针刺联合耳穴贴压对原发性高血压患者动态血压及血压变异性指标的影响

Clinical effect of the acupuncture therapy combined with the ear point application therapy on the ambulatory blood pressure and blood pressure variability indexes in patients with essential hypertension

目的探讨针刺联合耳穴贴压对原发性高血压患者动态血压及血压变异性指标的影响。方法选择104例原发性高血压患者,按随机数表法分为对照组与观察组,各52例。对照组给予苯磺酸氨氯地平片进行治疗,观察组在对照组基础上给予针刺联合耳穴贴压进行治疗,2组均持续治疗4周。比较2组治疗4周后的疗效,治疗前、治疗4周后的中医证候积分、动态血压及血压变异性指标水平。结果治疗4周后,观察组总有效率(94.23%,49/52)高于对照组(73.08%,38/52)(P<0.05)。与治疗前比较,治疗4周后,2组胸闷、头痛、心悸、眩晕、呕吐痰涎积分、中医证候总积分及24 h平均收缩压(24h SBP)、24h平均舒张压(24 h DBP)水平均降低,且观察组低于对照组(P<0.05)。与治疗前比较,治疗4周后,观察组夜间收缩压标准差(nSSD)、白昼收缩压标准差(dSSD)、白昼舒张压标准差(dDSD)均降低,对照组dSSD、dDSD均降低,且观察组dSSD低于对照组(P<0.05)。结论针刺联合耳穴贴压可明显改善原发性高血压患者中医证候,并能有效改善患者动态血压及血压变异性指标,提高临床疗效。

Objective To explore the effect of the acupuncture therapy combined with the ear point application therapy on the ambulatory blood pressure and blood pressure variability indexes in patients with essential hypertension.Methods A total of 104 patients with essential hypertension were selected and randomly divided into a control group and an observation group,with 52 cases in each group.The control group was treated with amlodipine besylate tablets,while the observation group was treated with the acupuncture therapy combined with the ear point application therapy on the basis of the control group,both for 4 weeks.The efficacy after treatment,the TCM syndrome scores,levels of the ambulatory blood pressure and blood pressure variability indexes before and after treatment were compared between the two groups.Results After treatment,the total effective rate of the observation group(94.23%)was higher than that of the control group(73.08%)(P<0.05).After treatment,the scores of chest tightness,headache,palpitations,vertigo,vomiting,sputum and saliva,the total scores of TCM syndromes,the levels of the 24 h mean systolic blood pressure(24 h SBP)and the 24 h mean diastolic blood pressure(24 h DBP)were decreased,and the observation group was lower than the control group(P<0.05).After treatment,the standard deviation of nocturnal systolic blood pressure(nSSD),standard deviation of daytime systolic blood pressure(dSSD)and standard deviation of daytime diastolic blood pressure(dDSD)in the observation group were all decreased,while the dSSD and dDSD in the control group were both decreased as well,and the dSSD in the observation group was lower than that in the control group(P<0.05).Conclusion The acupuncture therapy combined with the ear point application therapy can significantly improve the TCM syndromes,effectively improve the ambulatory blood pressure and blood pressure variability indicators of patients with primary hypertension,and improve the clinical efficacy.