活血散风针刺法治疗高血压病研究进展

Research Progress in the Treatment of Hypertension with Acupuncture of Invigorating Blood and Dispersing Wind

目前临床对于高血压的控制方法包括药物治疗和非药物措施两方面,非药物措施包括改变饮食习惯及生活方式等。其中,药物治疗是控制血压最有效的措施,但因药物治疗存在治疗费用较高,药物副作用较多等问题,导致服药不规范、不合理,加之患者对疾病关注度低,致使依从性较差。活血散风针刺法既有即刻降血压作用,又有长期降血压作用,在改善血压节律、降低晨峰血压方面也效果显著,减低了对靶器官的损害。其安全性、有效性也在多项试验中得到证实,然而该方法也面临一些问题。首先,活血散风针刺法的降血压机制尚未完全明确,尤其是针刺后腧穴功能机制及经脉穴位相关假说需要进一步研究;其次,针刺临床试验设计不够严谨,针刺降血压后停药、减药标准不一致,对于停减药物后的血压控制缺少长期随访数据;另外,临床试验方面,存在针刺降血压手法量学不一致,样本量少,随访时间短,对相关临床试验安全性的报道也较少等不足,还需要设计更为科学、系统、客观的试验方案以开展大样本量、多中心、长期随访的临床试验来提供证据,并结合循证医学证据和标准的手法量学以指导今后的研究。

At present,the clinical control methods for hypertension include drug treatment and non-drug measures.Non-drug measures include changing diet habits and lifestyle.Among them,drug therapy is the most effective measure to control blood pressure.However,due to the treatment costs,side effects and many kinds of drugs,different methods of taking drugs and other factors,the medication is not standardized and unreasonable.In addition,the patients pay low attention to the disease,resulting in poor medication compliance.Acupuncture of invigorating blood and dispersing wind has both immediate hypotensive effect and long-term treatment stability.It also has significant effect in improving blood pressure rhythm and reducing morning peak blood pressure,reducing damage to target organs.Its safety and effectiveness have been proved in many experiments,but the method also faces some problems.Firstly,its mechanism of reducing blood pressure has not been completely clear,especially for the function mechanism of points after acupuncture,and the hypothesis related to meridians and points needs further study.Secondly,the clinical trial design of acupuncture is not rigorous enough,the standards of drug withdrawal and drug reduction are inconsistent after acupuncture and blood pressure control after drug withdrawal and drug reduction is lack of long-term follow-up data.In addition,there are some shortcomings in clinical trials,such as inconsistent measurement of acupuncture and blood pressure reduction techniques,small sample size,short follow-up time,and fewer reports on the safety of related clinical trials.Therefore,more scientific,systematic and objective experimental programs should be designed to carry out large sample size,multi center,long-term follow-up clinical trials to provide evidence,and combine evidence-based medicine evidence and standard techniques metrology to guide future research.