不同参数针刺治疗原发性高血压的正交优化方案研究

目的:分析不同选穴、留针时间、针刺深度对原发性高血压患者24 h血压负荷及昼夜节律的影响,优选最佳针刺降压方案。方法:纳入48例临床病例,采用正交试验设计,按照3因素2水平,即选穴(人迎、太冲)、留针时间(15、30 min)、针刺深度(浅刺、深刺),分为8组,每组6例,观察针刺前后24 h动态血压负荷及血压昼夜节律的变化。结果:(1)针刺深度对收缩压负荷的影响最为显著(P<0.05),各因素不同水平的影响程度为:人迎>太冲,15 min<30 min,浅刺<深刺,最佳调节收缩压方案为深刺人迎30 min;(2)留针时间对舒张压负荷的影响最为显著(P<0.05),各因素不同水平的影响程度为:人迎<太冲,15 min<30 min,浅刺<深刺,最佳调节舒张压方案为深刺太冲30 min;(3)不同因素对于昼夜节律的影响程度为针刺深度>留针时间>选穴;各因素不同水平对昼夜节律的影响程度为:人迎<太冲,15 min<30 min,浅刺<深刺。最佳调节昼夜节律的方案为深刺太冲30 min。结论:深刺人迎或太冲30 min为针刺调节收缩压负荷、舒张压负荷及血压昼夜节律的最佳方案。     

针刺人迎穴为主治疗原发性高血压疗效的Meta分析

目的:系统评价针刺人迎穴为主治疗原发性高血压的疗效及安全性。方法:计算机检索Pub Med数据库、维普数据库(VIP)、万方数据库、中国期刊全文数据库(CNKI)建库至2015年10月31日有关针刺人迎穴治疗高血压的文献,纳入符合标准的随机对照试验及自身前后对照研究进行Meta分析。结果:共纳入9项研究,Meta分析结果显示,针刺人迎穴对收缩压即刻降压作用较明显,而对舒张压即刻降压作用不明显;针刺组方对即刻血压、24h平均血压、日间血压、夜间平均收缩压、血压负荷、日间收缩压变异性及夜间血压变异性都有明显下降作用,而夜间平均舒张压及日间舒张压变异性与针刺前相比无明显差异。结论:在即刻降压方面,针刺组方优于针刺人迎穴,综合监测血压及波动情况后,针刺组方对收缩压的改善优于对舒张压的改善。     

CLINICAL OBSERVATION ON ACUPUNCTURE TREATMENT OF MILD TO MODERATE HYPERTENSION

Objective: To determine the effects of acupuncturing point Renying(ST9) at different frequencies on mild to moderate hypertension.Methods: From July 2012 to June 2013, the hypertension clinic at the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine completed treatment on 38 patients(20 cases in Renying high-frequency group(RHFG), and 18 cases in Renying low-frequency group(RLFG)), using 24-hour ambulatory blood pressure indicators to investigate the effects of different needle manipulations on blood pressure.Results: Compared with before treatment, nighttime blood pressure of the RHFG was significantly lower after 6 and 12 weeks of treatment(P0.05); da ytime and nighttime blood pressure of the RLTG was lower after 6 weeks of treatment, but tended to rebound after 12 weeks of treatment.Conclusion: Renying high-frequency acupuncture has a lasting effect in lowering nighttime blood pressure; whereas Renying low-frequency acupuncture tends to lower both daytime and nighttime blood pressure, but is prone to develop tolerance.     

CLINICAL OBSERVATION ON PENETRATION NEEDLING TREATMENT OF 65 CASES OF HYPERTENSION

The present paper reports the results of 65 hypertension patients treated with pene-tration needling（point through point method in acupuncture）.For comparison,other ps cases ofhypertension were treated with routine needling method.Changes of blood pressure were ob-served before,during and after treatment.Results showed that the hypotensive effect of the pen-etration needling was significantly superior to that of the routine acupuncture（P<0.05）.Thefollowing-up survey 3 months after treatment showed significant differences between two groupsand between post-treatment and pre-treatment in each group in the mean vahes of systolic and di-astolic pressure（P<0.05）.It reveals that acupuncture has a good hypotensive action,and thepenetration needling is of a certain long-term therapeutic effect.     

