abstracted & translated by

Bob Flaws, Lic. Ac., Dipl. Ac. & C.H., FNAAOM (USA), FRCHM (UK)

Keywords: Chinese medicine, acupuncture-moxibustion, hypertension, high blood pressure, captopril, ACE inhibitor

In issue #12, 2003 of Xin Zhong Yi (New Chinese Medicine), Wu Qing-ming and Feng Guo-xiang, of the Second Affiliated Hospital of the Hunan College of Chinese Medicine in Changsha, published an article titled, "Clinical Observations on the Correlation Between the Hypotensive Effect & Serum Angiotensin II After Warm Needle Moxibustion Kai Si Guan (Opening the Four Bars) & Bai Hui (GV 20)." This article appeared on pages 45-47 of that journal. A summary is given below.

Cohort description:

Altogether, there were 80 patients with essential hypertension (EH) enrolled in this study. These patients’ blood pressure was equal to or greater than 140/90mmHg.These 80 patients were randomly divided into a treatment and a comparison group. In the treatment group, there were 18 patients with first degree hypertension and 22 patients with second degree hypertension. the median age of this group was 48.55 ± 10.79 years, and the mean course of disease was 5.15 ± 4.37 years. In the comparison group, there were 16 first degree patients and 24 second degree patients with a median age of 47.85 ± 11.23 years and median disease duration of 4.95 ± 4.48 years. First degree disease meant that there was no organic damage due to hypertension. Second degree disease meant that there was, such as thickening of the left ventricle, retinopathy, and albuminuria. Thus, using a Ridit scale analysis, these two groups were statistically comparable. Inclusion criteria were EH and being between 18-70 years of age. Exclusion criteria included age less than 18 or more than 70, pregnancy or breast-feeding, hypertension secondary to liver or kidney disease, labile blood pressure, or needle shock.

Treatment method:

Members of the treatment group received warm needle acupuncture at Opening the Four Bars points and Bai Hui. Opening the Four Bars points consisted of bilateral He Gu (LI 4) and Tai Chong (Liv 3). After disinfection, these four points were needled with 38 gauge, 1.5 inch fine needles inserted perpendicularly to a depth of 0.8-1 inch at He Gu and o.5-0.8 inches at Tai Chong. After stimulating these points with twisting-turning draining technique and mild stimulation, marked soreness and distention were created. However, the stimulation was not particularly difficult to bear. Each needle was retained for 20 minutes and was twisted again every five minutes. Bai Hui was needled with a 0.5 inch fine needle to a depth of 1-2 fen. Then 1.2-1.5cm of a moxa roll was affixed to the handle of this needle which was then lit and allowed to burn. Each time, three sections of moxa roll were burnt. This treatment was repeated once per day for a continuous 30 days. The members of the comparison group were administered 25mg of captopril TID for a continuous 30 days. Captopril is a commonly prescribed angiotension converting enzyme (ACE) inhibitor used for the treatment of high blood pressure.

Treatment outcomes:

At the end of the 30 days of treatment in the treatment group which received acupuncture-moxibustion, mean systolic blood pressure had gone from 163.5 ± 14.3mmHg to 145.7 ± 16.5mmHg and mean diastolic blood pressure had gone from 95.7 ± 8.49mmHg to 83.9 ± 10.28mmHg. In the comparison group, mean systolic blood pressure went from 164.8 ± 13.84mmHg to 143.6 ± 17.2mmHg and mean diastolic pressure went from 94.63 ± 9.1mmHg to 85.4 ± 9.87mmHg. Therefore, there was a marked decrease in mean blood pressure in both groups, and the acupuncture was equally as effective as the captopril. In addition, serum angiotensin II was measured in both groups before and after treatment. While captopril resulted in a significant decrease in mean serum angiotensin II (as one would expect from an ACE inhibitor), there was only an insignificant reduction of serum angiotensin II in the acupuncture-moxibustion group, and this reduction was not correlated with reductions in blood pressure. Therefore, Drs. Wu and Feng concluded that this acupuncture protocol does not achieve its reduction in blood pressure via inhibition of angiotensin-converting enzyme but achieves its effect through some other, possibly bi-phasic modulating, mechanism.

Discussion:

While Drs. Wu and Feng designed their study to hopefully show that their acupuncture-moxibustion protocol achieves its blood pressure lowering effects via the same mechanisms as ACE inhibitors, this does not mean that their study was, in any way, a failure. It conclusively shows that acupuncture-moxibustion can be equally as effective for lowering essential hypertension as captopril. Since captopril has a number of side effects, including possible kidney and liver damage, depression of bone marrow and white blood cell production, dizziness, nausea, constipation, and a dry cough, patients with EH may very well desire an alternative therapy, and acupuncture-moxibustion is such an alternative therapy with few or no side effects when performed by a properly trained professional.

Copyright © Blue Poppy Press, 2004. All rights reserved.

For more information on the Chinese medical treatment of hypertension, see Bob Flaws and Philippe Sionneau’s The Treatment of Modern Western Medical Diseases with Chinese Medicine available from Blue Poppy Press.