INTRODUCTION This systematic review aims to update the evidence for moxibustion for essential hypertension. METHODS Randomized controlled trials (RCTs) comparing moxibustion versus lifestyle intervention or moxibustion plus antihypertensive drugs versus antihypertensive drugs alone were searched in 9 databases up to March 29, 2020. In meta-analyses, mean difference (MD) and proportional odds ratio (pOR) with 95% confidence intervals (CIs) was pooled for continuous and ordinal outcomes, respectively. RESULTS Eighteen RCTs were included, involving 1,460 patients. Moxibustion decreased systolic (MD -7.85 mm Hg, 95% CI -9.69 to -6.00, p < 0.00001, I2 = 46%) and diastolic (MD -4.09 mm Hg, 95% CI -5.45 to -2.73, p < 0.0001, I2 = 56%) blood pressures and improved the response to hypotensive treatment (pOR 2.37, 95% CI 1.49-3.75, p = 0.0003, I2 = 57%) significantly more than did the control treatment. Moxibustion also significantly relieved headache and dizziness but the effects changed to be statistically nonsignificant after excluding RCTs with a high risk of bias. Moxibustion did not significantly relieve insomnia and anxiety. No adverse events were reported. CONCLUSIONS Based on the current low to moderate quality evidence, our study suggests that moxibustion may have effects on reducing blood pressure. The effects of moxibustion on typical hypertension symptoms and the long-term safety of moxibustion remain uncertain.

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艾灸治疗原发性高血压和高血压症状：18 项随机对照试验的系统评价

引言 本系统评价旨在更​​新艾灸治疗原发性高血压的证据。方法 在截至 2020 年 3 月 29 日的 9 个数据库中搜索了比较艾灸与生活方式干预或艾灸加降压药与单独降压药的随机对照试验 (RCT)。在荟萃分析中，均数差 (MD) 和比例优势比 (pOR)具有 95% 置信区间 (CI) 的数据分别用于连续和有序结果。结果 纳入 18 项 RCT，涉及 1,460 名患者。艾灸降低了收缩压（MD -7.85 mm Hg，95% CI -9.69 至 -6.00，p < 0.00001，I2 = 46%）和舒张压（MD -4.09 mm Hg，95% CI -5.45 至 -2.73，p < 1,000） I2 = 56%) 血压并改善对低血压治疗的反应 (pOR 2.37, 95% CI 1.49-3.75, p = 0.0003, I2 = 57%) 显着高于对照治疗。艾灸也显着缓解头痛和头晕，但在排除具有高偏倚风险的随机对照试验后，效果变为无统计学意义。艾灸并没有明显缓解失眠和焦虑。没有报告不良事件。结论 基于目前低至中等质量的证据，我们的研究表明，艾灸可能具有降低血压的作用。艾灸对典型高血压症状的影响以及艾灸的长期安全性尚不确定。艾灸并没有明显缓解失眠和焦虑。没有报告不良事件。结论 基于目前低至中等质量的证据，我们的研究表明，艾灸可能具有降低血压的作用。艾灸对典型高血压症状的影响以及艾灸的长期安全性尚不确定。艾灸并没有明显缓解失眠和焦虑。没有报告不良事件。结论 基于目前低至中等质量的证据，我们的研究表明，艾灸可能具有降低血压的作用。艾灸对典型高血压症状的影响以及艾灸的长期安全性尚不确定。