【摘要】 目的:分析不同选穴、留针时间、针刺深度对原发性高血压患者24 h血压负荷及昼夜节律的影响,优选最佳针刺降压方案。方法:纳入48例临床病例,采用正交试验设计,按照3因素2水平,即选穴(人迎、太冲)、留针时间(15、30 min)、针刺深度(浅刺、深刺),分为8组,每组6例,观察针刺前后24 h动态血压负荷及血压昼夜节律的变化。结果:(1)针刺深度对收缩压负荷的影响最为显著(P<0.05),各因素不同水平的影响程度为:人迎>太冲,15 min<30 min,浅刺<深刺,最佳调节收缩压方案为深刺人迎30 min;(2)留针时间对舒张压负荷的影响最为显著(P<0.05),各因素不同水平的影响程度为:人迎<太冲,15 min<30 min,浅刺<深刺,最佳调节舒张压方案为深刺太冲30 min;(3)不同因素对于昼夜节律的影响程度为针刺深度>留针时间>选穴;各因素不同水平对昼夜节律的影响程度为:人迎<太冲,15 min<30 min,浅刺<深刺。最佳调节昼夜节律的方案为深刺太冲30 min。结论:深刺人迎或太冲30 min为针刺调节收缩压负荷、舒张压负荷及血压昼夜节律的最佳方案。更多还原

【Abstract】 Objective: To analyze the effects of different point selection, needle retention time, and acupuncture depth on the 24-hour blood pressure load and circadian rhythm of essential hypertension patients,and to optimize the best acupuncture antihypertensive program. Methods: A total of 48 clinical cases were selected and divided into 8 groups with 6 cases in each group according to 3 factors and 2 levels, namely acupoint selection[Renying(ST9) and Taichong(LR3)], needle retention time(15 min and 30 min) and acupuncture depth(shallow needling and deep needling). Observe the changes of 24 h ambulatory blood pressure load and blood pressure circadian rhythm before and after acupuncture. Results:(1) The depth of acupuncture has the most significant effect on the systolic blood pressure load(P<0.05). The different levels of the influence of each factor are: Renying(ST9)>Taichong(LR3), 15 min < 30 min, shallow needling<deep needling. The best scheme of adjusting systolic blood pressure was deep needling Renying(ST9) for 30 min.(2) The effect of needle retention time on diastolic blood pressure load was the most significant(P<0.05), and the influence degree of different levels of each factor was as follows: Renying(ST9) <Taichong(LR3), 15 min <30 min, shallow needling < deep needling. The best scheme for adjusting diastolic blood pressure was deep needling Taichong(LR3) for 30 min.(3) The influence degree of different factors on circadian rhythm was acupuncture depth> needle retention time > acupoint selection;the influence degree of different factors on circadian rhythm was Renying(ST9)< Taichong(LR3), 15 min<30 min,shallow needling < deep needling. The best plan to regulate circadian rhythm was deep needling Taichong for30 minutes. Conclusion: Deep needling Renying(ST9) or Taichong(LR3) for 30 min is the best scheme for acupuncture to regulate systolic pressure load, diastolic pressure load and circadian rhythm of blood pressure.更多还原