A Randomized Controlled Trial Of Meridian-based Acupuncture For Mild Essential Hypertension

Objectives:This research aims to evaluate the clinical efficacy of acupuncture at the acupoints along the meridian for patients with grade 1 hypertension.We hope the findings will further clarify the hypothesis that acupoints have specific effects which are related to meridians and provide scientific evidence on mild essential hypertension treatment.Methods:A multi-center,randomized and controlled trial was designed.Total 428 patients who met the inclusion criteria were randomly assigned to 4 groups using central randomization: Acupoints selection along meridians group(Group A),acupoints selection on other meridians group(Group B),non-acupoint group(Group C)and waiting-list group(Group D).Group A took LR3 and ST9 as the primary acupoints,and then select corresponding matching acupoints according to syndrome differentiation of meridians.Group B acupunctured on GB20,SP9,SP10 and SJ5.Group C acupunctured on four predefined non-acpoints.Group D didn't recieve any intervention during the observation period,but instead receive 18 acupuncture treatments for free after waiting period.Participants in Group A,Group B and Group C received 18 acupuncture treatments of 30 minutes' duration over 6 weeks,3 session s per week,then all participants will receive 6 weeks of follow-up.The outcome were assessed at the baseline,6th,9th and 12 th week after randomization.The primary outcomes were the 24 h mean systolic blood pressure and 24 h mean diastolic blood pressure,while secondary outcomes included the mean pressure in day and night,pulse pressure,blood pressure load and circadian rhythm of blood pressure.Results:1.The changes of 24 h mean systolic blood pressure and day mean systolic blood pressure were significant different between A and D groups in 6th,9th and 12 th week after randomization(P<0.05).There were significant differences between A and D groups of 24 h mean diastolic blood pressure,day diastolic blood pressure and day systolic blood pressure load at week 6 and week 12(P<0.05).The differences between A and C group in week 9 and week 12 were also significant in the change of blood pressure(P<0.05).At week 12,the changes of night mean systolic pressure was significant different between A and D groups in week12(P<0.05).2.The changes of 24 h mean systolic blood pressure was significant different between A and C groups in 6th,9th and 12 th week(P<0.05).The differences between A and C group in week 6 were also significant in the change of 24 h mean diastolic blood pressure,day diastolic blood pressure and day systolic blood pressure load(P<0.05).3.The changes of 24 h mean systolic blood pressure,day diastolic blood pressure and pulse pressure were significant different between A and B groups in 6th after randomization(P<0.05).4.The clinical effects of group A was continuously effective from week 6 to week 12.24 h mean blood pressure,mean pressure in day and night,pulse pressure and blood pressure load of patients has continued to improve.But such effect of B?C and D groups start to gradually disappear on the 3rd week or 6th week after treatment.Conclusion:1.Compared to waiting-list group,acupoints selection along meridians group was more efficacious in improving 24 h mean systolic blood pressure,24 h mean diastolic blood pressure,night mean systolic pressure,day systolic blood pressure load and blood pressure.2.Compared to non-acupoint group,acupoints selection along meridians group was more efficacious in improving 24 h mean systolic blood pressure,24 h mean diastolic blood pressure,day mean systolic blood pressure and day systolic blood pressure load.3.Compared to acupoints selection on other meridians group,acupoints selection along meridians group was more efficacious in improving 24 h mean systolic blood pressure,day mean systolic blood pressure and blood pressure.4.It was demonstrated that selecting acupiont along merdians was obvious advantages on the effect,speed and persistence of lowering blood pressure.