中国针灸

目的：观察热敏灸联合西药治疗阳气亏虚型老年体位性低血压（OH）的临床疗效。方法：将60例阳气亏虚型老年OH患者随机分为观察组（30例，脱落1例）和对照组（30例）。对照组予盐酸米多君片口服，每次2.5 mg，每天2次；观察组在对照组基础上行热敏灸治疗，穴取大椎、风府、百会，每次30～40 min，每天1次。两组均治疗4周。分别于治疗前及治疗2、4周后观察两组患者卧位及立位血压、卧位转立位时血压下降值，并评定临床疗效。结果：治疗4周后，两组患者卧位及立位收缩压（SBP）、舒张压（DBP）均较治疗前升高（P<0.05），卧位转立位时SBP、DBP下降值均较治疗前降低（P<0.05）；观察组卧位及立位SBP、DBP高于对照组（P<0.05），卧位转立位时SBP、DBP下降值低于对照组（P<0.05）。观察组总有效率为96.6%(28/29)，高于对照组的70.0%(21/30,P<0.05)。结论：热敏灸联合西药可升高阳气亏虚型老年OH患者的卧位及立位血压，降低卧位转立位血压下降值。

Objective To observe the effect of heat-sensitive moxibustion combined with medication on orthostatic hypotension(OH) of yang-qi deficiency in the elderly. Methods Sixty elderly patients with OH of yang-qi deficiency were randomly divided into an observation group(30 cases, 1 case dropped out) and a control group(30 cases). The patients in the control group were treated with oral midodrine hydrochloride tablets, 2.5 mg each time and twice daily, while the patients in the observation group were treated with heat-sensitive moxibustion in addition to the treatment in the control group.Acupoints selected included Dazhui(GV 14), Fengfu(GV 16), and Baihui(GV 20), with each session lasting 30-40 min, once daily. Both groups were treated for 4 weeks. Blood pressure in the supine and standing positions, as well as the decrease of blood pressure when the position changing from supine to standing, were measured before treatment and after 2 and 4 weeks of treatment. Clinical efficacy was also evaluated. Results After 4 weeks of treatment, both groups showed an increase in systolic blood pressure(SBP) and diastolic blood pressure(DBP) in both the supine and standing positions(P<0.05), and the decrease in SBP and DBP when the position changing from supine to standing was reduced(P<0.05). Compared with the control group, the observation group had higher SBP and DBP in both positions and a smaller decrease in SBP and DBP when the position changing from supine to standing(P<0.05). The total effective rate was 96.6%(28/29) in the observation group,which was higher than 70.0%(21/30) in the control group(P<0.05). Conclusion Heat-sensitive moxibustion combined with medication could increase the blood pressure in both supine and standing position, and decrease the reducing of blood pressure when the position changing from supine to standing in elderly patients with OH of yang-qi deficiency.