scholarly journals Microvascular decompression for the treatment of neurogenic hypertension with trigeminal neuralgia

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Wenchao Lu ◽  
Hui Wang ◽  
Zhongnan Yan ◽  
Yuangang Wang ◽  
Hongmin Che

Abstract Background To evaluate the efficacy of microvascular decompression (MVD) in reducing hypertension (HTN) in hypertensive patients with trigeminal neuralgia (TN). Methods The clinical data of 58 cases of neurogenic HTN with TN treated in our hospital were retrospectively reviewed. Preoperative MR revealed abnormal blood pressure in the left rostral ventrolateral medulla (RVLM) and the posterior cranial nerve root entry zone (REZ). The patients were divided into control group: only trigeminal nerve was treated with MVD; experimental group: trigeminal nerve, RVLM and REZ were treated with MVD at the same time. The patients were followed up for 6 months to 1 year to observe the changes of blood pressure. Results There was no significant difference in gender, age, course of TN, course of HTN, grade of HTN and preoperative blood pressure between the two groups. After operation, the effective rate of HTN improvement with MVD was 32.1% in the control group. There was no significant difference in the preoperative and post operative blood pressure. (P△SBP = 0.131; P△BDP = 0.078). In the experimental group, the effective rate was 83.3%. The postoperative blood pressure was significantly lower than preoperative values. (P△SBP < 0.001; P△DBP < 0.001). Conclusions MVD is an effective treatment for neurogenic HTN. However, the criteria for selecting hypertensive patients who need MVD to control their HTN still needs to be further determined. Possible indications may include: left trigeminal neuralgia, neurogenic HTN; abnormal blood pressure compression in the left RVLM and REZ areas on MR; and blood pressure in these patients can not be effectively controlled by drugs.

2018 ◽  
Vol 2 (6) ◽  
Author(s):  
Xiaoye Wang

【Abstract】Objective: Toanalyze the efficacy of combined drug therapy for elderly patients with coronary heart disease and hypertension.METHODS:Sixty-six elderly patients with coronary heart disease and hypertension were enrolled from December 2017 to November 2018. They were randomly divided into two groups, 33 patients in each group. Patients in the experimental group received nifedipine. In combination with enalapril, patients enrolled in the control group received nifedipine monotherapy.RESULTS:Compared with the control group, the total effective rate, Serum Nitric Oxide (Serum NO) after treatment, CRP after treatment, HCY after treatment, and blood pressure after treatment were significantly improved (P<0.05). Serum NO and treatment before treatment in the 2 groups. There was no significant difference in pre-CRP, pre-treatment HCY, pre-treatment blood pressure, and adverse reactions during treatment (P>0.05).Conclusion: Theelderly patients with coronary heart disease and hypertension are treated with nifedipine and enalapril.


2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Gan-Hon Lin ◽  
Wei-Chun Chang ◽  
Kuan-Ju Chen ◽  
Chen-Chen Tsai ◽  
Sung-Yuan Hu ◽  
...  

Objectives. To evaluate the effectiveness of acupressure on the Taichong acupoint in lowering systolic and diastolic blood pressure (BP) in hypertensive patients.Methods. Eighty patients with hypertension attending a cardiology outpatient department in central Taiwan were included in this randomized clinical trial. Acupressure was applied to the Taichong acupoint in the experimental group (n=40) and to the first metatarsal (sham acupoint) in the control group (n=40). Blood pressure was measured by electronic monitoring before and immediately 15 min and 30 min after acupressure.Results. The average age of the experimental and control participants was 59.3 ± 9.2 years and 62.7 ± 8.4 years, respectively. The two groups were similar for demographics and antihypertensive drug use. Mean systolic and diastolic BP in the experimental group decreased at 0, 15, and 30 min after acupressure (165.0/96.3, 150.4/92.7, 145.7/90.8, and 142.9/88.6 mmHg); no significant changes occurred in the control group. There was a significant difference in systolic and diastolic BP between the experimental and control groups immediately and 15 and 30 min after acupressure (p<0.05).Conclusion. Acupressure on the Taichong acupoint can lower BP in hypertensive patients and may be included in the nursing care plan for hypertension. However, additional studies are needed to determine the optimal dosage, frequency, and long-term effects of this therapy.


