中文摘要：

目的：观察直接灸对老年原发性高血压患者24小时动态血压、中医临床症状的影响,探讨中医灸法的降压作用与影响因素。方法：将符合纳入标准的101例老年高血压患者随机分入直接灸I组（33例）、直接灸I I组（34例）和对照组（34例）。对照组采用钙拮抗剂（calcium antagonist,CCB）或血管紧张素I I受体拮抗剂（angiotensin II receptor antagonist,ARB）治疗,连续5星期。直接灸I组采用直接灸I配合药物治疗,每穴5壮,每星期3次,5星期为1疗程。直接灸I I组采用直接灸I I配合药物治疗,每穴5壮,每星期3次,5星期为1疗程。观察治疗前后3组患者中医临床症状的变化,检测24小时动态血压（ambulatory blood pressure,ABP）。结果：与治疗前比较,对照组治疗后24小时平均收缩压（mean 24-hour ambulatory systolic blood pressure,mean 24 h ASBP）、夜间A SBP、24小时平均舒张压（mean 24-hour ambulatory diastolic blood pressure,mean 24 h ADBP）〉90 mm Hg百分比与白昼ADBP〉90 mm Hg百分比上升均有统计学差异（均P〈0.05）。与治疗前比较,直接灸I组治疗后夜间A DBP〉80 mm Hg百分比明显降低（P〈0.01）;其余24小时动态血压观察指标[日间A SBP、mean 24 h ASBP〉140 mm Hg百分比、日间A SBP〉140 mm Hg百分比、夜间ASBP〉120 mm Hg百分比、24 h mean ADBP、日间A DBP、夜间ADBP及24小时动态脉压（ambulatory pulse pressure,APP）],各组治疗前后比较均无统计学差异（P〉0.05）。直接灸I组总有效率为73.3%,直接灸I I组总有效率为13.3%,对照组总有效率为10.0%,3组患者中医临床症状改善情况有统计学差异（P〈0.01）。结论：直接灸对老年原发性高血压患者的血压具有良性调节作用,能够改善患者的临床症状。直接灸方法 I（艾炷燃尽后再续灸下1壮）对老年原发性高血压患者血压和症状的改善作用优于直接灸方法 I I（不待艾炷燃尽就迅速熄灭艾炷,续灸下1壮）。

英文摘要：

Objective： To assess the effects of direct moxibustion on 24-hour ambulatory blood pressure （ABP） and clinical symptoms of traditional Chinese medicine （TCM） in elderly patients with essential hypertension, and to explore the antihypertensive effect and influencing factors of moxibustion. Methods： A total of 101 elderly hypertension patients who met the inclusion criteria were randomly assigned to a direct moxibustion I group （n=33）, a direct moxibustion II group （n=34）, and a control group （n----34）. The treatment of calcium antagonist （CCB） or angiotensin II receptor antagonist （ARB） was adopted in the control group. The treatment of direct moxibustion I plus the same medicine as the control group were adopted in the direct moxibustion I group, five cones per acupoint and three times per week, for 5 weeks in total. The treatment of direct moxibustion II plus the same medicine as the control group were adopted in the direct moxibustion II group, five cones per acupoint and three times per week, for 5 weeks in total. The changes of 24-hour ABP and clinical symptoms of TCM after treatment were compared in the three groups. Results： The mean 24-hour ambulatory systolic blood pressure （mean 24 h ASBP）, night ASBP, percentage of mean 24-hour ambulatory diastolic blood pressure （mean 24 h ADBP）~90 mmHg, and percentage of day ADBP~90 mmHg in the control group were elevated after treatment （P~0.05）. The percentage of night ADBP~80 mmHg in the direct moxibustion I group was reduced by treatment （P〈0.01）. There were no significant differences in the other outcome measures of 24 h ABP, such as day ASBP, percentage of mean 24 h ASBP~140 mmHg, percentage of day ASBP~140 mmHg, percentage of night ASBP 〉120 mmHg, mean 24 h ADBP, day ADBP, night ADBP, 24 h ambulatory pulse pressure （APP）, after treatment in all groups （P~0.05）. The degree of improvement of the clinical symptoms of TCM showed significant differences among the three groups of patients （P~0.01）. The