捻转补法针刺人迎穴干预原发性高血压亚急症的效应观察

目的观察不同手法针刺人迎穴对高血压亚急症患者血压的影响。方法将60例高血压亚急症患者随机分为观察组（捻转补法针刺人迎穴）、对照组（无手法针刺人迎穴），比较治疗前、治疗后3至360min期间的血压变化。结果与对照组比较观察组具有降压效果迅捷、稳定、持续时间长等特点。结论捻转补法针剌人迎穴可起到治疗原发性高血压亚急症的较佳效应。     

针刺人迎穴对高血压患者血清中血管活性物质影响的研究

目的:研究针刺人迎穴治疗高血压病(EH)的临床疗效及作用机理。方法:将120例EH患者随机分为针刺人迎穴组40例、传统针刺组40例和口服卡托普利片组40例,通过对患者血压的测定进行临床疗效评定,并在治疗前后分别对3组患者的血清ET、NO、ET/NO进行检测。结果:针刺人迎穴治疗EH有效率达86.84%,明显优于传统针刺组和西药组,经Ridit检验,具有显著性差异;针刺人迎穴治疗EH对血清ET、NO、ET/NO等血管活性物质的含量,疗前疗后比较差异显著(P0.01),与对照组比较差异显著(P0.01)。结论:针刺人迎穴治疗EH疗效肯定,而且能够调节血管内皮细胞的内分泌功能,为研究人迎穴治疗EH的作用机理奠定了理论基础。     

针刺对不同疾病患者血压与脉率的影响

目的 研究针刺对不同类型患者收缩压、舒张压和脉率的影响.方法 对106名受试者在针刺前和起针后立即测量血压和脉率,并咨询有无高血压病史及针刺史,记录下取穴和中西医诊断结果,以便评估针刺不同穴位有不同疾病患者的血压和脉率的作用.结果 针刺后收缩压、舒张压、脉率较针刺前均有不同程度的下降,且差异有统计学意义(P<0.01).针刺史和高血压病史可能不是针刺影响血压、脉率的因素(P>0.05).有些穴位与血压有关;有些穴位与脉率有关(P<0.05或P<0.01).结论 针刺某些穴位对血压和脉率有一定的影响.     

针刺太冲穴、人迎穴对自发性高血压大鼠降压效果比较

目的:探讨针刺太冲穴、人迎穴对自发性高血压(SHR)大鼠降压效果的差异。方法:6只Wistar大鼠为对照组,24只SHR大鼠随机分为模型组、太冲组、人迎组和非穴组,每组6只。每天固定时间针刺治疗1次,共14d。采用无创尾动脉血压测量技术检测血压。结果:与对照组比较,模型组大鼠同期收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)显著增高(P<0.05),太冲组SHR大鼠SBP自第7天开始显著下调(P<0.05),人迎组SHR大鼠自第6天开始显著下调(P<0.05);太冲组和人迎组SHR大鼠DBP和MAP自第6天开始显著下调(P<0.05),降压效果呈时间依赖性。结论:针刺太冲、人迎穴可显著降低SHR大鼠血压,但太冲穴和人迎穴降压效果差异无统计学意义。     

醒脑开窍针刺法治疗高血压合并中风临床观察

目的观察醒脑开窍针刺法对高血压合并中风病的降压效果。方法将150例高血压病合并中风的患者纳入研究病例,在醒脑开窍针剌法的基础上,配合人迎、曲池、合谷、太冲、足三里穴。于治疗前后分别对患者进行24h动态血压监测,观察24h、日间、夜间的平均收缩压和平均舒张压,脉压以及血压昼夜节律的变化。结果24h、日间、夜间的平均收缩压和平均舒张压,脉压与治疗前比较均有显著性降低（P〈0．05）,针刺可以使64．7％患者恢复正常杓型节律。结论醒脑开窍针刺法能有效地降低高血压合并中风病人的血压水平,纠正患者的血压节律。     

A CLINICAL OBSERVATION ON EFFICACY OF ACUPUNCTURE FOR THE ESSENTIAL HYPERTENSION MERGER CEREBRAL INFARCTION

Objective: To evaluate the acupuncture effects on the essential hypertension merger cerebral infarction by 24-hour ambulatory blood pressure monitoring.Methods: A total of 106 inpatients with essential hypertension merger cerebral infarction were randomly divided into two groups, 53 cases in each group.On consciousness-restoring obstructionclearing needing technique basis, the experimental group accepted acupuncture treatment combined with Western medicine drugs while the control group took Western medicine drugs step-down only.Two groups of patients before and after treatment received 24-hour ambulatory blood pressure monitoring.We collected blood pressure mean, blood pressure standard deviation, blood pressure circadian rhythms, pulse pressure and morning blood pressure for comparative analysis before and after the treatment.The investigated data were analyzed in statistics with SPSS 11.5 software.Results: After treatment, in comparison between the two groups, 24-hour and daytime systolic blood pressure, 24-hour systolic blood pressure variation, blood pressure circadian rhythms, dynamic pulse pressure, and morning section systolic pressure had significant differences.Conclusion: Treatment in both groups could smoothly lower blood pressure value and the antihypertensive effect of the experimental group was better.In reducing blood pressure variation, improving blood pressure circadian rhythms and reducing pulse pressure, the experimental group also had obvious curative effect, indicating that acupuncture treatment combined with Western medicine reduced blood pressure value effectively and it might be helpful for the protection of target organs.     

