近六年针刺治疗原发性高血压的临床研究证据图分析

Evidence map of clinical researches on treatment of essential hypertension with acupuncture in the past six years

目的 通过对针刺治疗原发性高血压的临床研究文献及系统评价/Meta分析进行概括梳理,分析针刺治疗原发性高血压的有效性和研究现状,为临床应用及其进一步的研究提供借鉴。方法计算机检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、EMbase、Web of Science数据库,检索时限为2015年1月至2022年8月。纳入针刺治疗原发性高血压的临床原始研究和系统评价,通过文字和图表、气泡图形式对临床研究的发表年度趋势、研究规模、辨证分型、结局指标等进行总结分析与展示;采用AMSTAR量表对系统评价进行质量评价。结果 共纳入192篇文献,其中临床研究185篇,系统评价7篇。整体发文趋势平稳,临床研究样本量多集中在50~100例,关注较多的结局指标主要包括血压、临床有效率、中医证候积分。纳入的7篇系统评价中等质量(4~7分)的4篇,高质量(8~11分)的3篇。5篇系统评价支持针刺治疗原发性高血压临床疗效。结论 多数临床研究和系统评价结果表明,针刺在降低血压、提高临床有效率、改善患者中医症状、减少不良反应方面具有一定优势。但也存在缺乏高质量临床研究、无统一规范的核心结局指标等问题,未来需要开展高质量、多中心、大样本的临床研究,同时提高相关Meta分析/系统评价质量,为针刺治疗原发性高血压提供高级别的循证医学证据。

Objective The objective of this study is to summarize and analyze the clinical research literature and systematic evaluations/Meta-analyses on the effectiveness and current research status of acupuncture in the treatment of essential hypertension.This analysis aims to guide clinical application and further research.Methods The China Knowledge Network(CNKI),Wanfang,VIP,SinoMed,PubMed,Embase,and Web of Science databases were searched from January 2015 to August 2022.Clinical original studies and systematic evaluations on acupuncture for essential hypertension were included.The findings,including publication trends,sample sizes,evidence-based typing,and outcome indicators,were summarized and analyzed using text and graphical formats.The quality of systematic evaluations was assessed using the AMSTAR scale.Results A total of 192 papers were included,comprising 185 clinical studies and 7 systematic evaluations.The overall publication trend was stable,with most clinical studies having sample sizes ranging from 50 to 100 cases.The commonly studied outcome indicators included blood pressure,clinical efficiency,and Traditional Chinese Medicine(TCM) evidence scores.Out of the seven included systematic evaluations,four were of moderate quality(4~7 points),and three were of high quality(8~11 points).Five systematic evaluations supported the clinical efficacy of acupuncture in the treatment of essential hypertension.Conclusions The majority of clinical studies and systematic evaluations indicate that acupuncture shows potential advantages in lowering blood pressure,increasing clinical efficiency,improving patients' TCM symptoms,and reducing adverse effects.However,there is a need for high-quality,multicenter,and large-sample clinical studies in the future.Additionally,improving the quality of Meta-analyses and systematic evaluations is necessary to provide high-level evidence for acupuncture in the treatment of essential hypertension.