CAJ | 학술논문

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。
목적：통과24 h 동태혈압감측，관찰백회투자전정대고혈압환자적혈압주야절률급혈관활성물질변화，초보탐토기작용궤제。방법：선택120례1、2급원발성고혈압（중저위）환자，수궤분위2조，대조조부진행건강교육생활방식간예；치료조재차기출상，진행백회투자전정혈치료，우치료전후행24 h 동태혈압감측，계산일간평균수축압、야간평균수축압、일간평균서장압、야간평균서장압、수축압화서장압곡봉비치급치료전후신소、철고동、혈관긴장소。결과：제4、12주，대조조화치료조균능강저일간급야간평균수축압、평균서장압，여료전비교（P ＜0．01），균유통계학의의。4주、12주조내비교，대조조무통계학의의（P ＞0．05），치료조균유통계학의의（P ＜0．05），원기료효치료조경우。4주여12주조간비교，치료조균우우대조조（P ＜0．05）。곡봉비치비교：치료전후2조대수축압곡봉비치유일정승고，비교유통계학의의（P ＜0．05），2조서장압곡봉비치비교무명현통계학의의（P ＞0．05）。혈관활성물질측정：치료후치료조신소수평교전하강，차이유통계학의의（P ＜0．05），철고동、혈관긴장소치료전후2조적조내급조간비교，차이무통계학의의（P ＞0．05）。결론：백회투자전정치료원발형고혈압1、2급능구현저강저주야평균수축압화평균서장압，대주야혈압절률화강저신소수평유일정작용。
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.