2019 ◽  
Vol 2 (1) ◽  
pp. 15-26
Author(s):  
Lilis Lismayanti ◽  
Barkah Hidayatulloh

Hypertension is a condition in blood pressure in the blood vessels chronically elevated. This can happen because the heart work harder to pump blood to meet the body's need for oxygen and nutrients Hypertension prevalence in Indonesia continues to increase every year, so did the prevalence in the city of Tasikmalaya. Management of hypertension require a serious, because if it would not affect other body systems disorders. SEFT is a complementary therapy that can be used for the treatment of hypertension. This study aims to determine the effectiveness of therapy SEFT on blood pressure in hypertensive patients with a given treatment 1 and 3 times round SEFT in two different groups, and find out the effect of the number of rounds SEFT to high blood pressure in hypertensive patients. The research method using the quasy experimental pretest-posttest with control group approach, using purposive sampling technique sampling. The research sample consisted of 30 patients with hypertension aged more thanr 18 years, and are divided into two groups: the experimental group and the control group. The results showed that SEFT effect on reduce of blood pressure in hypertensive patients, but there was no significant difference between treatment 1 rotation with 3 rotations of the number of rotations. The results of this study can be used as a reference by both academics and practitioners to apply nursing SEFT therapy in reducing blood pressure in hypertensive patients, especially for independent nursing practitioners


2021 ◽  
Author(s):  
Emrah Ersoy ◽  
Cuneyt Ardic

Abstract Background Blood pressure is influenced by biopsychosocial factors such as physical, environmental, emotional, cognitive and behavioral in hypertensive patients. ObjectiveThe aim of this study is to investigate confounding factors in hypertensive patients who have poor blood pressure control.DesignThis study was designed as a cross-sectional study.ParticipantsOur sample was 407 patients with hypertension in Rize, a Northern city in the Black Sea Region of Turkey. In study group, there were 207 hypertensive patients who had admission to emergency department due to high blood pressure. In control group, there were 200 hypertensive patients visiting family physician,who defined themselves as having regulated blood pressure over the past six months.Main MeasuresPatients completed the questionnaire including sociodemographic data, lifestyle behaviors, health risks and confounding factors via the face-to-face interview method. Key ResultsOf the hypertensive patients, 81.2% (n=168) of the study group and 34.0% (n=68) of the control group had confounding factors. There was a significant difference between the hypertensive patients of study and control group in terms of their confounding factors (p<0.001). When we asked the patients of study group questions to reveal their confounding factors, 21.3% (n=44) stated ‘anger’, 12.6% (n=26) ‘sadness’, 11.1% (n=23) ‘anxiety’, 10.6% (n=22) ‘depressed’, 9.2% (n=19) ‘unhealthy diet’, 7.2% (n=15) ‘fatigue and poor sleep quality’, and 3.9% (n=8) ‘irregular medication’. Mean systolic and diastolic blood pressure were significantly higher in hypertensive patients having confounding factors than those without confounding factors (p=0.001, p=0.001, respectively). Mean systolic blood pressure of hypertensives who stated their confounding factor as ‘anger’ was significantly higher than those the remaining groups (p<0.001).ConclusionsThis study has shown that confounding factors impair blood pressure control in patients with hypertension. Confounding factors should be kept in mind and revealed in case of poor blood pressure control in hypertensive patients.


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Ran Wang ◽  
Ying Han ◽  
Lijuan Lu

