针刺治疗原发性高血压病远期疗效的系统评价

摘要

Objective :To evaluate the long -term effects of domestic acupuncture on essential hypertension.Methods:We searched CNKI (1979 to May31,2010), VIP( 1989 to May31,2010), WF (1995 to May31,2010), CBM ( 1978 to May31,2010 ), and handsearched relevant journals and conference proceedings. We included all the relevant Randomized Controlled Trials(RCTs) and quasi - RCTs of acupuncture for treatment of essential hypertension. We evaluated the internal validity of the RCTs and quasi - RCTs. If all included trials were of high quality and homogeneity, then the meta -analysis was conducted. Results: 1460 patients being included 18 papers met the enrolled criteria. However, the methodological quality of 17 papers was relatively poor. Meta - analysis of 18 trials indicated that the final total effective rate of improvement of blood pressure in two trail, the final total effective rate of controlling of symptoms in one trail, the final SBP comparing in two trail and the final DBP comparing in two trail were better in the treatment groups than those of control groups. Conclusion:A reliable conclusion can not be drawn from the present data because of the defects in methodological quality and insufficient numbers of trials, although it shows a tendency that acupuncture can improve the conditions of essential hypertension. Therefore, it is necessary to perform more multi - central RCTs of high quality in the future.%目的:评价国内针刺治疗原发性高血压病的远期疗效.方法:计算机检索CNKI、VIP、WF、CBM,检索时间截止于2010年5月31日,同时手工检索天津中医药大学图书馆过期刊物及相关会议论文集.纳入所有的针刺治疗原发性高血压病远期疗效的随机和半随机对照试验.对符合纳入标准的研究进行内部真实性评价,如果所有纳入研究的质量足够高并具有相似性,则进行Meta分析.结果:共纳入18个随机对照试验(共1460例),17个为低质量试验.Meta分析结果显示:疗程结束后血压改善总有效率中2项研究试验组优于时照组,症状控制总有效率中1项研究试验组优于对照组,SBP比较、DBP比较中2项研究试验组优于对照组.结论:由于纳入研究数量和质量上的缺陷,虽显示针刺有改善高血压的趋势,无不良反应,但目前尚不能对其疗效得出肯定结论,因此开展更多高质量、多中心的RCT非常必要.