针刺对老年脑梗死伴原发性高血压患者血压变异性的影响
|
摘要
目的:观察针刺对老年脑梗死伴发原发性高血压患者血压变异性(BPV)的影响。方法:76例老年脑梗死伴原发性高血压患者随机分为观察组和对照组,每组38例。对照组给予"醒脑开窍"针刺法及口服硝苯地平控释片(拜新同)治疗,观察组在对照组治疗基础上行"活血散风、调和肝脾"针刺法,穴取人迎、合谷、曲池、足三里、太冲,留针30 min。每天1次,每周5次,共治疗8周(40次)。监测两组患者24 h动态血压,观察治疗前、治疗8周后血压及血压变异性的变化,并记录治疗过程中不良反应发生情况。结果:两组患者治疗8周后24 h平均收缩压(SBP)、舒张压(DBP),白昼SBP、DBP,夜间SBP、DBP均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。治疗8周后观察组白天、夜间及24h的收缩压变异性(SBPV)、舒张压变异性(DBPV)均较治疗前降低(P<0.05),而对照组治疗前后比较差异均无统计学意义(P>0.05)。结论:"活血散风、调和肝脾"配穴针刺法对改善老年脑梗死伴原发性高血压患者的血压及血压变异性效果明显。
Objective To observe the therapeutic effect of acupuncture on blood pressure variability(BPV) in elderly patients with cerebral infarction complicated with essential hypertension. Methods Seventy-six elderly patients with cerebral infraction complicated with essential hypertension were randomized into an observation group and a control group, 38 cases in each group. Xingnao Kaiqiao acupuncture and nifedipin were given in the control group. On the basis treatment in the control group, the Huoxue Sanfeng and Tiaohe Ganpi acupuncture was applied at Renying(ST 9), Hegu(LI 4), Quchi(LI 11), Zusanli(ST 36) and Taichong(LR 3) in the observation group for 30 min. The treatment was given once a day, 5 times a week for 8 weeks. The 24-hour ambulatory blood pressure was monitored in the two groups. The changes of blood pressure and blood pressure variability were observed before and after 8 weeks of treatment, and the occurrence of adverse reactions during the treatment were recorded. Results The mean systolic blood pressure(SBP), diastolic blood pressure(DBP), daytime SBP, DBP, nighttime SBP and DBP were reduced in the two groups after 8 weeks of treatment(P<0.05), and the results in the observation group were lower than those in the control group(P<0.05). After 8 weeks of treatment, the daytime, nighttime, 24 h systolic blood pressure variability(SBPV) and diastolic blood pressure variability(DBPV) in the observation group were lower than those before treatment(P<0.05), there was no significant difference between before and after treatment in the control group(P>0.05). Conclusion Huoxue Sanfeng and Tiaohe Ganpi acupuncture method can effectively control the blood pressure and blood pressure variability in the elderly patients with cerebral infraction complicated with essential hypertension.
Objective To observe the therapeutic effect of acupuncture on blood pressure variability(BPV) in elderly patients with cerebral infarction complicated with essential hypertension. Methods Seventy-six elderly patients with cerebral infraction complicated with essential hypertension were randomized into an observation group and a control group, 38 cases in each group. Xingnao Kaiqiao acupuncture and nifedipin were given in the control group. On the basis treatment in the control group, the Huoxue Sanfeng and Tiaohe Ganpi acupuncture was applied at Renying(ST 9), Hegu(LI 4), Quchi(LI 11), Zusanli(ST 36) and Taichong(LR 3) in the observation group for 30 min. The treatment was given once a day, 5 times a week for 8 weeks. The 24-hour ambulatory blood pressure was monitored in the two groups. The changes of blood pressure and blood pressure variability were observed before and after 8 weeks of treatment, and the occurrence of adverse reactions during the treatment were recorded. Results The mean systolic blood pressure(SBP), diastolic blood pressure(DBP), daytime SBP, DBP, nighttime SBP and DBP were reduced in the two groups after 8 weeks of treatment(P<0.05), and the results in the observation group were lower than those in the control group(P<0.05). After 8 weeks of treatment, the daytime, nighttime, 24 h systolic blood pressure variability(SBPV) and diastolic blood pressure variability(DBPV) in the observation group were lower than those before treatment(P<0.05), there was no significant difference between before and after treatment in the control group(P>0.05). Conclusion Huoxue Sanfeng and Tiaohe Ganpi acupuncture method can effectively control the blood pressure and blood pressure variability in the elderly patients with cerebral infraction complicated with essential hypertension.
引文
[1]林涛,丁元芳,张姝兰.原发性高血压患者血压变异性与肾功能损害的相关性研究[J].中国医药导报,2010,7(10):58-60.
