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针刺治疗轻度高血压患者的随机对照试验。

Acupuncture for patients with mild hypertension: A randomized controlled trial.

机构信息

Acupuncture and Tuina School/3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

出版信息

J Clin Hypertens (Greenwich). 2019 Mar;21(3):412-420. doi: 10.1111/jch.13490. Epub 2019 Feb 8.

Abstract

Acupuncture may be beneficial for patients with mild hypertension, but the evidence is not convincing. We aimed to examine the effect of acupuncture on blood pressure (BP) reduction in patients with mild hypertension. We conducted a multicenter, single-blind, sham-controlled, randomized trial in eleven hospitals in China. The trial included 428 patients with systolic blood pressure (SBP) from 140 to 159 mm Hg and/or with diastolic blood pressure (DBP) from 90 to 99 mm Hg. The patients were randomly assigned to receive 18 sessions of affected meridian acupuncture (n = 107) or non-affected meridian acupuncture (n = 107) or sham acupuncture (n = 107) during 6 weeks, or to stay in a waiting-list control (n = 107). All patients received 24-hour ambulatory blood pressure monitoring at weeks 6, 9, and 12. We included 415 participants in the intention-to-treat analysis. The two acupuncture groups were pooled in the analysis, since they had no difference in all outcomes. SBP decreased at week 6 in acupuncture group vs sham acupuncture vs waiting-list group (7.2 ± 11.0 mm Hg vs 4.1 ± 11.5 mm Hg vs 4.1 ± 13.2 mm Hg); acupuncture was not superior to sham acupuncture (mean difference 2.7 mm Hg, 95% CI 0.4 to 5.9, adjusted P = 0.103) or waiting-list control (2.9 mm Hg, 95% CI -0.2 to 6.0, adjusted P = 0.078). However, acupuncture was superior to sham acupuncture (3.3 mm Hg, 95% CI 0.2 to 6.3, adjusted P = 0.035) and waiting-list control (4.8 mm Hg, 95% CI 1.8 to 7.8, P < 0.001) at week 9. Acupuncture had a small effect size on the reduction of BP in patients with mild hypertension.

摘要

针刺可能对轻度高血压患者有益,但证据并不令人信服。我们旨在研究针刺对轻度高血压患者血压降低的影响。我们在中国的 11 家医院进行了一项多中心、单盲、假对照、随机试验。该试验纳入了收缩压(SBP)为 140 至 159 mmHg 且/或舒张压(DBP)为 90 至 99 mmHg 的 428 例患者。患者被随机分配接受 18 次受累经脉针刺(n=107)、非受累经脉针刺(n=107)或假针刺(n=107),或在 6 周内等待名单对照(n=107)。所有患者在第 6、9 和 12 周接受 24 小时动态血压监测。我们对意向治疗进行了 415 名参与者的分析。由于两组针刺在所有结局上均无差异,因此将它们合并进行分析。与假针刺相比,针刺组的 SBP 在第 6 周时降低(7.2±11.0 mmHg 比 4.1±11.5 mmHg 比 4.1±13.2 mmHg);针刺不比假针刺(平均差异 2.7 mmHg,95%CI 0.4 至 5.9,调整 P=0.103)或等待名单对照(2.9 mmHg,95%CI-0.2 至 6.0,调整 P=0.078)更优。然而,针刺在第 9 周时优于假针刺(3.3 mmHg,95%CI 0.2 至 6.3,调整 P=0.035)和等待名单对照(4.8 mmHg,95%CI 1.8 至 7.8,P<0.001)。针刺对轻度高血压患者血压降低的影响较小。

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