| ObjectiveTo observe the clinical efficacy and safety of acupressure with Tianma and Hooked Vine Drink in the treatment of medium-and low-risk hypertensive patients with hyperactivity of liver yang,and the effects on plasma renin(PRA),angiotensin II(Ang II)and aldosterone(ALD)levels,in order to provide a basis for the clinical prevention and treatment of hypertension with acupressure.MethodsA randomized controlled trial was used to screen 88 patients with intermediate and low-risk hypertension of the hyperactive liver Yang type who met the inclusion criteria from the population attending the physical examination department of the Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine from 02/2022 to 04/2023 into a test group and a control group using the randomized number table method,with 44 cases in each group.The control group was given primary hypertension lifestyle intervention,and the experimental group was given Tianma Hooked Vine Drink acupuncture point patch on five acupoints of Shen Que,Yong Quan(bilateral)and Tai Chong acupoints(bilateral)on the basis of the control group,with 4 weeks of intervention and 4 weeks of follow-up.The changes in blood pressure,TCM syndrome score,Chinese Cardiovascular Quality of Life Assessment Questionnaire(CQQC),and PRA,Ang Ⅱ,and ALD indexes were observed before,after,and 4 weeks after the end of the trial in both groups.The data were analyzed statistically using SPSS 24.0 analysis software.Results1 Case completion statusA total of 88 subjects were included,and there were 4 cases of shedding,and a total of84 cases were finally completed as required,including 42 cases in the test group and 42 cases in the control group,with a test completion rate of 95.45% and a shedding rate of4.55%.2 General informationBefore treatment,gender,age,disease duration,cardiovascular risk level stratification,blood pressure,TCM evidence score,CQQC and plasma PRA,Ang Ⅱ,ALD indexes of the test and control groups were analyzed medically and statistically,and the results were not statistically different(P>0.05),indicating that the general data of the subjects in the two groups were balanced and comparable.3 Comparison of blood pressure3.1 Efficacy: After the intervention of this study,there were 16 cases of significant effect,21 cases of effective effect and 5 cases of invalid effect in the test group,with a total effective rate of 88.10%,while 12 cases of significant effect,14 cases of effective effect and16 cases of invalid effect in the control group,with a total effective rate of 61.90%.The difference between the two groups was statistically significant(P<0.05).3.2 Pre-test vs.post-test: intra-group comparison: systolic and diastolic blood pressure in the test group were significantly lower(P<0.01);systolic and diastolic blood pressure in the control group were lower than before(P<0.05).Between-group comparison: systolic blood pressure was statistically different between the two groups after the test(P<0.01);diastolic blood pressure was statistically different between the two groups(P<0.05).Comparison of systolic blood pressure difference between the two groups after the test(P<0.01);comparison of diastolic blood pressure difference between the two groups after the test: P < 0.05.3.3 Before the test vs.4 weeks after the end of the test: intra-group comparison:systolic and diastolic blood pressure in the test group were significantly lower(P<0.01);systolic and diastolic blood pressure in the control group were lower than before(P<0.05).Comparison between groups: There was no statistical difference in systolic and diastolic blood pressure between the two groups 4 weeks after the end of the trial(P>0.05).4 Chinese medicine evidence score4.1 Efficacy: After the intervention of this study,there were 4 cases with significant effect,32 cases with effective effect,and 6 cases with invalid effect,and the total effective rate was 85.71% in the test group,while there were 0 cases with significant effect,24 cases with effective effect,and 16 cases with invalid effect in the control group,and the total effective rate was 61.90%.The difference between the two groups was statistically significant(P<0.05).4.2 Pre-test vs.post-test: within-group comparison: headache,red face,bitter mouth and total score were significantly lower in the test group(P<0.01),and dizziness,irritability and dry mouth were lower than before(P<0.05).In the control group,the total score was lower than before(P<0.05).Comparison between groups: The TCM evidence points of patients in the two groups were statistically different after the trial(P>0.01).4.3 Before the test vs.4 weeks after the end of the test: the total score of the test group was significantly lower(P<0.01),and the mouth bitterness was lower(P<0.05)than before.In the control group,the total score was lower than before(P<0.05).5 Quality of life assessment questionnaire for Chinese cardiovascular patients5.1 Pre-test vs.post-test: intra-group comparison: the quality of life score was significantly higher in the test group(P<0.01);the quality of life score was higher in the control group(P<0.05).Between-group comparison: there was no statistical difference between the quality of life scores of the two groups after the trial(P>0.05).5.2 Pre-test vs.4 weeks after the end of the trial: the quality of life score in the test group was higher than before(P<0.05).Comparison between groups: There was no statistical difference between the quality of life scores of patients in the two groups after 4weeks at the end of the trial(P>0.05).6 Plasma PRA,Ang Ⅱ,and ALD levels of patients in both groupsAfter the trial,PRA,Ang Ⅱ,and ALD were significantly lower in the test group(P<0.01);PRA,Ang Ⅱ,and ALD were lower in the control group than before(P<0.05).Comparison between groups: There was a statistical difference in PRA,Ang Ⅱ and ALD between the two groups after the trial(P<0.01).7 Judgment of safety and efficacyThe blood routine,liver function,kidney function and skin reaction of each subject before and after the intervention of 84 subjects who completed the whole trial process,no abnormalities were found in the safety indexes before and after the comparison,and no adverse events occurred.Conclusion1.TIANMA XIE TANGO DRINK acupressure can effectively lower blood pressure in patients with intermediate and low risk essential hypertension with hyperactivity of liver yang,and the efficacy of lowering systolic blood pressure is more prominent.2.Acupuncture point compressing with Tianma hook and vine can improve the clinical symptoms of dizziness,headache,irritability,redness,bitterness and dryness of the mouth and improve the quality of life in patients with intermediate and low-risk essential hypertension with hyperactivity of liver yang.3.Acupressure may lower blood pressure by lowering PRA,Ang II and ALD levels and inhibiting RAAS overactivation.4.Acupoint compresses are simple and safe for clinical use in the treatment of essential hypertension. |
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