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穴位敷贴疗法治疗原发性高血压:一项系统评价与Meta分析

Acupoint application therapies for essential hypertension: a systematic review and Meta-analysis.

作者信息

Wei Liu, Xingjiang Xiong, Lumin Qiao, Yuyi Chen, Yixuan L I, Xing S U, Fuyong Chu, Hongxu Liu

机构信息

Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China.

Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.

出版信息

J Tradit Chin Med. 2022 Apr;42(2):159-166. doi: 10.19852/j.cnki.jtcm.2022.02.001.

Abstract

OBJECTIVE

To evaluate the efficacy and safety of acupoint application therapies (AA) for hypertension.

METHODS

We searched PubMed, EMBASE, the Cochrane Center Controlled Trials Register, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, and Wanfang Med Online Database from their inceptions to October 7, 2019. No language restriction was applied. We included randomized clinical trials testing AA against Western Medicine, AA versus placebo, AA combined with Western Medicine versus Western Medicine. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards.

RESULTS

Totally 41 trials with 3772 participants were included. The methodological quality of the included trials was evaluated as generally low. AA plus Western Medicine significantly lowered systolic blood pressure (BP) [weighted mean difference (): -10.36, 95% confidence intervals (): -12.62, -8.10; 0.000 01], diastolic BP (: -5.71, 95% : -7.30, -4.13; 0.000 01), and total effect [risk ratio (): 1.23, 95% : 1.15, 1.32; 0.000 01]. The BP-lowering effect of AA was significantly higher than that of placebo [systolic BP (SBP): -8.05, 95% : -8.67, -7.43; 0.000 01; diastolic BP (DBP): -6.66, 95% : -7.31, -6.01, 0.000 01]. The total effect also improved significantly from baseline with AA than placebo (: 10.85, 95% : 4.71, 24.98; 0.000 01). Traditional Chinese Medicine symptoms score were significantly reduced by AA compared with Western Medicine (: -1.75, 95% : -2.52, -0.99; 0.000 01), 10 trials reported adverse events, indicating that the safety of SSYX Capsule is still uncertain.

CONCLUSIONS

Application therapies may be considered a safe and beneficial for the treatment of hypertension and can reduce BP and improve the total effect. Further well-designed trials are needed to support our conclusions.

摘要

目的

评估穴位敷贴疗法治疗高血压的疗效与安全性。

方法

检索了PubMed、EMBASE、Cochrane中心对照试验注册库、中国知网、维普中文科技期刊数据库及万方医学网数据库,检索时间从建库至2019年10月7日。不限语言。纳入比较穴位敷贴疗法与西药、穴位敷贴疗法与安慰剂、穴位敷贴疗法联合西药与西药的随机临床试验。按照Cochrane标准进行研究筛选、数据提取、质量评估及数据分析。

结果

共纳入41项试验,3772名参与者。纳入试验的方法学质量总体较低。穴位敷贴疗法联合西药显著降低收缩压[加权均数差(WMD):-10.36,95%置信区间(CI):-12.62,-8.10;P<0.00001]、舒张压(WMD:-5.71,95%CI:-7.30,-4.13;P<0.00001)及总效应[风险比(RR):1.23,95%CI:1.15,1.32;P<0.00001]。穴位敷贴疗法的降压效果显著高于安慰剂[收缩压(SBP):-8.05,95%CI:-8.67,-7.43;P<0.00001;舒张压(DBP):-6.66,95%CI:-7.31,-6.01;P<0.00001]。与安慰剂相比,穴位敷贴疗法的总效应从基线也有显著改善(RR:10.85,95%CI:4.71,24.98;P<0.00001)。与西药相比,穴位敷贴疗法显著降低中医症状评分(WMD:-1.75,95%CI:-2.52,-0.99;P<0.00001),10项试验报告了不良事件,表明松龄血脉康胶囊的安全性仍不确定。

结论

穴位敷贴疗法治疗高血压可能是安全有益的,可降低血压并改善总效应。需要进一步设计良好的试验来支持我们的结论。

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