中医外治法治疗难治性高血压临床疗效的Meta分析  

Clinical Efficacy of External Therapy of Traditional Chinese Medicine for Treating Resistant Hypertension:a Meta-analysis

作　　者：刘乐顺 薛梅[2,3] LIU Leshun;XUE Mei(Beijing University of Chinese Medicine,Beijing 100091,China;National Clinical Research Center for Chinese Medicine Cardiology,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;Center for Cardiovascular Disease,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]北京中医药大学,北京100091 [2]国家中医心血管病临床医学研究中心,中国中医科学院西苑医院,北京100091 [3]中国中医科学院西苑医院心血管病中心,北京100091

出　　处：《中西医结合心脑血管病杂志》2025年第7期1044-1049,共6页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家重点研发计划课题(No.2019YFC0840608);国家自然科学基金项目(No.81973686);中国中医科学院科技创新工程重大攻关项目(No.CI2021A00913);中国中医科学院西苑医院能力提升项目(No.XYZX0201-18)。

摘　　要：目的:系统评价中医外治法治疗难治性高血压的临床疗效。方法:系统检索万方、中国知网、维普3个中文数据库和PubMed、EMbase、the Cochrane Library、Web of Science 4个英文数据库中所有关于中医外治法(包括药物沐足、针刺、穴位贴敷等)治疗难治性高血压的文献,检索时间限定为建库至2024年12月13日。对纳入文献进行质量评价,标准参照Cochrane协作网提供的偏倚风险评估工具,并使用RevMan 5.3软件进行Meta分析。结果:共纳入8项随机对照研究,涉及病人665例,其中治疗组337例,对照组328例。Meta分析结果示,治疗组在降低收缩压[MD=-4.36,95%CI(-5.38,-3.35),P<0.000 01]、提高降压有效率[RR=1.28,95%CI(1.13,1.45),P<0.000 1]、提高总体疗效[RR=1.16,95%CI(1.05,1.28),P<0.000 1]方面优于对照组,但两组舒张压比较,差异无统计学意义[MD=-4.11,95%CI(-9.03,0.80),P=0.10]。治疗组不良反应的发生率低于对照组,差异有统计学意义[RR=0.22,95%CI(0.06,0.78),P=0.02]。结论:现有证据表明,中医外治法对于控制难治性高血压病人的血压,提高临床总体疗效具有一定意义,但仍需要更多包含多样化中医外治法、大样本且高质量的临床试验来证实。ObjectiveObjective:To evaluate the clinical effect of external therapy of traditional Chinese medicine(TCM)on resistant hypertension.MethodsMethods:All literatures of external therapy of TCM(including drug foot massage,acupuncture,acupoint application,etc.)for the treatment of resistant hypertension from 3 Chinese databases including WanFang Database and China National Knowledge Infrastructure(CNKI),and 4 English databases including PubMed,EMbase,the Cochrane Library and Web of Science were searched.The search period was limited before December 13,2024.The quality of the included literature was evaluated with reference to the risk assessment tool for bias provided by the Cochrane Collaboration and Meta-analysis was performed using RevMan 5.3 software.ResultsResults:A total of 8 randomized controlled studies were included,involving 665 patients,there were 337 patients in the treatment group and 328 patients in the control group.The results of Meta-analysis showed that the external therapy in decreasing systolic blood pressure(MD=-4.36,95%CI-5.38--3.35,P<0.00001),improving the antihypertensive effective rate(RR=1.28,95%CI 1.13-1.45,P<0.0001),and improving the overall curative effect(RR=1.16,95%CI 1.05-1.28,P<0.0001)was better than that of the control group,but there was no significant difference in diastolic blood pressure between the two groups(MD=-4.11,95%CI-9.03-0.80,P=0.10).The incidence of adverse reactions in the treatment group was lower than that in the control group,with statistical significance(RR=0.22,95%CI 0.06-0.78,P=0.02).ConclusionConclusion:Existing evidence shows that TCM external therapy shows certain significance for controlling blood pressure of resistant hypertension patients and improving the overall clinical efficacy,but it still needs more high-quality clinical trials involving diversified TCM external therapy and large samples to confirm.

关 键 词：难治性高血压 中医外治法 META分析 

分 类 号：R259[医药卫生—中西医结合]