针刺捻转补泻手法对应激性血压升高大鼠血浆乙酰胆碱及胸主动脉一氧化氮合酶、环鸟苷酸含量的影响

目的:观察针刺捻转补泻手法对应激性血压升高大鼠的血压及乙酰胆碱(Ach)/一氧化氮(NO)/环鸟苷酸(cGMP)传导途径的影响,探讨捻转补泻手法调控血压的效应机制。方法:60只Wistar大鼠随机分为空白组和造模组,造模组采用电击加噪声刺激15d制成应激性血压升高模型。造模成功的动物随机分为模型组、针刺组、捻转补法组、捻转泻法组,每组12只。各治疗组动物每日分别施以双侧"太冲"穴针刺不做手法、捻转补法和泻法操作。7d后,用ELISA法检测各组大鼠血浆Ach、胸主动脉一氧化氮合酶(NOS)和cGMP的含量。在造模前、造模后、针刺后分别测量动物收缩压。结果:与空白组比较,造模后各组大鼠血压明显上升(P0.01);针刺7d后,与模型组比较,各治疗组血压均有所降低(P0.05,P0.01),其中捻转泻法组较其它两个治疗组降低更明显(P0.05)。与空白组比较,模型组血浆Ach、动脉NOS和cGMP含量均明显下降(P0.01);与模型组比较,3个治疗组血浆Ach、动脉NOS含量均显著升高(P0.01,P0.05),捻转补法和泻法组的动脉cGMP含量也显著升高(P0.01);3个治疗组中,捻转泻法组Ach含量升高更明显(P0.01),捻转补法组NOS含量以及捻转补法和泻法组cGMP含量的升高较针刺组显著(P0.05,P0.01)。结论:针刺捻转泻手法可以有明显的降压作用,其作用机制可能是通过调整Ach/NO/cGMP实现的。     

针刺人迎治疗高血压病的研究现状

本文根据文献,从临床与实验研究方面归纳了人迎穴降压研究进展情况.针刺人迎治疗高血压病疗效确切,具有双向良性调节、保护靶器官,提高生存质量等独特优势.通过研究现状的分析,以期对今后的研究提出参考.     

24h动态血压监测观察针刺人迎穴为主对原发性高血压的影响1例

石学敏院士以中医"脑为元神之府"、"无风不作眩"等理论为基础,创立了以人迎等为主穴,以"活血散风,平肝降逆"为主的治法的针刺方法治疗高血压已取得了一定的效果.对于高血压患者血压波动性的影响还有赖于应用24 h动态血压监测(ambulatoryblood pressuremonitoring,ABPM)进行监测。24ABPM能较准确地反映日常生活中昼夜的血压变化规律,对临床准确诊断高血压具有重要意义,已广泛应用于临床实践。     

捣法加烧山火针刺手法治疗神经根型颈椎病的应用研究

目的：探讨捣法针刺与烧山火手法联用对神经根型颈椎病患者的治疗效果。方法与结果：采用简单随机的病例分组方法,将符合纳入标准的病例分为普通针刺组、捣刺组、烧山火组、捣刺＋温针组、捣刺＋烧山火组,每组各30例。各组均每日治疗1次,10次为1个疗程。观察临床疗效及治疗前后临床证候积分、血清肿瘤坏死因子（TNF-α）含量等指标的变化。结果：捣刺组、烧山火组、捣刺＋温针组、捣刺＋烧山火组在临床疗效、中医证候积分及血清肿瘤坏死因子（TNF-α）含量等方面改善均显著优于普通针刺组;且捣法与烧山火手法联用更为显著。结论：捣法加烧山火针刺手法治疗神经根型颈椎病,不仅能显著改善临床症状和体征,而且能降低或抑制血清肿瘤坏死因子的释放,具有良好的镇痛、消炎作用。     

近5年中风后语言障碍的针灸治疗进展

临床治疗中风后语言障碍虽然疗效肯定,但仍存在不足。不利于针刺疗法的大范围推广和运用。查阅近5年针灸治疗本病文献,从针灸疗法和综合疗法两方面进行综述,针灸疗法又包括以体针疗法为主、以头针疗法为主、以舌针疗法为主、以放血疗法为主和多种针法配合5个方面;综合疗法包括针药结合、针灸与语言康复相结合和针刺与音乐音调治疗法结合3个方面。并针对问题和不足,提出建议。     

