Xiong X J, Li S J, Zhang Y Q
Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Department of Biological Science and Technology, School of Life Sciences, Tsinghua University, Beijing, China.
J Hum Hypertens. 2015 Mar;29(3):143-51. doi: 10.1038/jhh.2014.52. Epub 2014 Jul 3.
Massage, an ancient Chinese healing art, is widely practiced for symptom relief in hypertensive patients with anxiety, depression, headache, vertigo, chronic pain in neck, shoulder and back. A large number of case series and clinical trials have been published. However, it is still unclear whether massage can be recommended as an effective therapy for essential hypertension (EH). We estimated the current clinical evidence of massage for EH. Articles published before 10 December 2013 were searched using Cochrane Library, PubMed, EMBASE, Chinese Scientific Journal Database (VIP), Chinese Biomedical Literature Database, Wanfang data and Chinese National Knowledge Infrastructure. Randomized controlled trials comparing massage with any type of control intervention were included. Trials testing massage combined with antihypertensive drugs versus antihypertensive drugs were included as well. Meta-analysis was performed on the effects on blood pressure (BP). Twenty-four articles involving 1962 patients with EH were selected. Methodological quality of most trials was evaluated as generally low. Meta-analyses demonstrated that massage combined with antihypertensive drugs may be more effective than antihypertensive drugs alone in lowering both systolic BP (SBP; mean difference (MD): -6.92 (-10.05, -3.80); P<0.0001) and diastolic BP (MD: -3.63 (-6.18, -1.09); P=0.005); massage appears beneficial for reducing SBP (MD: -3.47 (-5.39, -1.56); P=0.0004) for hypertensive patients as compared with antihypertensive drugs. Safety of massage is still unclear. There is some encouraging evidence of massage for EH. However, because of poor methodological quality, the evidence remains weak. Rigorously designed trials are needed to validate the use of massage in future.
按摩作为一种古老的中医疗法，在患有焦虑、抑郁、头痛、眩晕以及颈肩背部慢性疼痛的高血压患者中被广泛应用于缓解症状。大量的病例系列和临床试验已经发表。然而，按摩是否可被推荐作为原发性高血压（EH）的有效治疗方法仍不明确。我们评估了目前关于按摩治疗EH的临床证据。使用Cochrane图书馆、PubMed、EMBASE、中国科学期刊数据库（维普）、中国生物医学文献数据库、万方数据和中国知网检索了2013年12月10日前发表的文章。纳入了比较按摩与任何类型对照干预的随机对照试验。也纳入了测试按摩联合降压药与降压药对比的试验。对血压（BP）的影响进行了荟萃分析。选择了24篇涉及1962例EH患者的文章。大多数试验的方法学质量评估为普遍较低。荟萃分析表明，按摩联合降压药在降低收缩压（SBP；平均差（MD）：-6.92（-10.05，-3.80）；P<0.0001）和舒张压（MD：-3.63（-6.18，-1.09）；P=0.005）方面可能比单独使用降压药更有效；与降压药相比，按摩似乎对降低高血压患者的SBP有益（MD：-3.47（-5.39，-1.56）；P=0.0004）。按摩的安全性仍不明确。有一些关于按摩治疗EH的令人鼓舞的证据。然而，由于方法学质量较差，证据仍然薄弱。未来需要严格设计的试验来验证按摩的应用。
