A Network Meta Analysis Of Hypertension Treated By External Therapy Of Traditional Chinese Medicine

Objective: This study uses the method of network meta-analysis to compare the efficacy of different external treatment methods of traditional Chinese medicine in the treatment of hypertension,and according to the efficacy of the most likely intervention measures,to provide new ideas and evidence for the adjuvant treatment of hypertension.Methods: The research adopts the method of network meta-analysis.The literature retrieval includes electronic and manual retrieval.The methodological quality of included trials was evaluated according to Cochrane Handbook 5.1.0.Stata network software was used for frequency analysis.Results:Forty five RCTs were included.A total of 4044 patients with essential hypertension were included.It involves six kinds of external treatment of traditional Chinese medicine to assist the treatment of primary hypertension,which are auricular point sticking,auricular bleeding,acupoint sticking,acupuncture,foot bath with traditional Chinese medicine,moxibustion.(1)A total of 39 studies reported the antihypertensive effect,involving 14 interventions.Sucra ranked as follows: Moxibustion + auricular point +routine(85.9%)> moxibustion + auricular point(77.7%)> auricular point +acupuncture + routine(76.4%)> foot bath + routine(66.7%)> auricular point sticking + routine(59.9%)> acupoint sticking + auricular bleeding + routine(54.3%)> moxibustion + routine(52.1%)> acupuncture + routine(51.5%)>acupoint sticking + routine(46.1%)> foot bath + auricular point + routine(45.3%)9%)> auricular point + acupoint application + routine(34.9%)>auricular bleeding + routine(24.0%)> auricular point + auricular bleeding +routine(17.2%)> routine(7.5%).(2)A total of 12 studies reported the efficacy of TCM syndromes,involving 8 kinds of intervention measures.The order of Sucra was:bloodletting at ear tip + routine(98.1%)> moxibustion + auricular point +routine(85.5%)> moxibustion + routine(60.1%)> acupoint application +routine(48.3%)> auricular point sticking + routine(41.4%)> foot bath with Chinese medicine + auricular point + routine(38.1%)> acupuncture + routine(28.1%)> routine(0.4%).(3)A total of 33 studies reported diastolic blood pressure values,involving 13 interventions.The order of Sucra was: Foot Bath + routine(89.1%)> moxibustion + auricular point + routine(83.1%)> auricular point +acupoint application + routine(74.7%)> auricular point pressing + routine(63.4%)> auricular point + acupuncture + routine(62.5%)> moxibustion +routine(61.7%)> acupoint application + routine(49.3%)> acupuncture +routine(46.1%)> foot bath + auricular point + routine(43.1%)> acupoint application+auricular bleeding + Routine(34.8%)> auricular point +auricular apex bloodletting + routine(22.2%)> routine(20.0%)> auricular apex bloodletting + routine(0.0%).(4)A total of 33 studies reported systolic blood pressure values,involving13 interventions.The order of Sucra was moxibustion + auricular point +routine(95.2%)> auricular point sticking + routine(79.9%)> auricular point+ acupuncture + routine(76.6%)> foot bath + routine(68.9%)> acupoint sticking + routine(65.6%)> moxibustion + routine(48.5%)> auricular point+ acupoint sticking + routine(46.7%)> acupuncture + routine(45.4%)> foot bath + auricular point + routine(36.4%)> auricular point + auricular point bleeding + routine 9%)> acupoint application + ear tip bloodletting + routine(30.9%)> routine(20.9%)> ear tip bloodletting + routine(0.0%).Conclusion:1.This study concluded that in the treatment of hypertension after antihypertensive efficacy,TCM syndrome efficacy,diastolic blood pressure value,systolic blood pressure value,TCM external treatment intervention measures show certain advantages.2.SUCRA sequence showed that moxibustion + auricular point + routine,auricular bleeding + routine,foot bath with traditional Chinese medicine +routine,moxibustion + auricular point + routine could be a better choice for clinical treatment of hypertension in terms of antihypertensive efficacy,TCM syndrome efficacy,diastolic blood pressure and systolic blood pressure.