疗气虚血瘀型微血管性心绞痛的临床观察[J]. 临床医药文献电子杂志, 2017, 4(31): 5958-5959. https://www.cnki.com.cn/Article/CJFDTOTAL-LCWX201731014.htm SONG B Q, QI F. Clinical observation on the treatment of microvascular angina pectoris with Qi deficiency and blood stasis by acupuncture[J]. Electronic Journal of Clinical Medical Literature, 2017, 4(31): 5958-5959. https://www.cnki.com.cn/Article/CJFDTOTAL-LCWX201731014.htm
[16]	薛刚, 闻婷, 胡刚, 等. 中药复方穴位贴敷治疗冠心病心绞痛24例临床观察[J]. 湖南中医杂志, 2018, 34(10): 49-51. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZO201810027.htm XUE G, WEN T, HU G, et al. Clinical observation of 24 cases of angina pectoris of coronary heart disease treated by acupoint application of Chinese herbal compound[J]. Hunan Journal of Traditional Chinese Medicine, 2018, 34(10): 49-51. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZO201810027.htm
[17]	胡欣妍. 艾灸对稳定型心绞痛患者血管内皮细胞功能的影响[J]. 中国中医药现代远程教育, 2018, 16(15): 114-115. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYY201815055.htm HU X Y. The Effect of Moxibustion on the Function of Endothelial Cells of Stable Angina[J]. Chinese Medicine Modern Distance Education of China, 2018, 16(15): 114-115. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYY201815055.htm
[18]	王磊, 武冰. 三参扩冠汤配合通补宗气法针刺对伴高尿酸血症冠状动脉慢血流现象心绞痛患者尿酸、心率变异性、炎症反应的影响[J]. 现代中西医结合杂志, 2019, 28(24): 2660-2664. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJH201924009.htm WANG L, WU B. ffect of Sanshen Kuoguan decoction combined with Tongbu Zongqi acupuncture on uric acid, heart rate variability and inflammatory response in patients with angina pectoris with hyperuricemia and phenomenon of slow coronary flow[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2019, 28(24): 2660-2664. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJH201924009.htm
[19]	文平, 李娟. 参七胶囊联合耳穴压豆法治疗冠心病心绞痛的疗效[J]. 现代电生理学杂志, 2018, 25(1): 15-18. https://www.cnki.com.cn/Article/CJFDTOTAL-SDDS201801007.htm WEN P, LI J. Efficacy of Shenqi Capsule Combined with Auricular Points Plaster Therapy in the Treatment of Angina Pectoris of Coronary Heart Disease[J]. Journal of Modern Electrophysiology, 2018, 25(1): 15-18. https://www.cnki.com.cn/Article/CJFDTOTAL-SDDS201801007.htm
[20]	蒋友琴, 程玉峰. 舒心贴穴位敷贴治疗冠心病不稳定性心绞痛30例临床观察[J]. 中医药临床杂志, 2013, 25(9): 769-770. https://www.cnki.com.cn/Article/CJFDTOTAL-AHLC201309009.htm JIANG Y Q, CHENG Y F. Clinical observation of 30 cases of unstable angina pectoris treated by Shuxin Patch acupoint application[J]. Clinical Journal of Traditional Chinese Medicine, 2013, 25(9): 769-770. https://www.cnki.com.cn/Article/CJFDTOTAL-AHLC201309009.htm
[21]	李雪梅, 常军英, 王勇. 穴位贴敷治疗胸痹心痛41例的临床观察[J]. 世界最新医学信息文摘, 2016, 16(28): 136, 138. https://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201628102.htm LI X M, CHANG J Y, WANG Y. Clinical observation of acupoint application in treating 41 cases of chest arthralgia and heartache[J]. World Latest Medicine Information, 2016, 16(28): 136, 138. https://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201628102.htm
[22]	陈洪, 黄桂琼, 洪晓华, 等. 联合应用耳穴压豆治疗冠心病心绞痛的临床疗效观察[C]//中国中医药研究促进会首届全国专科专病建设学术研讨会论文集, 2014: 780-782.
