Observational Analysis Of Efficacy Index And Qualitative Interview Study On The Acupuncture Treatment Of Essential Hypertension

Objectives: 1.To understand the current status of the use of clinical efficacy indicators for studies on acupuncture treatment of essential hypertension in China,and to find new ideas for the evaluation of acupuncture efficacy.2.To understand the evaluation criteria and the influencing factors of the curative effect that patients care about most,and provide new ideas for researchers to determine the effect indexes and acupuncture schemes of clinical trials of acupuncture treatment for hypertension.Methods: This study includes two parts: literature research and qualitative interview.(1)The first part of the literature research: with "acupuncture","acupuncture","electric acupuncture","primary hypertension","primary hypertension" as free words,in the How Net,Wanfang,Weipu and The four major databases of the Biomedical Network search the clinical literature of acupuncture treatment of essential hypertension in the past decade.Then,according to the inclusion and exclusion criteria,the selected literatures were screened,and Microsoft Excel was used to establish a database to analyze the current status of the use of efficacy indicators in such studies and provide a basis for the next qualitative interview.(2)The second part of semi-structured interviews: After determining the subject of the interview,develop a preliminary interview outline and conduct a preliminary interview.After the pre-interview,modify it according to the actual situation and generate a formal interview outline.Then selected the early participation in the "Twelfth Five-Year" National Science and Technology Support Project sub-project "Shi Xuemin acupuncture antihypertensive technology treatment of hypertension inheritance research" and Tianjin chronic disease prevention technology major project "acupuncture treatment frequency affects primary hypertension clinical In the two clinical trials of "Efficacy Study",hypertension patients were recruited,and patients who had undergone acupuncture to lower blood pressure were interviewed as the target study population.Use the purposeful sampling method,and follow the principles of dynamic sampling and information saturation,select the individuals who are most likely to provide rich information for interviews,and terminate the interview when the information saturation is achieved and the research purpose is achieved.For data analysis,Nvivo analysis software is used to familiarize with the interview information as a whole,form a "predetermined topic",establish an index and draw a topic-oriented table,and finally find a series relationship.And treatment needs”.Results: 1.Literature research analysis:(1)A total of 1437 articles were retrieved after a search-based professional search.After excluding documents that did not meet the standards,37 articles were finally included.According to the improved Jadad table score,there are only 3 high-quality documents,and most of the rest are low-quality documents.(2)The curative effect indexes used mainly include total effective rate and average blood pressure(including the average blood pressure in the clinic and the average blood pressure at24h).A few literatures use dynamic blood pressure indexes,laboratory indexes,symptom scores,cardiac function indexes and carotid artery indexes.(3)In the included literatures,the most frequent acupuncture is seven times a week,followed by five acupuncture weekly,and some documents are acupuncture six times a week or three times a week.In addition,the frequency of acupuncture in one document is twice a day.The acupuncture treatment course has the most literature in four weeks.There are 4 courses for 6weeks and 5 courses for more than 2 months.2.Interview research analysis has proposed three topics including evaluation criteria of therapeutic effect,influencing factors of therapeutic effect,and treatment needs:(1)Respondents have different criteria for evaluating the effectiveness of acupuncture antihypertensive drugs.The main criteria are blood pressure drop,stable blood pressure,improvement of discomfort symptoms,and physical and mental comfort;some are effective by stopping antihypertensive drugs and no longer rebounding.(2)In addition to factors related to the patient's own state,such as sleep and mood,the interviewees believed that the therapeutic effect was also strong,such as a strong sense of acupuncture,doctor's level,treatment time,encouragement of others,and the feeling of wearing a 24 h ambulatory blood pressure monitor Wait.(3)The biggest distress caused by high blood pressure to the interviewees is that high blood pressure can cause strokes,causing hemiplegia and affecting the quality of life.In addition,long-term use of antihypertensive drugs will also have greater side effects on the body.Acupuncture treatment can lower blood pressure while getting rid of drug dependence and side effects.Conclusion: 1.At present,the curative effect index of acupuncture treatment for primary hypertension is relatively single,mainly based on the total effective rate and average blood pressure value,and lack of assessment of patients' psychology,quality of life and other aspects;the frequency of acupuncture is more than Seven times a week or five times a week,the duration of acupuncture treatment is usually within 4-6 weeks,and there is a lack of follow-up investigation after treatment.2.The interviewees are more concerned about the stability of blood pressure,the improvement of their own state after acupuncture(including psychological and emotional,etc.),and the status of drug withdrawal.At the same time,the treatment needs of the interviewees are mainly a series of problems such as a decline in quality of life caused by complications of hypertension and side effects of drugs,which also have a certain impact on the evaluation of efficacy.