Acupuncture has been shown effective for the management of high blood pressure. Researchers compared the efficacy of captopril with the use of three specific acupoints. The acupoint combination outperformed the medication control group by 14%.
Essential hypertension (EH) is a prevalent cardiovascular disorder, prevalent among middle-aged and elderly populations. EH is the primary form of hypertension; persistent increases in blood pressure can damage various target organs, heightening the risk of disability and mortality rates. EH is a significant public health threat.
One hundred patients with EH admitted to the Traditional Chinese Medicine Hospital of Qiqihar were selected for the study. They were randomly divided into control and study groups, each including 50 cases.
Method
The control group was treated with captopril, utilizing tablets produced by Changzhou Pharmaceutical Co., Ltd. Captopril is an FDA-approved angiotensin converting enzyme (ACE) inhibitor used for the treatment of hypertension, ventricular disorders after myocardial infarction, and diabetic nephropathy. The prescribed dose was 25mg per administration, taken 2–3 times per day over a treatment period of 4 weeks.
In the study group, four gates acupuncture combined with warm needle moxibustion at Baihui (GV20) was administered. Routine disinfection was performed at bilateral Taichong (LV3) and Hegu (LI4) acupoints. Using 1.5-inch filiform needles, acupuncture was administered at LV3 to a depth of 0.5 to 0.8 inches and at LI4 to a depth of 0.8 to 1.0 inches. The needles were inserted and twisted for stimulation using the reducing method until the patients experienced a deqi soreness, numbness, or swelling sensation. The needles were retained for 20 minutes, manipulated every 5 minutes, and twisted for 30 seconds each time.
Additionally, a 0.5-inch needle was inserted directly at Baihui (GV20), and upon deqi, a 1.2 cm moxa piece was placed on the handle of the needle and ignited. After the first moxa stick burned down, it was replaced with two more segments, and the needle was removed after all three segments burned completely. This procedure was repeated once daily for a treatment duration of 4 weeks.
Results
The total effective rate of the study group was 96.0%, which was better than the 82.0% rate in the control group. The blood pressure levels of the study group 140.2 ±17.0 over 82.1 ±9.9 were lower than those of the control group 147.3 ±15.8 over 86.2 ±8.1, and the difference was statistically significant.
Review
In Traditional Chinese Medicine (TCM), essential hypertension is often categorized along with headaches caused by a deficiency in the liver and kidney or ascendance of liver yang. In TCM terminology, acupuncture at the LV3 acupoint soothes the liver fire and dispels wind due to dryness. It is commonly used with LI4 to treat diseases such as alternating chills, fevers, or painful obstruction. In biomedical terminology, this combination of acupoints increases parasympathetic tone and decreases excesses in sympathetic nervous system stimulation along with reestablishing brain functional connectivity in the regulation of blood pressure. The terminology differs between TCM principles and modern biomedicine, but both refer to the same phenomena.
LI4 is the source point of the large intestine meridian of the hand yangming. LI4 clears heat, expels the exterior, activates the blood and meridians, thus improves circulation, dilates blood vessels, reduces peripheral resistance, and lowers blood pressure. GV20 is the meeting point of all the meridians and governs the qi of the entire body. Moxibustion at GV20 warms and unblocks the meridians, balances yin and yang, and regulates brain function. The acupuncture study group, which received four gates acupuncture with GV20 treatment, had a significantly higher overall effectivity rate compared with the captopril control group.
Warm needle acupuncture at GV20 and needling the four gates has the effect of purging excess yang from the yangming channel, soothing liver fire, and promoting qi circulation. It provides a stable and safe method to reduce blood pressure and has no long-term toxic side effects. The researchers conclude that acupuncture is a safe and reliable treatment for patients with hypertension. [1]
Patient Care
This investigation was limited to a two-arm model. At HealthCMi, we would like to see another investigation using the same approach to patient care with a third arm combining acupuncture and medication protocols to determine levels of additive or synergistic effects. Acupuncturists routinely achieve antihypertensive results. A clinical complexity is that patients are often concurrently taking antihypertensive medications. The addition of acupuncture’s antihypertensive effects often requires reducing or eliminating medications to avoid hypotension. At HealthCMi, we would like to see an investigation quantifying the interaction between medications and acupuncture to improve the administration of patient care.
Reference:
1. Li Tianshu & Zhang Li. (2019). Study on the effect of acupuncture to open the four passes and warm acupuncture at Baihui point in the treatment of essential hypertension. Electronic Journal of Cardiovascular Diseases with Integrated Traditional Chinese and Western Medicine (01), 167.
