Acupuncture for Lowering Blood Pressure: Systematic Review and Meta-analysis
Acupuncture for Lowering Blood Pressure: Systematic Review and Meta-analysis
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DOI：
10.1038/ajh.2008.311
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发表时间：
2009-01-01
影响因子：
3.2
通讯作者：
Park, Hi-Joon
中科院分区：
文献类型：
--
作者：
Lee, Hyangsook;Kim, Song-Yi;Park, Hi-Joon
目的：对针刺对高血压患者血压（BP）的影响进行系统评价。方法：电子文献检索随机对照试验（RCT）的针灸在六个电子数据库中进行，到2007年6月，没有语言限制。质量，主要是由于报告质量差。对11项研究中的3项假手术对照试验进行了统计学汇总：收缩压（SBP）变化无统计学意义（平均差-5 mm Hg，95%CI（-12，1），P = 0.12），而针刺仅使舒张压（DBP）略微降低3 mm Hg（95% CI（-6，0），P = 0.05），但观察到显著异质性（SBP的I-2 = 92%，DBP的I-2 = 79%）。当与抗高血压药物联合使用时，针刺显著降低SBP（-8 mmHg，95% CI（-10，-5），P < 0.00001）和DBP（-4 mmHg，95% CI（-6，-2），P < 0.0001），未检测到研究间异质性。四项研究调查了针灸对降压药物的非劣效性，针灸在降低血压，虽然他们的质量很差，他们的样本量是不令人满意的等效性研究。其他研究比较针灸与各种控制程序有不一致的结果，他们中的大多数是低方法quality.CONCLUSIONSConsidering的四个积极的非劣效性研究和三个假对照研究的荟萃分析结果的局限性，针灸可能降低高血压的概念是不确定的。需要进行更严格的试验。
BACKGROUNDWe conducted a systematic review to estimate the effect of acupuncture on blood pressure (BP) in hypertensive patients.METHODSElectronic literature searches for randomized controlled trials (RCTs) of acupuncture were performed in six electronic databases to June 2007 without language restrictions.RESULTSEleven RCTs testing acupuncture either as an adjunct or an alternative met our inclusion criteria and they showed a wide variety of methodological quality, mainly due to poor reporting. Three sham-controlled trials out of 11 studies were statistically pooled: systolic BP (SBP) change was not statistically significant (mean difference -5 mm Hg, 95% Cl (-12, 1), P = 0.12) and acupuncture only marginally reduced diastolic BP (DBP) by 3 mm Hg (95% Cl (-6, 0), P = 0.05), but substantial heterogeneity was observed (I-2 = 92% for SBP, I-2 = 79% for DBP). When given with anti hypertensive medication, acupuncture significantly reduced SBP (-8 mm Hg, 95% Cl (-10, -5), P < 0.00001) and DBP (-4 mm Hg, 95% Cl (-6,-2), P < 0.0001) and no heterogeneity between studies was detected. Four studies that investigated acupuncture against anti hypertensive medication indicated noninferiority of acupuncture in lowering BP, albeit the quality of them was poor, and their sample sizes were not satisfactory as an equivalence study. Other studies comparing acupuncture with various control procedures had inconsistent findings and most of them were of low methodological quality.CONCLUSIONSConsidering the limitation of the four positive noninferiority studies and the results of the meta-analysis of the three sham-controlled studies, the notion that acupuncture may lower high BP is inconclusive. More rigorous trials are warranted.