摘 要
原发性高血压是心血管疾病的重要危险因素，其发病率逐年上升且发病机制复杂。本研究旨在探讨针灸治疗原发性高血压的临床疗效及其作用机制。选取某地区医院收治的120例原发性高血压患者作为研究对象，按照随机数字表法分为观察组和对照组各60例，对照组采用常规降压药物治疗，观察组在对照组基础上加用针灸治疗，疗程均为8周。通过对比两组患者治疗前后血压水平、中医证候积分及不良反应发生情况来评价临床疗效，并检测血浆内皮素、一氧化氮等指标以探究针灸的作用机制。结果显示，观察组总有效率为91.67%，明显高于对照组的75.00%，差异有统计学意义；观察组治疗后收缩压、舒张压、中医证候积分均低于对照组，血浆内皮素含量低于对照组，一氧化氮含量高于对照组，且未见严重不良反应。这表明针灸可有效降低原发性高血压患者的血压，改善临床症状，其机制可能与调节血管活性物质有关，为针灸治疗原发性高血压提供了新的思路和理论依据，也为中医药在高血压防治领域的应用拓展了空间。
关键词：原发性高血压；针灸治疗；临床疗效；血管活性物质；中医证候积分
Abstract
Primary hypertension is a significant risk factor for cardiovascular diseases, with its incidence increasing annually and its pathogenesis being complex. This study aimed to investigate the clinical efficacy and underlying mechanisms of acupuncture in treating primary hypertension. A total of 120 patients diagnosed with primary hypertension from a regional hospital were selected as subjects and randomly divided into an observation group and a control group, each comprising 60 patients, using a random number table method. The control group received conventional antihypertensive medication, while the observation group was treated with acupuncture in addition to the conventional medication. Both groups underwent an 8-week treatment course. Clinical efficacy was evaluated by comparing pre- and post-treatment blood pressure levels, TCM syndrome scores, and adverse reactions between the two groups. Plasma endothelin and nitric oxide levels were also measured to explore the mechanisms of acupuncture. The results showed that the overall effective rate in the observation group was 91.67%, significantly higher than the 75.00% in the control group, with statistically significant differences. Post-treatment systolic and diastolic blood pressures, as well as TCM syndrome scores, were lower in the observation group compared to the control group. Additionally, plasma endothelin levels were lower, and nitric oxide levels were higher in the observation group compared to the control group, with no severe adverse reactions observed. These findings indicate that acupuncture can effectively reduce blood pressure and improve clinical symptoms in patients with primary hypertension, possibly through the regulation of vasoactive substances. This study provides new insights and theoretical evidence for the application of acupuncture in treating primary hypertension and expands the potential of traditional Chinese medicine in the prevention and treatment of hypertension.
Keywords：Primary Hypertension；Acupuncture Therapy；Clinical Efficacy；Vasoactive Substances；Traditional Chinese Medicine Syndrome Scores
目 录
摘 要 I
Abstract II
引 言 1
第一章 针灸治疗原发性高血压的临床疗效评估 2
1.1 临床研究设计与方法 2
1.2 治疗前后血压变化分析 2
1.3 症状改善情况观察 3
第二章 针灸对高血压患者生理指标的影响 4
2.1 血液流变学指标变化 4
2.2 自主神经功能调节 4
2.3 内分泌系统反应特征 5
第三章 针灸治疗高血压的作用机制探讨 7
3.1 中医理论基础解析 7
3.2 现代医学机制研究 7
3.3 关键穴位作用原理 8
第四章 针灸治疗高血压的安全性及应用前景 9
4.1 不良反应发生率统计 9
4.2 与其他疗法的比较优势 9
4.3 临床推广应用建议 10
结 论 11
参考文献 12
致 谢 13
