循证针灸治疗高血压病的临床依据

Evidence-based Medical Study of Treating Hypertension with Acupuncture and Moxibustion

目的评价国内针灸治疗高血压病的临床证据。方法采用计算机检索中国生物医学文献数据库(CBM,1979-2009年)、中国知网(CNKI,1979-2010年)、维普数据库(VIP,1989-2010年)和万方数字化期刊群(WF,1998-2010年),其中中国知网包括中国期刊文献数据库、重要会议全文数据库、硕博学位论文数据库;中文检索词为针灸、针刺、高血压等,所有检索均截止2010年11月30日。对检索文献按照循证医学5级标准进行阅读、筛查,两位评价者独立阅读文题和摘要,并交叉核实纳入结果。结果针灸对照假针刺治疗高血压有效;针灸与常规西药(倍他乐克、硝苯地平、卡托普利)相比可能有治疗优势;针灸结合西药(硝苯地平)可能有增效之功;不同干预措施中针刺人迎穴可能优于其他穴位。结论针灸治疗高血压的疗效是肯定,特别是在与西药相比方面,具有一定疗效优势,但由于纳入样本数量及治疗规范性问题,尚需要高级别证据支持。

Objective To evaluate the clinical evidence of treating hypertension with acupuncture and moxibustion domestically. Methods By means of computer, we retrieved the paper in CBM from 1979 to 2009, CNKI from 1979 to 2010, VIP from 1989 to 2010 and Wanfang data from 1998 to 2010. Among these databases, CNKI includes Chinese journal full -text database, important conference full -text database and PhD dissertation database. The key words were acupuncture and moxibustion, acupuncture and hypertension and so on. The retrieve closed on December 30, 2010. The retrieved paper were read and screened according to 5 degrees of standard in evidence - based medicine. Results The outcome in acupuncture and moxibustion group was better than that of sham acupuncture group, acupuncture and moxibutstion therapy better than conventional western medicine such as Betaloc and nifedipine. Combining application of acupuncture and western medicine may strengthen the therapeutic effect. In different intervention measures, the effect of puncturing at Renying（ ST 9） was superior to other points. Conclusions acupuncture and moxibustion have a certain effect on hypertension, and have therapeutic advantage by contrasting to the result of the western medicine. However the number of researches which included in our study is scant and treatment standard is undefined, it still needed high rank evidence.