[23]	李颖, 李雯斌, 黄桢, 等. 穴位敷贴治疗冠心病心绞痛疗效观察[J]. 现代中西医结合杂志, 2012, 21(4): 352-353, 356. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJH201204008.htm LI Y, LI W B, HUANG Z, et al. Observation of the effect of point application on angina pectoris of coronary heart disease[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2012, 21(4): 352-353, 356. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJH201204008.htm
[24]	范亚妮. 枳实薤白桂枝汤联合穴位贴敷治疗冠心病心绞痛疗效观察[J]. 四川中医, 2019, 37(1): 85-88. https://www.cnki.com.cn/Article/CJFDTOTAL-SCZY201901029.htm FAN Y N. Curative effect of Zhishi Xiebai Guizhi Decoction combined with acupoint application in treating angina pectoris of coronary heart disease[J]. Journal of Sichuan of Traditional Chinese Medicine, 2019, 37(1): 85-88. https://www.cnki.com.cn/Article/CJFDTOTAL-SCZY201901029.htm
[25]	张其宝. 评价中药穴位贴敷联合养心汤治疗慢性稳定型心绞痛对其血清炎症相关因子水平的影响[J]. 大医生, 2019, 4(22): 89-91. ZHANG Q B. To Evaluate the Effect of Acupoint Application of Traditional Chinese Medicine Combined with Yangxin Decoction on Chronic Stable Angina Pectoris on the Level of Serum Inflammation-Related Factors[J]. Doctor, 2019, 4(22): 89-91.
[26]	李祎楠, 刘欣艳. 祛瘀化痰汤联合针刺治疗痰浊痹阻型冠心病心绞痛发作期的临床观察[J]. 河北中医, 2019, 41(11): 1712-1716. https://www.cnki.com.cn/Article/CJFDTOTAL-HBZY201911023.htm LI Y N, LIU X Y. Clinical observation of Quyu Huatan decoction combined with acupuncture in the treatment of angina pectoris of coronary heart disease with phlegm turbid obstruction type[J]. Hebei Journal of Traditional Chinese Medicine, 2019, 41(11): 1712-1716. https://www.cnki.com.cn/Article/CJFDTOTAL-HBZY201911023.htm
[27]	姜会来. 穴位贴敷联合瓜蒌皮注射液治疗痰浊闭阻证稳定型心绞痛临床观察[J]. 光明中医, 2020, 35(18): 2799-2803. https://www.cnki.com.cn/Article/CJFDTOTAL-GMZY202018005.htm JIANG H L. Research on the Therapeutic Effect of Acupoint Application Combined with Gualoupi Injection in the Treatment of Stable Angina Pectoris of Phlegm Stagnation Syndrome[J]. Guangming Journal of Chinese Medicine, 2020, 35(18): 2799-2803. https://www.cnki.com.cn/Article/CJFDTOTAL-GMZY202018005.htm
[28]	王秀玲. 穴位贴敷联合汤药治疗冠心病心绞痛对超敏C-反应蛋白和纤维蛋白原的影响[J]. 世界最新医学信息文摘, 2018, 18(5): 132, 134. https://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201805108.htm WANG X L. Effect of acupoint application combined with decoction on hypersensitive C-reactive protein and fibrinogen in the treatment of angina pectoris of coronary heart disease[J]. World Latest Medicine Information, 2018, 18(5): 132, 134. https://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201805108.htm
[29]	廖振裕. 穴位贴敷配合通脉化浊汤加味对冠心病心绞痛痰瘀互结证的临床观察[J]. 湖南中医药大学学报, 2016, 36(A01): 2. LIAO Z Y. Clinical observation on phlegm-stasis interjunction syndrome of angina pectoris of coronary heart disease treated by acupoint application combined with Tongmai Huazhuo Decoction[J]. Journal of Traditional Chinese Medicine University of Hunan, 2016, 36(A01): 2.