Objective. Radiofrequency thermocoagulation (RFT) through the foramen rotundum has emerged as an alternative for treatment of isolated V2 trigeminal neuralgia. But puncture of the foramen rotundum is difficult and time-consuming. In current study, we introduced the application of a computer-assisted design (CAD) template to guide foramen rotundum cannulation. Meanwhile, we assessed its safety and efficacy in the treatment of isolated V2 trigeminal neuralgia. Methods. From November 2015 to August 2017, thirty-eight patients with isolated V2 trigeminal neuralgia were treated with computed tomography- (CT-) guided RFT through the foramen rotundum in our institution. All cases were reviewed, and patients were divided into the experimental group (n=17, puncture with a CAD template) and control group (n=21, free-hand puncture) according to the puncture method used. The puncture times, duration of puncture, and duration of operation were collected. The outcome of pain remission was evaluated utilizing the Barrow Neurological Institute’s (BNI) pain score. Complications and recurrence of pain were also recorded. Data were compared between groups. Results. The rate of one-time successful puncture in the experimental group was obviously higher than that in the control group. Mean puncture times in the experimental group was fewer. Average duration of puncture and operation in the experimental group was also shorter than that in the control group. All patients experienced good pain remission (BNI Class I or II) postoperatively. At four follow-up points (7 days, 3 months, 6 months, and 12 months after operation), there was no significant difference in good pain relief rate between the two groups. Meanwhile, no significant difference was found in complications. Conclusions. CAD template is a safe and precise navigation instrument for RFT treatment of isolated V2 trigeminal neuralgia via the foramen rotundum. Therefore, this novel tool is worthy of clinical promotion.


2019 ◽  
Vol 65 (3) ◽  
pp. 446-451
Author(s):  
Dilek Karaman ◽  
Funda Erol ◽  
Dilek Yılmaz ◽  
Yurdanur Dikmen

SUMMARY OBJECTIVE: This study aimed to investigate the effect of virtual reality application on experimental ischemic pain created with a blood pressure instrument in healthy volunteers. METHODS: The research sample consisted of 172 volunteer adult students who conformed to the inclusion criteria. These individuals were assigned into an experimental (n=86) and a control group (n=86) by a simple randomization method. All individuals in the experimental and control groups wereexperimentally subjected to pain for two minutes by applying 260 mmHg of pressure 3-4 cm above the antecubital region of the left arm with an aneroid adult-type blood pressure instrument. During the procedure, the volunteers in the experimental group watched virtual reality images, while those in the control group received no intervention. Immediately after the procedure, the pain levels of the individuals in both groups were assessed with a Visual Analog Scale (VAS). RESULTS: We found that the mean pain score of the individuals in the experimental group was 2.62±1.82, and that of individuals in the control group was 5.75±1.65. Results of the statistical analysis showed a statistically significant difference between the mean pain scores of the individuals in the experimental and control groups (p<0.001). CONCLUSION: This study found that the use of virtual reality was effective in reducing the level of pain in healthy individuals. This method used a smartphone with widespread availability and ease of transportation, which can be used by health professionals as a non-pharmacological method in the management of pain.


1999 ◽  
Vol 84 (3_suppl) ◽  
pp. 1123-1126
Author(s):  
Hendrik M. DeVos ◽  
Justus R. Potgieter ◽  
Johannes H. Blaauw

10 female physical education students were given posthypnotic suggestions alluding to economy of effort in exercise. These suggestions were affirmed under self-hypnosis over two weeks. Experimental subjects pedalled on an exercise bicycle for 20 min. at 60% of their maximal work capacity while listening to suggestions from a hypnotist. The Control group ( n = 9) showed no differences between mean pretest and posttest scores on physical self-efficacy, trait anxiety, state anxiety, heart rate, blood pressure, and perceived rate of exertion. The average systolic blood pressure of the experimental group was the only positive significant difference between the pretest and posttest scores.


2021 ◽  
Vol 9 (G) ◽  
pp. 217-222
Author(s):  
Fadli Fadli ◽  
Sumbara Sumbara ◽  
Arabta M. Peraten Pelawi ◽  
Suratun Suratun ◽  
Rohandi Baharuddin

