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电针降压作用的证据、机制和临床应用

JohnCLonghurst^*, StephanieCTjen-A-Looi

加州大学欧文分校医学院，生理、生物物理和药理学院；Susan Samueli综合医学研究中心，欧文 CA 92697，美国

摘要

高血压增加心血管动脉粥样硬化、中风、残疾和死亡的风险，是一个严重的全球健康问题。收缩压和舒张压，尤其是收缩压随年龄增长而增加。药物治疗高血压存在副作用，可以考虑辅助治疗，比如针灸通过调节体内神经-内分泌系统降低血压。用基础研究指导临床实践的结果显示，低频，低强度电针降低约70%的轻中度停服降压药高血压患者的交感神经活动。每周1次、持续8周的电针治疗结束后，收缩压和舒张压(较小幅度)降低能维持2~4周，甚至1个月。至于针灸的长期疗效、耐药患者的治疗以及对服药患者的疗效等问题，有待进一步研究。目前的证据表明针灸对高血压有一定的疗效。

关键词： 交感神经系统; 转录调节 ; 肾素 ; 去甲肾上腺素 ; 高血压

分类号：R246

Evidence-based blood pressure reducing actions of electroacupuncture: mechanisms and clinical application

John C Longhurst^*, Stephanie C Tjen-A-Looi

Susan Samueli Center for Integrative Medicine; Departments of Medicine, Physiology and Biophysics and Pharmacology, University of California, Irvine, Irvine, CA 92697, USA

Abstract

Hypertension is a serious world-wide health problem as it increases cardiovascular atherosclerotic risk, stroke and attending morbidity and mortality.  Both systolic and diastolic blood pressures and particularly systolic pressure increase with aging.  The downsides from pharmacological therapy have led to consideration of additional treatments, including acupuncture, which evokes endogenous neural-hormonal systems to lower blood pressure. Using basic science studies to guide clinical approaches to research, it is apparent that low frequency, low intensity electroacupuncture reduces sympathetic outflow in approximately 70% of patients with mild to moderate hypertension who are off antihypertensive drugs. Systolic and, to a lesser extent, diastolic arterial blood pressures can be lowered over two to four weeks for prolonged periods, lasting as long as one month, after cessation of an eight weeks of once weekly stimulation. Many questions about long-term therapy, treatment of resistant patients and efficacy in patients on medication remain to be studied. Current data, however, suggest that there may be a role of acupuncture in treatment of hypertension.  

Key words: sympathetic; transcriptional regulation ; renin ; norepinephrine ; hypertension

收稿日期：2017-02-23　　录用日期：2017-06-02

通讯作者：JohnCLonghurst　　E-mail: jcl@uci.edu

DOI: 10.13294/j.aps.2017.0035

引用本文：

JohnCLonghurst, StephanieCTjen-A-Looi. 电针降压作用的证据、机制和临床应用[J]. 生理学报 2017; 69 (5): 587-597.

John C Longhurst, Stephanie C Tjen-A-Looi. Evidence-based blood pressure reducing actions of electroacupuncture: mechanisms and clinical application. Acta Physiol Sin 2017; 69 (5): 587-597