[2]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华高血压杂志,2011,19(8):701-743.
[3]中国血压测量工作组.中国血压测量指南[J].中华高血压杂志,2011,19(2):1101-1115.
[4]Emmanuel A,Andreadis,Gerasimos D,et al.Automated office blood pressure is associated with urine albumin excretion in hypertensive subjects[J].Am Hypertens,2012,25(9):969-973.
[5]Madden JM,OFlynn AM,Dolan E,et al.Short-term blood pressure variability over 24 h and target organ damage in middle-aged men and women[J].Hum Hypertens,2015,29(12):719-725.
[6]郭艺芳,白晓谊.血压变异性的基本概念[J].中华高血压杂志,2011,19(7):601-602.
[7]邱萌,朱昀,张福春.老年高血压患者动脉僵硬度与血压变异性的关系[J].中国循环杂志,2015,30(2):136-139.
[8]张清琼,张新军,常彬宾,等.老年高血压患者血压变异性与靶器官损害的相关性研究[J].四川大学学报(医学版),2011,42(2):252-255.
[9]王海军,司全金,李开亮,等.老年原发性高血压患者血压变异性对新发心房颤动的影响[J].中华老年心脑血管病杂志,2017,19(3):228-231.
[10]殷颖,单秋华.人迎穴特异性探讨[J].山东中医杂志,2009,28(3):182-183.
[11]马瑞玲.浅淡人迎调节血压的机理[J].甘肃中医学院学报,1996(8):50-51.
[12]卫彦,孙忠人,寇吉友,等.针刺人迎穴治疗高血压病120例临床观察[J].针灸临床杂志,2006,22(2):4-5.
[13]刘海华,王莹莹,高海波,等.针灸治疗高血压病选穴规律文献研究[J].中医杂志,2014,55(12):1055-1058.
[14]高新新,马芬,赵琦,等.“活血散风、疏肝健脾”针刺法调控脑梗死伴原发性高血压患者清晨血压疗效观察[J].中国针灸,2016,36(5):459-462.
[15]谷文龙,柳昌希,王增荣,等,活血散风针刺法对高血压前期患者血压的影响[J].中国中西医结合杂志,2015,35(11):1318-1321.
[16]李会娟,申鹏飞.针刺降低血压变异性[J].吉林中医药,2011,31(1):53-54.
[2]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华高血压杂志,2011,19(8):701-743.
[3]中国血压测量工作组.中国血压测量指南[J].中华高血压杂志,2011,19(2):1101-1115.
[4]Emmanuel A,Andreadis,Gerasimos D,et al.Automated office blood pressure is associated with urine albumin excretion in hypertensive subjects[J].Am Hypertens,2012,25(9):969-973.
[5]Madden JM,OFlynn AM,Dolan E,et al.Short-term blood pressure variability over 24 h and target organ damage in middle-aged men and women[J].Hum Hypertens,2015,29(12):719-725.
[6]郭艺芳,白晓谊.血压变异性的基本概念[J].中华高血压杂志,2011,19(7):601-602.
[7]邱萌,朱昀,张福春.老年高血压患者动脉僵硬度与血压变异性的关系[J].中国循环杂志,2015,30(2):136-139.
[8]张清琼,张新军,常彬宾,等.老年高血压患者血压变异性与靶器官损害的相关性研究[J].四川大学学报(医学版),2011,42(2):252-255.
[9]王海军,司全金,李开亮,等.老年原发性高血压患者血压变异性对新发心房颤动的影响[J].中华老年心脑血管病杂志,2017,19(3):228-231.
[10]殷颖,单秋华.人迎穴特异性探讨[J].山东中医杂志,2009,28(3):182-183.
[11]马瑞玲.浅淡人迎调节血压的机理[J].甘肃中医学院学报,1996(8):50-51.
[12]卫彦,孙忠人,寇吉友,等.针刺人迎穴治疗高血压病120例临床观察[J].针灸临床杂志,2006,22(2):4-5.
[13]刘海华,王莹莹,高海波,等.针灸治疗高血压病选穴规律文献研究[J].中医杂志,2014,55(12):1055-1058.
[14]高新新,马芬,赵琦,等.“活血散风、疏肝健脾”针刺法调控脑梗死伴原发性高血压患者清晨血压疗效观察[J].中国针灸,2016,36(5):459-462.
[15]谷文龙,柳昌希,王增荣,等,活血散风针刺法对高血压前期患者血压的影响[J].中国中西医结合杂志,2015,35(11):1318-1321.
[16]李会娟,申鹏飞.针刺降低血压变异性[J].吉林中医药,2011,31(1):53-54.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |