Acupoint application therapies for essential hypertension: a systematic review and Meta-analysis

To evaluate the efficacy and safety of acupoint application therapies (AA) for hypertension. METHODS: We searched PubMed, EMBASE, the Cochrane Center Controlled Trials Register, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, and Wanfang Med Online Database from their inceptions to October 7, 2019. No language restriction was applied. We included randomized clinical trials testing AA against Western Medicine, AA versus placebo, AA combined with Western Medicine versus Western Medicine. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards. RESULTS: Totally 41 trials with 3772 participants were included. The methodological quality of the included trials was evaluated as generally low. AA plus Western Medicine significantly lowered systolic blood pressure (BP) [weighted mean difference (WMD): -10.36, 95% confidence intervals (CI): -12.62, -8.10; P < 0.000 01], diastolic BP (WMD: -5.71, 95% CI: -7.30, -4.13; P < 0.000 01), and total effect [risk ratio (RR): 1.23, 95% CI: 1.15, 1.32; P < 0.000 01]. The BP-lowering effect of AA was significantly higher than that of placebo [systolic BP (SBP): -8.05, 95% CI: - 8.67, - 7.43; P < 0.000 01; diastolic BP (DBP): -6.66, 95% CI: -7.31, -6.01, P < 0.000 01]. The total effect also improved significantly from baseline with AA than placebo (RR: 10.85, 95% CI: 4.71, 24.98; P < 0.000 01). Traditional Chinese Medicine symptoms score were significantly reduced by AA compared with Western Medicine (WMD: - 1.75, 95% CI: - 2.52, - 0.99; P < 0.000 01), 10 trials reported adverse events, indicating that the safety of SSYX Capsule is still uncertain. CONCLUSIONS: Application therapies may be considered a safe and beneficial for the treatment of hypertension and can reduce BP and improve the total effect. Further well-designed trials are needed to support our conclusions. (C) 2022 JTCM. All rights reserved.