神门关联配穴压丸法治疗肝阳上亢型1级原发性高血压病患者的疗效分析

背景　2018年，笔者所在课题组通过分析文献及复杂系统熵聚类法得出神门关联配穴治疗原发性高血压病的核心组方，但将其应用于临床发现部分患者疗效欠佳，后经调整耳穴按压时间后取得一定疗效。目的　分析神门关联配穴压丸法治疗肝阳上亢型1级原发性高血压病患者的疗效。方法　选取2019年5-8月上海市嘉定区南翔镇社区卫生服务中心收治的肝阳上亢型1级原发性高血压病患者150例，采用随机数字表法分为对照组、不固定时间按压组、固定时间按压组，每组50例。对照组患者保持原有常规西医治疗，不固定时间按压组患者在原有常规西医治疗基础上联合神门关联配穴压丸法，但不规定按压时间点，而固定时间按压组患者则在原有常规西医治疗基础上联合神门关联配穴压丸法并在规定时间点按压；三组患者均连续治疗3个月。评价三组患者疗效并比较三组患者治疗前后收缩压、舒张压、中医证候积分，同时记录三组患者治疗期间不良反应/不适发生情况。结果　本研究中无一例患者脱落或被剔除。不固定时间按压组、固定时间按压组患者疗效优于对照组，且固定时间按压组患者疗效优于不固定时间按压组（P<0.05）。不固定时间按压组、固定时间按压组患者治疗后收缩压、舒张压低于对照组（P<0.05），而不固定时间按压组与固定时间按压组患者治疗后收缩压、舒张压比较，差异无统计学意义（P>0.05）。不固定时间按压组、固定时间按压组患者治疗后中医证候积分低于对照组，且固定时间按压组患者治疗后中医证候积分低于不固定时间按压组（P<0.05）。三组患者治疗期间无一例出现不良反应/不适。结论　在常规西医治疗基础上应用神门关联配穴压丸法治疗肝阳上亢型1级原发性高血压病患者的疗效确切，安全性较高，降压优势明显，可有效缓解患者症状，且与不固定时间按压相比，固定时间按压神门关联配穴可更有效地缓解患者症状。

Therapeutic Effect of Pressing Shenmen-associated Acupoints with Seeds in Stage 1 Essential Hypertension Patients with Liver-yang Hyperactivity Syndrome

Background　Our research group sorted out the core components of pressing Shenmen-associated acupoints with seeds for essential hypertension through literature review and complex system entropy clustering method in 2018，but its curative effect was not satisfactory in some clinically treated patients.After adjusting the time of pressing acupoints，the curative effect has revealed.Objective　To analyze the therapeutic effect of pressing Shenmen-associated acupoints with seeds in stage 1 essential hypertension patients with liver-yang hyperactivity syndrome.Methods　Participants were 150 patients with stage 1 essential hypertension with liver-yang hyperactivity syndrome who were treated in Shanghai Jiading District Nanxiang Community Health Center during May to August 2019.They were equally divided into control group，regular pressing group，and irregular pressing group according to random number table method.All groups continued to use the originally prescribed Western medicine therapy，but regular and irregular pressing groups were additionally treated with pressing Shenmen-associated acupoints with seeds regularly and irregularly，respectively.Efficacies of the three regimens were evaluated at the end of a consecutive 3-month treatment by comparing pre- and post-treatment SBP，DBP and TCM syndrome score，and safety of the regimens was evaluated by incidence of adverse reactions or discomfort during treatment.Results　All the participants were included in the final analysis since no one dropped out or was excluded.The control group showed lower treatment response than the other two groups，however regular pressing group had higher treatment response than irregular pressing group（P<0.05）.The average post-treatment SBP and DBP in control group were significantly higher than those in the other two groups（P<0.05）.Regular and irregular pressing groups had no significant differences in average post-treatment SBP and DBP（P>0.05）.The average post-treatment TCM syndrome score in control group was significantly higher than that in the other groups，respectively（P<0.05）.The average post-treatment TCM syndrome score in regular pressing group was significantly lower than that in irregular pressing group（P<0.05）.No adverse reactions or discomfort occurred in all groups during treatment.Conclusion　Routine Western medicine therapy plus pressing Shenmen-associated acupoints with seeds is highly safe，which can achieve obvious efficacies such as good antihypertensive effect and symptom relief.Furthermore，regular pressing may achieve better symptom relief than irregular pressing.