The Ancient And Modern Literature Research For External Therapies Of Hypetrension

ObjectiveWe systematicly collated all ancient literature about external therapies ofhypertension.Then we revealed the types of external therapies of hypertension in ancient toenrich the means and content of modern external therapies of hypertension.Wecomprehensive searched of the modern literature of external therapies of hypertension athome. Using descriptive statistical analysis and system evaluation,we evaluated the law ofselecting points and meridians for hypertension.and clarify the clinical efficacy of externaltherapies of hypertension for clinical reference.Content and methodsThe study was divided into two major parts of the ancient literature and modernliterature. Following the literature research methods--literature collection, analysis andevaluation, we carried out research, specific research methods as followed:1Make sure the scope of relevant literature search1.1Ancient literature section: mainly used computer to retrieve the upgraded version of the"Chinese Medical Classics" with manual inspection. The basic search terms are "Dizziness,headaches, palpitations, tinnitus", retrieved the ancient provisions about external therapiesof the above related disorders. Then we sorted out common methods of ancient externaltherapies for hypertension areas disorders. We statistics the major types and applicationlaws of meridian and acupoint for external therapies of hypertension.1.2Modern literature section: The main search strategy1.2.1Database:Using computer to retrieve VIP Information (VIP,1989-2012.6), ChineseBiomedical Literature Database (CBMDisc,1988-2012.6), WanfangDatabase(WF,1989-2012.6),the Qinghua Tongfang series database (CNKI,1956-2012.6),we rigorous evaluated the quality of the literature and stata software was used for systematic evaluation. All relevant Randomized Controlled Trials(RCTs) of externaltherapies of hypertension were included and literature which met the inclusion criteriawere performed a Meta-analysis, then the frequency of points that the inclusion criteriastudies used were summed up.1.2.2Retrieval type: Cross search all literature using Key words and Subject words (xx,xxx xxxxx) in major, all the literature including hypertension, in order to complete andcomprehensive literature.2Established literature inclusion and exclusion criteria2.1Literature inclusion criteriaLiterature that meets the following conditions are included:①xxx;②Language isChinese;③Research object in accordance with xxx clinical literature;④Clinicalintervention factors: external therapies of TCM.2.2Literature exclusion criteriaContaining one of the following conditions literature were excluded:①Repeat report;②Cases, and examination case reports;③Animal experimental class, scienceclasssummarized the literature;④A variety of therapy combined;⑤Western medicine;⑥Newspaper, patent and other non-paperliterature.Result1Common methodsThe common methods of the ancient external therapies of hypertension areasdisorders as following: acupuncture, moxibustion, bloodletting therapy, acupointapplication, diet therapy, bath therapy, pillow with medicine, Thermotherapy, fumigation,qigong.The common methods of the modern external therapies of hypertension as following:Acupuncture, auricular acupoint application, external therapies of bloodletting,moxibustion, qigong, catgut embedding, physical therapy, massage, foot bath, pillow withmedicine.2Points frequency statistics2.1Previously the Han Dynasty and the Han DynastyNo statistics of acupoints frequency.2.2Wei, Jin and Southern and Northern Dynasties, Sui and Tang DynastiesWe counted95related acupoints. Higher frequency points are Kunlun, Tianzhu, Zhongzhu, Yanggu and Yongquan. Meridians of higher frequency points: Bladder Meridian,Gall bladder Meridian, Sanjiao Meridian. Meridians of more number of points: BladderMeridian, Gall bladder Meridian, Sanjiao Meridian.2.3Song, Jin and Yuan DynastiesWe counted140related points. Higher frequency points: Baihui, Shenting, Qianding,Yuzhen, Shangxing. Meridians of higher frequency points: Bladder Meridian, Gall bladderMeridian, Du Meridian. Meridians of more number of points: