摘要
目的:系统评价针灸治疗颈源性高血压(Cervical High Blood Pressure,CHBP)的临床疗效。方法:检索中国期刊全文数据库、万方数据库、维普科技期刊数据库、中国生物医学文献数据库(Sino Med)及Pub Med、Embase、Cochrane Library、Web of Science和临床试验注册中心收录的针灸治疗CHBP的随机对照试验,检索时间为自建库起到2023年6月30日。采用Rev Man5.4软件评价纳入文献的研究质量,绘制偏倚风险图;采用STATA17软件进行数据合并,绘制森林图和漏斗图。结果:共纳入11篇文献,涉及656例患者。Meta分析结果显示:(1)相较于降压药,针灸降压疗效[相对危险度(RR)=1.11,95%置信区间(CI):1.03~1.19,Z=2.794,P=0.005]更加突出;(2)针灸在降低患者收缩压[均数差(MD=–13.27,95%CI:–20.49~–6.06,Z=–3.606,P <0.001)]和舒张压(MD=–7.06,95%CI:–10.36~–3.75,Z=–4.188,P <0.0001)方面优于降压药;(3)针灸在3个月后的总有效率(RR=1.43,95%CI:1.14~1.79,Z=3.137,P=0.002)高于降压药;(4)针灸在改善颈椎功能(MD=–4.96,95%CI:–6.51~–3.40,Z=–6.241,P <0.0001)上比降压药更具优势;(5)针药联合在降低患者收缩压(MD=–6.44,95%CI:–12.59~–0.29,Z=–2.051,P=0.04)和舒张压(MD=–5.27,95%CI:–7.30~–3.25,Z=–5.104,P <0.001)方面优于降压药。结论:基于现有文献,针灸或针药联合治疗CHBP的疗效优于降压药,因此呼吁临床工作者重视血压升高的颈性原因和针灸在降压治疗中的应用。
Objective:To systematically evaluate the clinical efficacy of acupuncture and moxibustion in the treatment of cervical Ohigh blood pressure.Methods:The randomized controlled trials of acupuncture and moxibustion for cervical high blood pressure included in China National Knowledge Infrastructure(CNKI),Wanfang Database(Wanfang),VIP Database,SinoMed Database,PubMed,Embase,Cochrane Library,Web of Science,and Home-ClinicalTrials.gov were retrieved from the establishment of database to June 30,2023.RevMan 5.4 software was used to evaluate the research quality of the included literature and draw the bias risk assessment plot;STATA 17 software was used to merge data and draw forest plots and funnel plots.Results:A total of 11 articles were included,involving 656 patients.The results of Meta-analysis showed that:①Compared with antihypertensive drugs,the antihypertensive effect of acupuncture and moxibustion was more prominent(RR=1.11,95%CI:1.03-–1.19,Z=2.794,P=0.005);②Acupuncture was superior to antihypertensive drugs in reducing systolic blood pressure(MD=–13.27,95%CI:–20.49-–6.06,Z=–3.606,P<0.001)and diastolic blood pressure(MD=–7.06,95%CI:–10.36-–3.75,Z=–4.188,P<0.0001);③The total effective rate of acupuncture and moxibustion treatment after 3 months(RR=1.43,95%CI:1.14-–1.79,Z=3.137,P=0.002)was higher than that of antihypertensive drugs;④Acupuncture and moxibustion was superior to antihypertensive drugs in improving cervical spine function(MD=–4.96,95%CI:–6.51-–3.40,Z=–6.241,P<0.0001);⑤The combination of acupuncture and drug was superior to antihypertensive drugs in reducing systolic blood pressure(MD=–6.44,95%CI:–12.59-–0.29,Z=–2.051,P=0.04)and diastolic blood pressure(MD=–5.27,95%CI:–7.30-–3.25,Z=–5.104,P<0.001)in patients.Conclusion:Based on the existing literature,the efficacy of acupuncture or combination of acupuncture and antihypertensive medicine is better than that of antihypertensive drugs in the treatment of cervical high blood pressure,so clinicians should pay attention to the cervical causes of elevated blood pressure and the application of acupuncture and moxibustion in antihypertensive treatment.
作者
郝楠
罗泳茵
单晓倩
常军
宋京京
赵岚
HAO Nan;LUO Yongyin;SHAN Xiaoqian;CHANG Jun;SONG Jingjing;ZHAO Lan
出处
《中医临床研究》
2025年第3期68-74,共7页
Clinical Journal Of Chinese Medicine
基金
天津市教委科研计划项目(2021KJ142)
天津中医药大学第一附属医院“拓新工程”基金科研课题(院2020041)。
关键词
针灸
颈源性高血压
降压药
随机对照试验
META分析
Acupuncture
Cervical high blood presure
Antihypertensive drugs
Randomized controlled trial
Meta-analysis