[30]	许延林. 自拟补心畅脉汤合耳穴压豆治疗不稳定型心绞痛(气滞血瘀证)疗效观察[J]. 中国中医急症, 2016, 25(11): 2184-2186. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJZ201611059.htm XU Y L. Observation on the curative effect of Buxin Changmai Decoction combined with earpoint pressure Dou in the treatment of unstable angina pectoris (Qi stagnation and blood stasis syndrome)[J]. Journal of Emergency in Traditional Chinese Medicine, 2016, 25(11): 2184-2186. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJZ201611059.htm
[31]	丁力, 周淑妮. 加味瓜蒌薤白半夏汤联合针刺治疗冠心病心绞痛的疗效和对血清HMGB1、CGRP、GM-CSF的影响[J]. 山东中医杂志, 2021, 40(3): 269-274. https://www.cnki.com.cn/Article/CJFDTOTAL-SDZY202103010.htm DING L, ZHOU S N. Curative Efficacy of Modified Gualou Xiebai Banxia Decoction Combined with Acupuncture on Angina Pectoris in Coronary Heart Disease and Its Effect on Serum HMGB1, CGRP and GM-CSF[J]. Shandong Journal of Traditional Chinese Medicine, 2021, 40(3): 269-274. https://www.cnki.com.cn/Article/CJFDTOTAL-SDZY202103010.htm
[32]	王毅然, 于玲, 周亚滨. 中药穴位贴敷联合养心汤治疗慢性稳定型心绞痛[J]. 吉林中医药, 2019, 39(10): 1377-1380. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJL201910031.htm WANG Y R, YU L, ZHOU Y B. Chronic Stable Angina Pectoris Treated by Acupoint Application Combined with Yangxin Decoction[J]. Jilin Journal of Chinese Medicine, 2019, 39(10): 1377-1380 https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJL201910031.htm
[33]	ZHOU W, LONGHURST J C. Neuroendocrine mechanisms of acupuncture in the treatment of hypertension[J]. Evid Based Complement Alternat Med, 2012, 2012: 878673. DOI: 10.1155/2012/878673.
[34]	ARTHUR H M, PATTERSON C, STONE J A. The role of complementary and alternative therapies in cardiac rehabilitation: a systematic evaluation[J]. Eur J Cardiovasc Prev Rehabil, 2006, 13(1): 3-9. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.918.726&rep=rep1&type=pdf
[35]	LONGHURST J C. Electroacupuncture treatment of arrhythmias in myocardial ischemia[J]. Am J Physiol Heart Circ Physiol, 2007, 292(5): H2032-H2034. DOI: 10.1152/ajpheart.00071.2007.
[36]	ZHOU W, BENHARASH P. Effects and Mechanisms of acupuncture based on the principle of meridians[J]. J Acupunct Meridian Stud, 2014, 7(4): 190-193. http://www.onacademic.com/detail/journal_1000036662579810_b038.html
[37]	RICHTER A, HERLITZ J, HJALMARSON A. Effect of acupuncture in patients with angina pectoris[J]. Eur Heart J, 1991, 12(2): 175-178. http://eurheartj.oxfordjournals.org/http://eurheartj.oxfordjournals.org/content/ehj/12/2/175.full.pdf
[38]	SPINKA F, AICHINGER J, WALLNER E, et al. Functional status and life satisfaction of patients with stable angina pectoris in Austria[J]. BMJ Open, 2019, 9(9): e029661. DOI: 10.1136/bmjopen-2019-029661.
[39]	TAWA M, FUKUMOTO T, OHKITA M, et al. Contribution of nitric oxide in big endothelin-1-induced cardioprotective effects on ischemia/reperfusion injury in rat hearts[J]. J Cardiovasc Pharmacol, 2011, 57(5): 575-578. http://www.onacademic.com/detail/journal_1000039358472510_a439.html
[40]	COLETTA C, PAPAPETROPOULOS A, ERDELYI K, et al. Hydrogen sulfide and nitric oxide are mutually dependent in the regulation of angiogenesis and endothelium-dependent vasorelaxation[J]. Proc Natl Acad Sci U S A, 2012, 109(23): 9161-9166. http://www.xueshufan.com/publication/2043239658