Khapre Meenakshi, Dhanlika Dhanlika, Mohanty Sriloy, Mehndiratta Amrita
Additional Professor, Department of Community and Family Medicine, AIIMS, Rishikesh, Uttarakhand, India.
J Educ Health Promot. 2025 Jan 31;14:28. doi: 10.4103/jehp.jehp_464_24. eCollection 2025.
Essential hypertension, a common multifactorial condition, is a significant public health concern. In India, the prevalence of hypertension is high, with estimates indicating a rising trend. Shirodhara, an Ayurvedic therapy, has exhibited the potential for stress reduction and relaxation. Thus, the review investigates the effect of Shirodhara on systolic and diastolic blood pressure and its impact on clinical symptoms like palpitation, insomnia, giddiness, fatigue, and headache in essential hypertensive patients. We searched PubMed, Embase, Scopus, Google Scholar, and Shodhganga, Web of Science search for this systematic review and meta-analysis from inception to June 2023. Evidence from RCTs was synthesized as a standardized mean difference (SMDs) for systolic and diastolic blood pressure, comparing participants who received Shirodhara intervention along with Ayurveda medication and those who received only Ayurveda medication. The Revised Cochrane Risk of Bias tool for randomized control trials (RoB-2) was used for the quality assessment of randomized control trials. Analysis was done using Medcalc software. The comparison table is provided for the percentage of relief in clinical symptoms in both groups. Out of four RCTs, only three were included for quantitative analysis, which mentioned the mean and standard deviation of systolic and diastolic blood pressure. Meta-analyses revealed the effects of Shirodhara on systolic blood pressure ( = 100), the mean difference (MD) was - 1.257 mmHg, (2.660-0.145), = 89.3%, and diastolic blood pressure ( = 100) MD was - 0.40 mmHg, (-0.79-0.01) = 0. The percentage of relief in clinical symptoms was notably higher in the Shirodhara and Ayurveda groups than in the Ayurvedic drug group. Shirodhara lowered diastolic blood pressure significantly, but it has low clinical value. Shirodhara's effect on systolic blood pressure remained unclear. Relief in clinical symptom score was notable. Larger, well-designed research is needed to prove Shirodhara's effectiveness in hypertension management and optimize therapy methods.
原发性高血压是一种常见的多因素疾病，是一个重大的公共卫生问题。在印度，高血压患病率很高，且估计呈上升趋势。希罗达拉疗法是一种阿育吠陀疗法，已显示出减轻压力和放松身心的潜力。因此，本综述调查了希罗达拉疗法对原发性高血压患者收缩压和舒张压的影响及其对心悸、失眠、头晕、疲劳和头痛等临床症状的影响。我们检索了PubMed、Embase、Scopus、谷歌学术以及Shodhganga、科学网，对从创刊到2023年6月的相关文献进行了系统综述和荟萃分析。将随机对照试验的证据合成为收缩压和舒张压的标准化均数差（SMD），比较接受希罗达拉干预加阿育吠陀药物治疗的参与者与仅接受阿育吠陀药物治疗的参与者。采用修订版Cochrane随机对照试验偏倚风险工具（RoB - 2）对随机对照试验进行质量评估。使用Medcalc软件进行分析。提供了两组临床症状缓解百分比的比较表。在四项随机对照试验中，只有三项纳入定量分析，其中提到了收缩压和舒张压的均值和标准差。荟萃分析显示希罗达拉疗法对收缩压（n = 100）的影响，平均差（MD）为 - 1.257 mmHg，（ - 2.660 - 0.145），I² = 89.3%；对舒张压（n = 100）的影响，MD为 - 0.40 mmHg，（ - 0.79 - 0.01），I² = 0。希罗达拉和阿育吠陀药物组临床症状缓解的百分比明显高于阿育吠陀药物组。希罗达拉疗法能显著降低舒张压，但临床价值较低。希罗达拉疗法对收缩压的影响尚不清楚。临床症状评分的缓解较为显著。需要开展更大规模、设计良好的研究来证明希罗达拉疗法在高血压管理中的有效性并优化治疗方法。
