He Aixin, Zhao Lihua, Zou Zhuocheng, Huang Yu, Huang Dingjian
Graduate School of Guangxi University of CM, Nanning 530001, China.
Department of Acupuncture and Moxibustion, Renai Branch of First Affiliated Hospital of Guangxi University of CM, Nanning 530000.
Zhongguo Zhen Jiu. 2025 Aug 12;45(8):1083-1091. doi: 10.13703/j.0255-2930.20240610-k0002. Epub 2025 May 6.
To observe the effects of moxibustion (moxibustion for benefiting the marrow and nourishing the heart) in sequential trial on blood pressure (BP), perimenopausal symptoms, cardiovascular function and heart rate variability (HRV) in prehypertension in perimenopausal women.
The eligible female patients of prehypertension of perimenopausal period were collected according to the inclusion criteria. Based on the requirements of open two-way qualitative response sequential trial, the sample size was not set in advance, and the matched pair design was used for random division into a moxibustion group and a health education group. The patients of the two groups were treated in pairs, and the analysis was immediately performed after the end of treatment for each pair, and the sequential trial analysis (STA) was diagrammed. The health education group provided the health education for prehypertension to the patients according to . In the moxibustion group, beside the health education for prehypertension, the non-suppurative moxibustion was delivered at Baihui (GV20), Guanyuan (CV4) and bilateral Neiguan (PC6) and Zusanli (ST36), once every two days, 3 treatments per week and for 4 consecutive weeks. Before treatment, in 2 and 4 weeks of treatment, as well as in 1-month follow-up after treatment, BP was measured in each group, separately. Before treatment and in 4 weeks of treatment, the observation was performed in the score of the modified Kupperman scale, and Pittsburgh sleep quality index (PSQI) score, the indexes of cardiovascular function (stroke volume [SV], cardiac output per minute [CO], stroke index [SI], cardiac index [CI], left ventricular effective pumping force [VPE], left ventricular energy efficiency [EWK], arterial compliance [AC], left ventricular ejection resistance [VER], blood viscosity (N), and microcirculation half update rate [MHR]), and heart rate variability (HRV) indexes (low frequency [LF], high frequency [HF], LF/HF, standard deviation of NN interval [SDNN], root mean square of successive differences in adjacent NN intervals [RMSSD]).
Based on sequential test line, when the trial was performed to the 17th pair, and the test line touched the upper limit , meaning the results of the moxibustion group was superior to the health education group, thus, the trial stopped immediately. In 2 and 4 weeks of treatment and in follow-up, the systolic blood pressure (SBP) and diastolic blood pressure (DBP) were lower when compared with those before treatment in the moxibustion group (<0.05); SBP at each time point and DBP in 2 and 4 weeks of treatment in the moxibustion group were lower than those of the health education group (<0.05). After treatment, the score of the modified Kupperman scale was reduced when compared with that before treatment in the moxibustion group (<0.05). The score of the modified Kupperman scale and PSQI in the moxibustion group were lower than those of the health education group after treatment (<0.05). After treatment, SV, CO, SI, CI and EWK were increased in comparison with the indexes before treatment in the moxibustion group (<0.05), and VER and N were dropped (<0.05). After treatment, SV, CO, SI, CI and EWK in the moxibustion group were higher than those of the health education group (<0.05), and VER and N were lower (<0.05). After treatment, in the moxibustion group, LF, HF, SDNN and RMSSD were increased in comparison with those before treatment (<0.05), and LF/HF was declined (<0.05). In the health education group, after treatment, LF, HF, SDNN and RMSSD decreased when compared with those before treatment (<0.05). After treatment, LF, HF, SDNN and RMSSD in the moxibustion group were higher than those of the health education group (<0.05), and LF/HF was lower (<0.05). The total effective rate was 94.1% (16/17) in the moxibustion group, higher than that (41.2%, 7/17) in the health education group (<0.05).
Moxibustion can reduce SBP and DBP in prehypertension of perimenopausal women, alleviate perimenopausal symptoms, improve cardiac function and adjust the overall balance of cardiac autonomic nerves.
观察序贯试验中艾灸(益髓养心灸)对围绝经期女性高血压前期患者血压、围绝经期症状、心血管功能及心率变异性(HRV)的影响。
按照纳入标准收集符合条件的围绝经期高血压前期女性患者。根据开放式双向定性反应序贯试验的要求,不预先设定样本量,采用配对设计随机分为艾灸组和健康教育组。两组患者配对治疗,每对治疗结束后立即进行分析,并绘制序贯试验分析图。健康教育组根据……为患者提供高血压相关健康教育。艾灸组在高血压相关健康教育基础上,于百会(GV20)、关元(CV4)及双侧内关(PC6)、足三里(ST36)进行非化脓性艾灸,每两天1次,每周3次,连续4周。治疗前、治疗2周和4周以及治疗后1个月随访时,分别测量每组患者的血压。治疗前和治疗4周时,观察改良Kupperman量表评分、匹兹堡睡眠质量指数(PSQI)评分、心血管功能指标(每搏输出量[SV]、每分钟心输出量[CO]、每搏指数[SI]、心脏指数[CI]、左心室有效泵力[VPE]、左心室能量效率[EWK]、动脉顺应性[AC]、左心室射血阻力[VER]、血液黏度[N]和微循环半更新率[MHR])以及心率变异性(HRV)指标(低频[LF]、高频[HF]、LF/HF、NN间期标准差[SDNN]、相邻NN间期逐差的均方根[RMSSD])。
根据序贯试验线,试验进行到第17对时,试验线触及上限……,表明艾灸组结果优于健康教育组,试验立即停止。治疗2周和4周以及随访时,艾灸组收缩压(SBP)和舒张压(DBP)较治疗前降低(<0.05);艾灸组各时间点SBP及治疗2周和4周时的DBP低于健康教育组(<0.05)。治疗后,艾灸组改良Kupperman量表评分较治疗前降低(<0.05)。治疗后,艾灸组改良Kupperman量表评分和PSQI低于健康教育组(<0.05)。治疗后,艾灸组SV、CO、SI、CI和EWK较治疗前升高(<0.05),VER和N降低(<0.05)。治疗后,艾灸组SV、CO、SI、CI和EWK高于健康教育组(<0.05),VER和N低于健康教育组(<0.05)。治疗后,艾灸组LF、HF、SDNN和RMSSD较治疗前升高(<0.05),LF/HF降低(<0.05)。健康教育组治疗后LF、HF、SDNN和RMSSD较治疗前降低(<0.05)。治疗后,艾灸组LF、HF、SDNN和RMSSD高于健康教育组(<0.05),LF/HF低于健康教育组(<0.05)。艾灸组总有效率为94.1%(16/17),高于健康教育组的41.2%(7/17)(<0.05)。
艾灸可降低围绝经期女性高血压前期患者的SBP和DBP,缓解围绝经期症状,改善心脏功能,调节心脏自主神经的整体平衡。