Study On Acupuncture Treatment Based On Source-point And The Collateral-point For Hyperactivity Of The Liver Yang In Essential Hypertension

Objective1.To make a systematic review for acupuncture treatment of essential hypertension, and to look for evidence-based acupuncture lowering blood pressure.2. To evaluate the clinical effect of acupuncturing on the liver meridian source-point and the collateral point for hyperactivity of the Liver yang in essential hypertension, and the impact on quality of life.Methods1. Systematic reviewRCT studies of acupuncture treatment of essential hypertension were searched in MEDLINE、EMBASE、Cochrane library、CNKI、VIP、CBM. Review Manager5.1software was used for data analysis. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards.2.Clinical researchPatiens who met inclusion criteria were screened from outpatients of Guangdong provincial hospital of Traditional Chinese Medicine from January2012to October2013.According to the software PEMS3.1generate random numbers, patients were divided into an acupuncture group and western medicine group. Random cards contained sequence numbers were added into the opaque sealed envelopes. Eligible patients entered the study, according to the information on the card which was opened by the specific priorities order.Therapeutic method:Acupuncture group received the antihypertensive medicine therapy combined acupuncture therapy. Western medicine group only received drug treatment programs. Acupuncture location:Taichong (LR03)、 Guangming (GB37). Needled for20minutes, when got the "qi" sensation. Treatment course:treatment received every other day, for3times a week,12times as a course.Effect evaluation:Selected diastolic and mean arterial systolic pressure as the main evaluation index, condensed quality of life scale (SF-36), antihypertensive medication use as a secondary evaluation. Average systolic diastolic blood pressure and SF-36were measured at five points:prior to treatment, after six acupuncture treatments, the end of acupuncture treatment,1month and3months follow-up. Instant changes in blood pressure of acupuncture were observed at5points:before acupuncture, the needling moment,10minutes after the needle,20minutes after the needle,10minutes after the treatment.Data management and statistical analysis:EpiData software to build a database application SPSS18.0software package for statistical analysis, count data using chi-square test, measurement data using t test. All statistical tests were performed using two-sided test, P≤0.05will be considered statistically significant difference.Result1. Systematic review38randomized trials were included,34were conducted in china which published in chiese,4were conducted in china published in English. All studies were single-center trials. The methodological quality of the included trials was evaluated as generally low except4foreign trials. A total of2958patients participated in research. The number of patients in each group included in the study from12to127cases.12trials reported the effect of acupuncture compared with western medicine. SBP:MD=-1.51,95%C (-3.69,-0.68)(P0.05); DBP:MD=-1.15,95%CI (-2.12,-0.18)(P<0.05)5trials reported the effect of acupuncture plus western medicine compared with western medicine. SBP:MD=-11.24,95%CI (-15.54,-6.94)(P<0.01); DBP:MD=-5.39,95%CI (-9.84,-0.94)(P<0.05)2trials reported the effect of acupuncture compared with sham acupuncture. SBP:MD=1.70,95%CI (-1.26,4.65)(P>0.05); DBP:MD=-0.38,95%CI (-2.69,1.92)(P>0.05). 2trials reported the effect of acupuncture compared with sham acupuncture plus western medicine. SBP:MD=-7.47,95%CI (-10.43,-4.51)(P<0.05); DBP: MD=-4.42,95%CI (-6.26,-2.18)(P<0.01)2.Clinical researchWhen accepted the1st acupuncture treatment, SBP of10minutes after the needle,20minutes after the needle,10minutes after the treatment had significant difference comparing before treatment (P<0.05). DBP of20minutes after the needle,10minutes after the treatment had significant difference comparing before treatment (P<0.05)The SBP of both groups after six acupuncture treatments, the end of acupuncture treatment,1month and3months follow-up had significant difference comparing before treatment (P<0.05)There are statistically significant differences in SBP for two groups at the end of acupuncture treatment,1month and3months follow-up(P<0.05). There are not statistically significant differences in SBP for two groups after6times treatment (P>0.05).The DBP of both groups after six acupuncture treatments, the end of acupuncture treatment,1month and3months follow-up had significant difference comparing before treatment (P<0.05)There are statistically significant differences in DBP for two groups all4time points(P<0.05).There are statistically significant differences in blood pressure pass rate after six acupuncture treatments, the end of acupuncture treatment(P <0.05). There are not statistically significant differences in blood pressure pass rate at1month and3months follow-up (P>0.05).There are statistically significant differences in Drug use situation for two groups at1month and3months follow-up (P<0.05).Conelusion1. While there are some evidences that suggest slightly determinel effectiveness of acupuncture for lowering blood, the results were limited by the methodological flaws of the studies. But acupuncture was still as a safe alternative therapy for clinical application.2-. Acupuncture for lowering blood pressure has immediate, short-term and long-term effects, and improve the quality of life of patients. Acupuncture can help to achieve blood pressure control goals and reduce drug association situation.