针刺治疗原发性高血压病的近期及远期疗效
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摘要
目的观察针刺治疗原发性高血压病的近期疗效和远期疗效。方法 52例原发性高血压病患者于早上8:00—11:00时段进行针刺治疗。观察治疗前、治疗后、1个月随访及3个月随访时24 h动态血压监测(ABPM)中24 h平均血压、24 h血压变异性、昼夜血压负荷、24 h平滑指数、夜间血压节律变化,并比较临床疗效和达标率。结果治疗后、1个月随访和3个月随访的24 h动态血压监测的平均血压、血压负荷、平滑指数、夜间血压节律变化均优于治疗前(P<0.05)。1个月随访和3个月随访的24 h动态血压监测的24 h平均血压、24 h血压变异性、昼夜血压负荷、24 h平滑指数与治疗后比较,差异有统计学意义(P<0.05)。不同服药类型高血压患者的总有效率和达标率比较,差异有统计学意义(P<0.05)。结论针刺疗法能平稳调控血压,并保持良好的降压效果,具有近期及远期疗效作用。
Objective To observe the short-term and long-term therapeutic efficacies of acupuncture in treating primary hypertension. Method Fifty-two patients with primary hypertension received acupuncture during 8:00-11:00 of a day. The 24 h mean blood pressure, 24 h blood pressure variability, circadian blood pressure load, 24 h smoothness index and change in nocturnal blood pressure rhythm were observed by 24 h ambulatory blood pressure monitoring (ABPM) before and after the treatment, as well as at the 1-month and 3-month follow-ups. The clinical efficacies and qualified rates were compared. Result After the treatment and at the 1-month and 3-month follow-ups, the mean blood pressure, blood pressure load, smoothness index and nocturnal blood pressure rhythm change shown on the 24 h ABPM were better than those before the treatment (P<0.05). At the 1-month and 3-month follow-ups, the 24 h ABPM showed that the 24 h mean blood pressure, 24 h blood pressure variability, circadian blood pressure load and 24 h smoothness index were significantly different from those at the end of the treatment (P<0.05). There were significant differences in the total effective rate and qualified rate among different groups of patients based on different types of medication (P<0.05). Conclusion Acupuncture therapy can stabilize and modulate blood pressure. Its effect is satisfactory in lowering hypertension in both short and long run.
Objective To observe the short-term and long-term therapeutic efficacies of acupuncture in treating primary hypertension. Method Fifty-two patients with primary hypertension received acupuncture during 8:00-11:00 of a day. The 24 h mean blood pressure, 24 h blood pressure variability, circadian blood pressure load, 24 h smoothness index and change in nocturnal blood pressure rhythm were observed by 24 h ambulatory blood pressure monitoring (ABPM) before and after the treatment, as well as at the 1-month and 3-month follow-ups. The clinical efficacies and qualified rates were compared. Result After the treatment and at the 1-month and 3-month follow-ups, the mean blood pressure, blood pressure load, smoothness index and nocturnal blood pressure rhythm change shown on the 24 h ABPM were better than those before the treatment (P<0.05). At the 1-month and 3-month follow-ups, the 24 h ABPM showed that the 24 h mean blood pressure, 24 h blood pressure variability, circadian blood pressure load and 24 h smoothness index were significantly different from those at the end of the treatment (P<0.05). There were significant differences in the total effective rate and qualified rate among different groups of patients based on different types of medication (P<0.05). Conclusion Acupuncture therapy can stabilize and modulate blood pressure. Its effect is satisfactory in lowering hypertension in both short and long run.
引文
[1]中国高血压联盟,中国医师协会高血压专业委员会血压测量与监测工作委员会,《中华高血压杂志》编委会.动态血压监测临床应用中国专家共识[J].中华高血压杂志,2015,23(8):727-730.
[2]Krause T,Lovibond K,Caulfield M,et al.Management of hypertension:summary of NICE guidance[J].BMJ,2011,343:d4891.
[3]卞金玲,张春红.石学敏院士针刺手法量学的概念及核心[J].中国针灸,2003,23(5):287-289.
[4]王文,张维忠,孙宁玲,等.中国血压测量指南[J].中华高血压杂志,2011,19(12):1101-1115.
[5]Parati G,Stergiou G,O’Brien E,et al.European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring[J].J Hypertens,2014,32(7):1359-1366.
[6]郑筱萸.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:73.
