针刺与针药联合治疗轻、中度原发性高血压疗效的Meta分析

Meta-analysis on Efficacy of Acupuncture and Acupuncture Combined with Medicine in Treatment for Mild to Moderate Essential Hypertension

目的:系统评价针刺与针药联合治疗轻、中度原发性高血压的临床疗效及安全性。方法:电子检索维普中文期刊全文数据库(VIP,1989-2013.7)、中国知网(CNKI1979-2013.7)、万方数据库(1998—2013.7)有关针刺治疗高血压的文献,采用循证医学的方法对纳入文献进行Meta分析。结果:共纳入13项1066例符合标准的研究,Meta分析结果显示,单纯针刺治疗轻中度原发性高血压在总有效率、收缩压、舒张压的疗效上与单用西药降压疗效相似。针药联合降压与单用西药在降舒张压方面虽无差异,但在总有效率、收缩压改善上均优于单用西药;症状积分评价上,针刺在改善头晕、头痛、心悸等患者主观症状方面优于单用西药。不良反应评估安全性上,针刺发生率低于单用西药。结论:针刺是很有价值的医疗手段,在一定程度上可作为一种安全绿色有益的疗法替代西药降压,而针药联合降压具有更好的疗效。

Objective：To evaluate the clinical efficacy and safety of acupuncture and acupuncture combined with medicine in the treatment for mild-to-moderate essential hypertension. Methods ： The literature relating to acupuncture and acupuncture in the treatment for hypertension were searched from the databases of VIP ,CNKI and Wanfang data by electronic retrieval. Meta-analysis was conducted in according to the requirements of evidence-based- medicine. Results：Thirteen researches meeting the standards were included with a total of 1,066 patients. Meta-analysis indicated that： Comparing between the acupuncture trail and Western medicine trail in terms of the total effective rate, SBP, DBP after treatment, no differences could be found on effect of acupuncture in the treatment for mild- to-moderate essential hypertension. There existed a same therapeutic efficacy between Acupuncture com- bined with Western medicine trail and Western medicine trail in lowering DBP, but the former was superior to the latter in terms of the total effective rate and SBP. The evaluation of symptom score showed that acupuncture treatment displayed a higher superi- ority versus western medicine in improving subjective symptoms of patients including dizziness, headache, heart palpitations, etc. Assessment of the adverse reactions reported acupuncture trail had a lower incidence. Conclusion：Acupuncture is an alternative therapy which is safe green beneficial therapy to western medicine, to a certain extent, it can be used as a valuable medical means to control hypertension.