刺络放血治疗高血压亚急症的临床效果观察

A clinical observation of blood-letting puncture in treating hypertensive urgencies

目的探讨刺络放血治疗高血压亚急症（hypertensive crisis，HC）的急救处理疗效。方法选择我院针灸脑病科及心病科2014-10～2015-10期间收治的90例高血压亚急症患者，采用随机数字表的方法随机分为试验组45例及对照组45例，试验组运用刺络放血疗法进行紧急降压及序贯治疗，对照组采用口服降压药物治疗。观察两种方法的急救疗效及保持血压稳定的有效性。结果两组患者于急救1h后收缩压、舒张压及平均动脉压比较差异均具有统计学意义（t=5．767，P=0．000；f=3．127，P=0．002；t=4．387，P=0．000）；两组患者于急救2h收缩压、舒张压及平均动脉压比较差异均具有统计学意义（t=7．963，P=0．000；t=3．563，P=0．000；t=4．299，P=0．000）；两组患者于急救24h收缩压、舒张压及平均动脉压比较差异均具有统计学意义（t=4．531，P=0．000；t=2．445，P=0．017；t=3．386，P=0．001）；两组患者于急救72h后收缩压、舒张压及平均动脉压比较均差异有统计学意义（沁6．265，P=0．000；t=2．819，P=0．006；t=4．626，P=0．000）。结论刺络放血疗法可以有效降低血压。适时、科学地运用此疗法可以提高抢救成功率，避免过度治疗。同时，还可以通过序贯治疗保持血压的稳定性。

Objective To explore the emergency effect of blood-letting treatment on high blood pressure. Methods A total of 90 patients with hypertension urgency who were in acupuncture department and heart disease department of a tertiary traditional hospital from October 2014 to October 2015 were enrolled in this study. They were divided into two groups by random number table method. Patients in treatment group using blood-letting therapy （n=45 patients）; patients in control group using oral medication （n = 45 patients）. The emergency treatment efficiency and the stability of blood pressure were compared between the two groups. Results The systolic pressure, diastolic pressure and mean arterial pressure 1 h after emergency treatment were had significant difference between the two groups （t = 5.767, P = 0.000; t = 3.127, P = 0.002; t = 4,387, P = 0.000）. The systolic pressure, diastolic pressure and mean arterial pressure 2 h after emergency treatment between the two groups were statistically difterent （t = 7.963, P = 0.000; t = 3.563, P = 0.000 ; t = 4.299, P = 0.000）. The systolic pressure, diastolic pressure and mean arterial pressure 24 h after emergency treatment were significantly different between two groups （t = 4.531, P = 0.000; t = 2.445, P = 0.017 ; t = 3.386, P = 0.001）. The systolic pressure, diastolic pressure and mean arterial pressure 72 h after emergency treatment had significantly difference between two groups （t = 6.265, P = 0.000; t = 2.819, P = 0.006; t = 4,626, P = 0.000）. Conclusion Blood-letting therapy can effectively step-down blood pressure. This therapy improves the success rate of rescue and avoids excessive treatment. In the meantime, this therapy can keep the stability of blood pressure.