【针刺加穴位敷贴与尼群地平在老年收缩期高血压治疗中的比较分析】 十二经络
[摘要] 目的 比较针刺加穴位敷贴与尼群地平对老年收缩期高血压的治疗作用。 方法 采用前瞻性对照研究方法，选取符合老年收缩期高血压诊断标准的人群，随机分为两组，观察组单纯选用穴位敷贴加针刺，对照组采用传统抗高血压药物（尼群地平）治疗。治疗后每月随访1次，观察血压变化情况。 结果 观察组血压治疗结束时及治疗后1、2、3个月与治疗前比较，差异均有统计学意义（均P < 0.05）。观察组总有效率为98%，对照组总有效率为92%，两组比较，差异有统计学意义（P < 0.05）。 结论 针刺加穴位敷贴在控制老年收缩期高血压的治疗上，对改善临床症状、降压、降血脂和改善血流动力学方面均有一定的疗效。
[关键词] 针刺；穴位敷贴；尼群地平；老年收缩期高血压
[中图分类号] R544.1 [文献标识码] C [文章编号] 1673-7210（2012）07（b）-0151-02
Comparative analysis of acupuncture combined with acupoint application and Nitrendipine therapy in the treatment of elderly patients with systolic hypertension
HE Jingwei DU Liping GU Hao ZHANG Weihong XIA Fang XU Zhong SUN Junlei
Xinzhuang Community Health Service Center of Minhang District, Shanghai 201100, China
[Abstract] Objective To compare the treatment effect between acupuncture combined with acupoint application and Nitrendipine in the treatment of elderly patients with systolic hypertension. Methods A prospective control study and 100 elderly patients with systolic hypertension were selected. All the cases were randomly assigned into observation group and control group equally. Patients in observation group were given the choice of acupoint application combined with acupuncture, and patients in control group were received the traditional antihypertensive drugs (Nitrendipine) treatment. After the treatment, the blood pressure was observed and given follow-up every month. Results The differences in observation group after treatment for 1, 2, 3 months had statistically significant differences compared with that before (P < 0.05). The total efficiency in observation group was 98%, and in control group was 92%, the difference was statistically significant between the two groups (P < 0.05). Conclusion Acupuncture and acupoint application in the treatment of elderly patients with systolic hypertension has a certain effect, not only can improve the clinical symptoms and hemodynamics, but also decrease the blood pressure and blood lipid.
[Key words] Acupuncture; Acupoint application; Nitrendipine; Elderly systolic hypertension
老年收缩期高血压作为单纯收缩期高血压（ISH）的一种，其定义同为2004年中国高血压指南和2007年欧洲高血压指南，主要的特征为收缩压（SBP）≥140 mm Hg（1 mm Hg =0.133 kPa），舒张压（DBP）< 90 mm Hg。ISH为老年高血压中的一种常见类型，其主要转归为心、脑血管病[1]。2001年，Circulation杂志公布了美国Framingham的老年高血压调查结果发现：近80％的老年高血压患者属于ISH。本文就针刺加穴位敷贴与尼群地平在控制老年收缩期高血压上的治疗作用进行对比分析，现报道如下：
1 资料与方法
1.1 一般资料
本次研究的研究对象为2009年1月～2011年12月在我院收治的老年收缩期高血压患者100例，其中，男68例，女32例，年龄60～81岁，平均（71.8±11.2）岁。入选前无论是否曾服用抗高血压药物均停药，停药后选3个不同日再行测量血压，3次测量后有两次符合上述标准者再进行全面体格检查。入选者需要检查身高、体重、血常规、尿常规、血糖、血脂、心电图、肾功能以及24 h动态血压，年龄＞ 60岁，坐位SBP≥140 mm Hg，且DBP ＜ 90 mm Hg。通过随机分组的方式分为两组，观察组50例，给予穴位敷贴加针刺治疗；对照组50例，给予传统抗高血压药物（尼群地平）治疗。排除心、脑、肾、糖尿病、恶性肿瘤、继发性高血压等。每个入选患者均建立档案，进行前瞻性观察。两组年龄、性别、血压、生化检查等一般资料差异均无统计学意义（P ＞ 0.05），具有可比性。