[7]文佳,陈轶愔,李莹,等.24h动态血压在高血压分级和疗效评估中的价值[J].中华高血压杂志,2015,23(10):926-929.
[8]马秀芬,王义围,冯玉梅,等.老年高血压患者血压节律与脉压指数及踝臂指数的关系研究[J].河北医药,2012,34(15):2303-2304.
[9]王继光.24 h动态血压监测:适用人群及临床意义[J].中华高血压杂志,2014,22(7):614-615.
[10]王文,张宇清,张学中,等.高血压患者治疗后平均血压水平与心脑血管事件的关系-非洛地平降低并发症研究分析[J].中华高血压杂志,2010,18(5):439-443.
[11]李村淑,姚福梅,彭威,等.高血压患者动态动脉僵硬指数与血压变异性的关系[J].中华高血压杂志,2012,20(6):561-564.
[12]何星球,潘妙君,谢志玲.老年高血压患者血压负荷值和血压昼夜节律、靶器官损害相关性[J].中国循证心血管医学杂志,2016,8(4):468-470.
[13]鹿秀云,樊小农,王舒.24 h动态血压监测与家庭血压自测在原发性高血压诊治中的应用[J].中国医药导报,2015,12(24):44-47,52.
[14]文佳,陈轶愔,李莹,等.24 h动态血压在高血压分级和疗效评估中的价值[J].中华高血压杂志,2015,23(10):926-929.
[15]母昌欢,陈明.老年单纯收缩期高血压的舒张压问题[J].中华高血压杂志,2014,22(11):1089-1092.
[16]许军峰,卞金玲,吕建明.石学敏院士针刺治疗高血压病的核心阐释[J].中华针灸电子杂志,2015,4(1):13-15.
[17]常晓波,樊小农,王舒,石学敏.“针刺量学”研究之探本溯源[J].中医杂志,2011,52(5):363-366.
[18]石学敏.石学敏针灸全集[M].北京:科学出版社,2016:439.
[2]Krause T,Lovibond K,Caulfield M,et al.Management of hypertension:summary of NICE guidance[J].BMJ,2011,343:d4891.
[3]卞金玲,张春红.石学敏院士针刺手法量学的概念及核心[J].中国针灸,2003,23(5):287-289.
[4]王文,张维忠,孙宁玲,等.中国血压测量指南[J].中华高血压杂志,2011,19(12):1101-1115.
[5]Parati G,Stergiou G,O’Brien E,et al.European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring[J].J Hypertens,2014,32(7):1359-1366.
[6]郑筱萸.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:73.
[7]文佳,陈轶愔,李莹,等.24h动态血压在高血压分级和疗效评估中的价值[J].中华高血压杂志,2015,23(10):926-929.
[8]马秀芬,王义围,冯玉梅,等.老年高血压患者血压节律与脉压指数及踝臂指数的关系研究[J].河北医药,2012,34(15):2303-2304.
[9]王继光.24 h动态血压监测:适用人群及临床意义[J].中华高血压杂志,2014,22(7):614-615.
[10]王文,张宇清,张学中,等.高血压患者治疗后平均血压水平与心脑血管事件的关系-非洛地平降低并发症研究分析[J].中华高血压杂志,2010,18(5):439-443.
[11]李村淑,姚福梅,彭威,等.高血压患者动态动脉僵硬指数与血压变异性的关系[J].中华高血压杂志,2012,20(6):561-564.
[12]何星球,潘妙君,谢志玲.老年高血压患者血压负荷值和血压昼夜节律、靶器官损害相关性[J].中国循证心血管医学杂志,2016,8(4):468-470.
[13]鹿秀云,樊小农,王舒.24 h动态血压监测与家庭血压自测在原发性高血压诊治中的应用[J].中国医药导报,2015,12(24):44-47,52.
[14]文佳,陈轶愔,李莹,等.24 h动态血压在高血压分级和疗效评估中的价值[J].中华高血压杂志,2015,23(10):926-929.
[15]母昌欢,陈明.老年单纯收缩期高血压的舒张压问题[J].中华高血压杂志,2014,22(11):1089-1092.
[16]许军峰,卞金玲,吕建明.石学敏院士针刺治疗高血压病的核心阐释[J].中华针灸电子杂志,2015,4(1):13-15.
[17]常晓波,樊小农,王舒,石学敏.“针刺量学”研究之探本溯源[J].中医杂志,2011,52(5):363-366.
[18]石学敏.石学敏针灸全集[M].北京:科学出版社,2016:439.