[Effectiveness evaluation of heat-sensitive moxibustion self-management in community patients with essential hypertension： a randomized controlled trial].
Researchers
Hui Wang, Shuqing Li, Luyu Chai, Guihua Deng, Xu Zhou
Abstract
To evaluate the effectiveness, safety and compliance of heat-sensitive moxibustion self-management in community patients with essential hypertension. A total of 120 patients with essential hypertension were recruited from three communities and randomly assigned at a 1∶1 ratio to either the intervention group (heat-sensitive moxibustion self-management combined with original antihypertensive regimen) or the control group (original antihypertensive regimen alone). In the intervention group, heat-sensitive moxibustion was applied to one main acupoint with the strongest moxibustion sensation selected from three main acupoints (Yongquan［KI1］, Baihui［GV20］, Shenque［CV8］) and one adjunct acupoint with the strongest moxibustion sensation selected from five adjunct acupoints (Quchi［LI11］, Zusanli［ST36］, Hegu［LI4］, Taichong［LR3］, Dazhui［GV14］). The treatment lasted approximately 30 minutes once daily, with flexible adjustment of frequency allowed. The intervention and follow-up period lasted 6 months. The primary outcome was the reduction in systolic blood pressure. Secondary outcomes included the reduction in diastolic blood pressure, antihypertensive effective rate, changes in antihypertensive medication dosage, traditional Chinese medicine (TCM) symptom score for hypertension, quality of life score measured by the EuroQol Five-Dimension Five-Level Questionnaire (EQ-5D-5L), and incidence of new-onset cardiovascular and cerebrovascular events. Compliance with heat-sensitive moxibustion self-management and incidence of adverse events were also assessed. A total of 89.2% (107/120) of patients completed the 6-month follow-up. At the end of the 6-month intervention, the reduction in systolic blood pressure from baseline was significantly greater in the intervention group than in the control group (<i>P</i><0.01), whereas no significant difference was observed in the change in diastolic blood pressure from baseline between the two groups. The antihypertensive effective rate was significantly higher in the intervention group than in the control group (<i>P</i><0.05). The intervention group showed significantly greater improvements in the EQ-5D-5L overall health self-rating score, total TCM hypertension symptom score, and individual symptoms including headache, tinnitus and red eyes compared with the control group (<i>P</i><0.01, <i>P</i><0.05). All heat-sensitive moxibustion-related adverse events were mild. Heat-sensitive moxibustion self-management can reduce systolic blood pressure, improve antihypertensive effective rate, and alleviate hypertension-related symptoms and quality of life in community patients with essential hypertension, with favorable safety and compliance. These findings suggest that heat-sensitive moxibustion can be promoted as an adjunctive management strategy for essential hypertension in community settings. <b>目的</b>: 评估社区原发性高血压患者热敏灸自我管理的疗效、安全性和依从性。<b>方法</b>: 从3个社区招募120例原发性高血压患者，以1∶1比例随机分配于热敏灸自我管理联合原降压方案组（试验组）或单用原降压方案组（对照组）。试验组分别在3个主穴（涌泉、百会、神阙）和5个配穴（曲池、足三里、合谷、太冲、大椎）中各选灸感最强的一处主穴和配穴实施热敏灸，每次约30 min，每日1次并允许调整频次。共干预和访视6个月。主要结局指标为收缩压降幅，次要结局指标包括舒张压降幅、降压有效率、降压药剂量变化情况、高血压中医症状评分、生活质量评分[欧洲五维健康量表（EQ-5D-5L）]、新发心脑血管事件发生率;同时评价热敏灸自我管理依从性和不良事件发生率。<b>结果</b>: 89.2%（107/120）的患者完成了6个月的访视。完成6个月干预时，试验组收缩压相对基线降幅显著大于对照组（<i>P</i><0.01），但两组舒张压相对基线变化差异无统计学意义。试验组降压有效率显著高于对照组（<i>P</i><0.05）。试验组EQ-5D-5L整体健康状况自评分和高血压中医症状总评分、头痛、耳鸣、目赤的改善幅度均显著大于对照组（<i>P</i><0.01，<i>P</i><0.05）。所有热敏灸相关不良事件均为轻度。<b>结论</b>: 社区原发性高血压患者热敏灸自我管理可降低收缩压、提高降压有效率，并改善高血压症状和生活质量，安全性和依从性良好，提示热敏灸可推广用于社区原发性高血压的辅助管理。.Source: PubMed (PMID: 42779403)View Original on PubMed