CURATIVE EFFECT OBSERVATION OF ACUPUNCTURE IN TREATING FORTY CASES OF PRIMARY HYPERTENSION DISEASE

Objective: To observe the influence of acupuncture on immediate blood pressure, blood pressure at 8:00, 16:00 o'clock and 24-hour dynamic blood pressure of 40 patients with primary hypertension disease.Methods: Needles were inserted in bilateral Renying(ST9), Hegu(LI4), Taichong(LR3), Quchi(LI11), and Zusanli(ST36) at daily time of 9:00 and 15:00, and patients' immediate blood pressure value 20 min after insertion, blood pressure value at daily 8:00, 16:00, and 24-hour dynamic blood pressure were recorded, 30 d for one period of treatment, 2 d off per week.Immediate blood pressure values, 8:00 and 16:00 blood pressure values and two dynamic blood pressure values at 3 d before treatment and the last 3 d of treatment were compared.Results: The immediate blood pressure value, 8:00 and 16:00 blood pressure value and dynamic blood pressure value significantly decreased as compared with before treatment, especially the systolic blood pressure, and there was statistically significant difference(P0.05).Conclusion: Acupuncture could reduce the immediate blood pressure value, mean value of day and night blood pressure, blood pressure load, blood pressure variability and morning blood pressure, effectively improve the rhythm of day and night blood pressure, and reverse the non-scoop type blood pressure.     

针刺人迎穴为主对原发性高血压降压效应观察

目的:观察针刺对高血压病血压的即刻作用及长期影响.方法:原发性高血压患者70例,于每日14:00-16:00针刺人迎、合谷、太冲、曲池、足三里,记录患者每日针刺前以及针刺5 min、15 min、30min的血压值,每周治疗5天休息2天,共治疗3个月.比较同一天内针刺各时点与针刺前血压,比较每隔15天针刺前与第1天的针刺前血压.结果:同一天针刺各时点收缩压较针刺前收缩压下降显著,差异具有统计学意义(均P＜0.05),第1天、第15天、第30天及第60天各时点舒张压较针刺前下降,差异有统计学意叉(均P＜0.05);治疗3个月期间,每隔15天针刺前的收缩压及舒张压与第1天针刺前比较均下降明显(均P＜0.05).结论:针刺治疗原发性高血压既可降低即刻血压,又可维持降压效应,起到长期平稳降压的作用.     

EVALUATION OF EFFICACY AND SAFETY PROFILE OF ELECTROACUPUNCTURE ASSESSED IN THE CHRONIC ATRIOVENTRICULAR BLOCK CANINE MODEL WITH SEVERE HYPERTENSION AND HEART FAILURE

Objective: Previous animal and clinical studies have shown that acupuncture is an effective alternative treatment in the management of stages I and II hypertension; however, information is still limited for stage III hypertension.In this study, we assessed the acute cardiohemodynamic and electrophysiological effects ofelectroacupuncture in the chronic atrioventricular block canine model with severe hypertension and heart failure(n=4).Methods: Seven sessions of electroacupuncture were performed for 2 weeks.In each session, needles were inserted at Renying(ST9) and Taichong(LR3), and then an electroacupuncture protocol consisting of 2 Hz frequency and 2 mA amplitude was carried out for 30 min with a Han's acupoint nerve stimulator.The animals were anesthetized with pentobarbital in the initial and last sessions to estimate the acute and chronic cardiohemodynamic and electrophysiological effects of electroacupuncture.Results: Ventricular rate decreased during continuous stimulation at the first and the seventh sessions(P0.05).Mean blood pressure increased and atrial rate decreased only during the first stimulation(P0.05).There was no significant change in the systolic blood pressure, diastolic blood pressure, cardiac output, total peripheral resistance, double product, and QRS width or QT interval during electrical stimulation in the first and the seventh sessions.There was no significant difference in any time-matched variable between those two sessions.Conclusion: These results suggest that electroacupuncture may rather expose a risk for hypertension crisis by a short application and that 7 sessions of treatment by electroacupuncture for 2 weeks might not be enough to lower the blood pressure in this special canine model.     

针刺人迎穴的降压作用研究概况

人迎穴被医务工作者应用于治疗心脑血管、内分泌系统、神经系统等疾病。从天津中医药大学第一附属医院以人迎穴为主穴的方法治疗高血压病的临床相关研究，以及人迎穴的降压机理研究等方面考证相关文献，并证明其对于高血压病的治疗确实起到了良好的作用与效果。     

针刺治疗头痛对血浆多巴胺-β-羟化酶(DβH)含量的影响

<正> 通过前一阶段实验,我们初步观察到,在经络疗法治疗头痛的研究中,以20%当归液刺激背部俞穴,有效患者血浆中多巴胺-β-羟化酶(DβH)含量降低,并具显著性。但针刺治疗头痛时血浆DβH含量的变化尚未见报导。为了进一步了解神经介质在针刺镇痛过程中的作用,现将针刺治疗头痛对血浆DβH含量的变化报导如下。