针刺治疗对原发性高血压患者血压变异性和心率变异性的影响

摘要

Objective To investigate the effects of acupuncture on blood pressure and heart rate variability in patients with essential hypertension. Methods 60 hypertensive patients were selected to be treated with acupuncture for 30 days. Before and after acupuncture treatment, 24⁃hour ambulatory blood pressure and 24 hours Holter were detected. Results After acupuncture treatment, blood pressure variability indexes ( 24 h average systolic and diastolic blood pressure, standard deviations of 24 h systolic and diastolic blood pressure, standard deviations of systolic and diastolic blood pressure at daytime, standard deviations of systolic and diastolic blood pressure at night) were significantly lower than those before treatment ( P<0.05) . Compared with original level, heart rate varia⁃bility indexes ( standard deviation of all RR intervals, standard deviation of the averages of RR intervals in all 5⁃minute segments of the entire recording, standard deviation of difference between adjacent RR intervals, square root of the mean of the sum of the squares of difference between adjacent RR interval, percent of difference between adjacent RR intervals that are greater than 50 ms) were im⁃proved after acupuncture treatment ( P<0.05 ) . Conclusion Acupuncture treatment can significantly reduce blood pressure variability in patients with essential hypertension, and improve heart rate variability, which may improve the target organ damage in patients with hypertension.%目的：探讨针刺治疗对原发性高血压患者血压变异性和心率变异性的影响。方法选择符合条件的60例原发性高血压患者进行针刺治疗，疗程为30 d，采用自身前后对照，分别于治疗前后完善24 h动态血压及24 h动态心电图检查。结果针刺治疗后血压变异性各指标（24 h平均收缩压、24 h平均舒张压、24 h收缩压标准差、24 h舒张压标准差、白昼收缩压标准差、白昼舒张压标准差、夜间收缩压标准差、夜间舒张压标准差）均较治疗前降低，差异具有统计学意义（ P＜0．05）；心率变异性各指标（连续RR间期标准差、平均5 min RR间期标准差、平均5 min RR间期标准差的平均值、连续RR间期差值的均方根值、相邻RR间期大于50 ms的百分数）均较治疗前有所改善，差异具有统计学意义（ P＜0．05）。结论针刺治疗能显著降低原发性高血压患者的血压变异性，改善心率变异性，从而可能改善高血压患者的靶器官损害。