Bladder Meridian, Gallbladder Meridian, Du Meridian.2.4Ming, Qing and Minguo DynastiesWe counted141related points. Higher frequency points: Baihui, Hegu, Fengchi,Shangxing, Jiexi. Meridians of higher frequency points: Bladder Meridian, Gall bladderMeridian, Du Meridian. Meridians of more number of points: Bladder Meridian, Gallbladder Meridian, Du Meridian.2.5modern timesIn the included literature studies, We counted141related points,17auriculars. Higherfrequency points: Taichong, Zusanli, Quchi, Fengchi, Sanyinjiao, Fenglong; As the mainpoints, The acupoints of used more frequency: Fengchi, Zusanli, Quchi, Taichong, Baihui,Sanyinjiao; As a distribution point, the acupoints of used more frequency: Fenglong, Taixi,Taichong, Neiguan, Zusanli. more frequency acupoints in Auricular: Jiangyagou, Shenmen,Gan, Xin, Shen.Meridians of higher frequency points: Stomach Meridian, Gall bladderMeridian, Bladder Meridian, Liver Meridian, Large intestine Meridian. Meridians of morenumber of points: Bladder Meridian, Gall bladder Meridian, Qijingbamai Meridian, DuMeridian, Ren Meridian.3Clinical evaluation:Meta-analysis results showed that:In the total efficiency of improving blood pressure, acupuncture［RR=1.036，95%CI(0.946，1.135)，P=0.447＞0.05］, auricular therapy［RR=1.065，95%C(I0.903，1.256)，P=0.457＞0.05］ have the same efficacy with oral antihypertensive drugs; Acupointapplication［RR=1.741，95%CI(1.079，2.808)，P=0.023＜0.05］, massage［RR=1.076，95%C(I1.011，1.144)，P=0.021＜0.05］, and footbath therapy［RR=1.188，95%C(I1.039，1.358)，P=0.012＜0.05］combined with antihypertensive drugs has a better efficacycompared oral antihypertensive drugs alone. In aspects of improving SBP, acupuncture［SMD=–0.12，95%CI(–0.378，0.129)，P=0.335＞0.05］, qigong［SMD=-0.693，95%CI(-1.606，0.220)，P=0.137＞0.05］ havethe same efficacy with oral antihypertensive drugs; massage［SMD=-0.709，95%CI(-0.987，0.431)，P=0.000＜0.01］combined with antihypertensive drugs has a betterefficacy compared oral antihypertensive drugs alone; footbath therapy［SMD=-0.059，95%CI(-0.284，0.165)，P=0.604＞0.05］combined with antihypertensive drugs has thesame efficacy with oral antihypertensive drugs alone.In aspects of improving DBP, acupuncture［SMD=–0.051，95%CI(–0.195，0.092)，P=0.483＞0.05］、qigong［SMD=-0.298，95%CI(-0.818，0.221)，P=0.260＞0.05］havethe same efficacy with oral antihypertensive drugs; massage［SMD=-0.334，95%CI(-0.606，0.063)，P=0.016＜0.05］、footbath therapy［SMD=-0.279，95%CI(-0.504，0.053)，P=0.015＜0.05］combined with antihypertensive drugs has a better efficacycompared oral antihypertensive drugs alone.Conclusion1.Treatment methodsAncient external treatment areas of the treatment of hypertension commonly usedmethods are: acupuncture, moxibustion, bloodletting, acupoint application, dietary therapy,bath therapy, medicinal pillow, ironing, fumigation, qigong. The modern common methodsare: acupuncture, auricular acupoint application, bloodletting, moxibustion, Qigong, catgutembedding, physiotherapy, massage, foot bath, medicinal pillow.2.The common meridiansSelected acupoints which were used to treat hypertension, are mainly belongs toBladde Meridian, Gallbladder Meridian, Liver Meridian and Du Meridian. WheneverBladde Meridian and Gallbladder Meridian are the main meridians to treat hypertension.3. The common acupointsIn ancient, the common acupoints to treat hypertension are Baihui, Fengchi, Taichong.At present, the common acupoints are Taichong, Zusanli, Quchi, Fengchi,.4.Treatment effectAcupuncture, qigong, auricular therapy has the same efficacy with oralantihypertensive drugs. Acupoint application, massage therapy combined with oralantihypertensive drugs have the better dfficacy with oral medicine alone. Foot Therapycombined with drugs had no significant effect in SBP,but there are certain advantages in improving DBP aspects.5.InadequaciesIn the study of this subject, we can find there are a lot of inadequacies in retrievingexternal therapies of hypertension literaure, such as Screening of ancient literature; theapplication of the blinded grading and staging of hypertension in the treatment ofhypertension, clinical practical standardized specifications, and so on, these are we need tomake up in the future study.