百会透刺前顶对高血压患者血压昼夜节律及血管活性物质的影响

摘要

目的：通过24 h 动态血压监测，观察百会透刺前顶对高血压患者的血压昼夜节律及血管活性物质变化，初步探讨其作用机制。方法：选择120例1、2级原发性高血压（中低危）患者，随机分为2组，对照组仅进行健康教育生活方式干预；治疗组在此基础上，进行百会透刺前顶穴治疗，于治疗前后行24 h 动态血压监测，计算日间平均收缩压、夜间平均收缩压、日间平均舒张压、夜间平均舒张压、收缩压和舒张压谷峰比值及治疗前后肾素、醛固酮、血管紧张素。结果：第4、12周，对照组和治疗组均能降低日间及夜间平均收缩压、平均舒张压，与疗前比较（P ＜0．01），均有统计学意义。4周、12周组内比较，对照组无统计学意义（P ＞0．05），治疗组均有统计学意义（P ＜0．05），远期疗效治疗组更优。4周与12周组间比较，治疗组均优于对照组（P ＜0．05）。谷峰比值比较：治疗前后2组对收缩压谷峰比值有一定升高，比较有统计学意义（P ＜0．05），2组舒张压谷峰比值比较无明显统计学意义（P ＞0．05）。血管活性物质测定：治疗后治疗组肾素水平较前下降，差异有统计学意义（P ＜0．05），醛固酮、血管紧张素治疗前后2组的组内及组间比较，差异无统计学意义（P ＞0．05）。结论：百会透刺前顶治疗原发型高血压1、2级能够显著降低昼夜平均收缩压和平均舒张压，对昼夜血压节律和降低肾素水平有一定作用。%Objective:By monitoring 24 hours circadian rhythm and vaso-active substances changes,to observe the effect of acu-puncturing Baihui(DU20)to Qianding(DU21)on primary hypertension and explore its mechanism of action.Methods:One hun-dred and twenty patients with primary hypertension of 1-2 level (low risk)were randomly divided to two groups.Control group with health education and lifestyle intervention,and treatment group with acupuncture Baihui to Qianding plus health education and life-style intervention.Before and after treatment,two groups were monitored by 24h ambulatory blood pressure,calculated daytime av-erage systolic blood pressure,nighttime average systolic blood pressure,daytime average diastolic blood pressure,nighttime aver-age diastolic blood pressure,peak ratio of systolic pressure and diastolic pressure,renin,aldosterone and angiotensin.Results:Observation on the 4th and 12th weeks,both the groups could reduce the daytime and nighttime average systolic blood pressure, diastolic blood pressure,and compared with before treatment,there was statistically significant (P <0.01).In the control group, to compare the results of 12th week with 4th week,there are no statistical significance (P >0.05);in the treatment group,when compared the results of 12th week with 4th week,there was statistical significance (P <0.05),and the long-term efficacy of the treatment group is better.Comparison of 4th week and 12th weeks between the two groups,the treatment group performed better than the control group (P <0.05).Before and after treatment,blood pressure peak ratio in the two groups have increased,and there were statistical difference (P <0.05),while diastolic Gu Feng ratio in the two groups were not statistically significant (P >0.05).Before and after treatment,aldosterone,angiotensin in the two groups were no significant difference (P >0.05),but the comparison of renin showed statistical significance (P <0.05).Conclusion:Acupuncture Baihui(DU20)to Qianding(DU21) therapy can significantly reduce the day and night average systolic blood pressure and diastolic blood pressure,which have a cer-tain effect on the circadian rhythm of blood pressure and the reduction of renin.