Wet cupping therapy  removes toxins  thereby increasing blood flow and  stimulating baroreceptors sensitivity which provides a stimulus to the autonomic nerves. This stimulus reduces the sympathetic nerves’ work and inhibits  the vasomotor center, leading to vasodilation, therefore decreasing blood pressure and pulse frequency. This research aims to determine the effect of wet cupping therapy on baroreceptors sensitivity with blood pressure and pulse frequency indicators. It was conducted in Sidenreng Rappang Regency, South Sulawesi, eastern Indonesia from February to May 2021. Randomized Controlled Trial (RCT) method was used including two groups of 31 respondents each. The intervention group used wet cupping therapy to regulate anti-hypertensive drugs and the control group used anti-hypertensive drugs with blood pressure and pulse frequency measurements until 6 weeks after the therapy. Wet cupping affects baroreceptor sensitivity by reducing the indicators. The result showed a significant difference in blood pressure measurement (systolic; diastolic) before and after the 2-week follow-up period (P = 0.000; P = 0.001), and between 2 and 4 weeks (P = 0.000; P = 0.000), but between 4 and 6 weeks there was no significant difference in the intervention group (P = 0.248; P = 0.583). There was a significant difference in pulse frequency at 2 and 4 weeks after the intervention (P = 0.016). In conclusion, wet cupping therapy effectively increases baroreceptor sensitivity by reducing blood pressure and pulse frequency indicators in hypertensive patients up to 4 weeks limit after the therapy, without any serious side effects experienced by respondents.


Author(s):  
Kmendalin Nongspung ◽  
Kavita Narang ◽  
J. S. Thakur

Background: Hypertension is the most common non-communicable diseases. Strict adherence to prescribed antihypertensive treatments is the key to blood pressure control. The present study was conducted with the objective to develop, implement and assess an interventional package on treatment adherence for hypertensive patients.Methods: A clustered randomized control trial of 3 months conducted in two community sites of Chandigarh. The two sites were first randomized by lottery method as experimental and control sites. Total of 250 subjects (n=125 on each sites) were selected by a systematic random sampling technique (every fourth) from the sampling frame. Diagnosed hypertensive patients taking treatment were included in the study and females with pregnancy induced hypertension were excluded. Participants were interviewed as per Interview schedule. Data was collected from July to November 2018. Interventional package was in the form of booklet and flash card, delivered as one to one teachings. Total of 5 face to face follow ups were done to the experimental group. Control group received routine care. Final evaluation was done at 3rd month in both the groups to assess the effectiveness of an interventional package on treatment adherence. Data analysis and interpretation was done by using chi square, paired t test, unpaired t- test, Mc Nemar test were applied to determine the level of significance at p<0.05.Results: The proportion of subjects who were adhered to the treatment has increased from 16% to 68% in the experimental group at third month of follow up. The mean change in systolic blood pressure and diastolic blood pressure were 26.29±12.81 mmHg and 7.74±8.95 mmHg respectively in the experimental group as compared to the control group (p<0.05).Conclusions: The interventional package on treatment adherence among hypertensive patients was effective in improving the treatment adherence.


2020 ◽  
Vol 185 ◽  
pp. 03017
Author(s):  
Zike He ◽  
Kaifei He ◽  
Shangzeng Wang

Objective: To explore the clinical intervention effect of applying Huoxue Jiangu Decoction in the treatment of patients with osteoarthritis. Methods: Research work was carried out in our hospital from December 2018 to December 2019. A total of 100 patients with osteoarthritis received treatment during this period were selected and divided into two groups using random number method. One group was given sodium hyaluronate injection for treatment, which was the control group, and the other group was given Huoxuejiangu Decoction combined with sodium hyaluronate injection, which was the experimental group. The clinical treatment of the two groups of patients was compared and analyzed. Results: The patients' pain levels were compared. There was no significant difference between the groups before the intervention treatment. After treatment, the experimental group score was (3.05±0.55), which was lower than the control group, the improvement effect was more significant, and the difference between the groups was significant (P< 0.05), the experimental group had a better effect. The clinical treatment of the two groups of patients was compared and analyzed. There was no significant difference in the WOMAS index between the two groups before treatment. After treatment, the score of the experimental group was (34.33±6.98), and the improvement rate was (37.45±13.22). After treatment, the score was lower and the improvement rate was higher, which was significantly higher than the control group (P <0.05), which was significant. The treatment effective rate of the patients in the experimental group was 80.00%, and the treatment effective rate of the patients in the control group was 64.00%. When comparing, the effective rate of the experimental group was higher, and the data comparison between the groups was significantly different. Conclusion: For the patients with osteoarthritis, the application of Huoxue Jiangu Decoction has a significant clinical effect, which can reduce the patient's pain level, improve the patient's clinical symptoms, have high clinical value, and it can be promoted.


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