Clinical Research Of Acupressure In Essential Hypertension Patients With Insomnia Of Heart-Kidney Disharmony Type

Objective To discuss the effects of4weeks acupressure to blood pressure,sleep quality and TCM symptoms in hypertension patients with insomnia of Heart-Kidney disharmony type,so as to provide clinical and theoretical basis for the treatment.Methods75objects were recruited according to the diagnosis and reception criterion.They were randomly divided into two groups,38in experimental group and the other37in control group.All objects received routine treatment and health education, while objects in experimental group receive acupressure treatment for4weeks,twice per day and20minutes everytime. We observed and recorded the blood pressure of all objects during the trail.The Sleep efficiency,the scores of PSQI and TCM symptoms were monitored before and after acupressure treatment as well as4weeks over the research.Results1.Baseline ComparisonThere was no significant difference in the general condition(age,sex and height,etc),basic clinical data(medical history,medication and complication,etc) and the major effect factors of sleep quality(siesta,drinking and anxiety,etc) between groups before intervention(P>0.05). There was no significant difference in SBP,DBP,pulse pressure,sleep efficiency,the scores of PSQI and TCM symptoms(P>0.05).There was also no significant difference in the kinds of antihypertensive agent,diuretics and hypnotic between groups during the trial(P>0.05). It showed that the two groups were comparable.2.Clinical EfficacyAfter4weeks of the intervention,the total effectiveness of experimental group was78.9%,higher than control group which was56.8%(P<0.05).And4weeks over the research,the total effectiveness of experimental group was65.8%,while control group was was54.1%(P>0.05).It proved that acupressure was effective to hypertension patients with insomnia of Heart-Kidney disharmony type,but the long-term efficacy was not found.3.Pinsburgh Sleep Quality Index(PSQI)A significant change in the global sum of PSQI in the two groups(P<0.01) was found after4weeks of the intervention and after4weeks over the research.And it was significant lower in experimental group.The global sum of PSQI in control group after4weeks over the research was significant lower than that after4weeks of the intervention(P<O.O5),but not the experimental group(P>0.05).Comparison within group:Significant changes in subjective sleep quality,the time of fall asleep,bedtime,sleep efficiency,hypnotic drug and daytime function in experimental group were found after4weeks of the intervention and after4weeks over the research(P<0.01).Significant changes in subjective sleep quality,bedtime and sleep efficiency in control group were found after4weeks of the intervention and after4weeks over the research(P<0.01).Comparison between groups:After4weeks of the intervention,subjective sleep quality,the time of fall asleep,bedtime and sleep efficiency in experimental group were significant better than that in control group(P<0.01/P<0.05).After4weeks over the research,the time of fall asleep and bedtime in experimental group were significant better than that in control group(P<0.01/P<0.05).4.Sleep EfficiencySleep efficiency was both significant higher in the two groups after4weeks of the intervention and after4weeks over the research compare with that before intervention(P<0.01).And a significant difference was found between the two groups after4weeks of the intervention(P<0.05).5.Blood PressureAfter4weeks of the intervention,both the SBP and DBP in experimental group has dropped(P<0.01),and there was a significant difference in SBP compare with control group(P <0.05).The SBP and DBP in two groups has dropped after4weeks over the research(P<0.01),but there was no significant difference between the two groups(P>0.05).6.TCM symptomsSignificant changes in upset and insomnia,feverish palms and soles,hectic fever,dry mouth and the global sum of TCM symptoms in the two groups were found after4weeks of the intervention and after4weeks over the research.Scores in upset and insomnia,feverish palms and soles.dizziness and tinnitus,palpitations.amnesia,hectic fever,dry mouth and the global sum of TCM symptoms in experimental group after4weeks of the intervention and after4weeks over the research were significant lower than that before intervention(P<0.01/P <0.05).Score in palpitations and the global sum of TCM symptoms in control group after4weeks of the intervention were significant lower than that before intervention(P<0.01).Scores in upset and insomnia,dizziness and tinnitus,palpitations,hectic fever and the global sum of TCM symptoms in control group after4weeks of the intervention and after4weeks over the research were significant lower than that before intervention(P<0.01).Conclusion1.Acupressure can not only effectively improve the sleep quality,prolong the bedtime and increase the sleep efficiency of hypertension patients with insomnia of Heart-Kidney disharmony type,but also has the long-term efficacy of prolonging bedtime.2.Acupressure help to decrease the SBP of hypertension patients with insomnia of Heart-Kidney disharmony type,and to maintain the stability of lowering blood pressure.Sleep is related to blood pressure,especially to the SBPImproving sleep quality can help to lower blood pressure.3.Acupressure can ameliorate the symptom of upset and insomnia,feverish palms and soles,hectic fever as well as dry mouth of hypertension patients with insomnia of Heart-Kidney disharmony type,and maintain the long-term efficacy.