“Efficacy of Auriculotherapy for Stage 1 and Stage 2
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A Dissertation On “EFFICACY OF AURICULOTHERAPY FOR STAGE 1 AND STAGE 2 HYPERTNSION – A RANDAMIZED CONTROL TRAIL” Submitted By Dr.N.LILLY B.N.Y.S (Reg. No.461613002 ) Under the Guidance of Prof. Dr. N. MANGAIARKARASI, B.N.Y.S, M Sc (PSY),PGDHAN. Submitted to The Tamil Nadu Dr. M. G. R. Medical University, Chennai In partial fulfilment of the requirements for the award of degree of DOCTOR OF MEDICINE BRANCH – III: ACUPUNCTURE & ENERGY MEDICINE POST GRADUATE STUDIES-DEPARTMENT OF AEM GOVERNMENT YOGA AND NATUROPATHY MEDICAL COLLEGE & HOSPITAL, CHENNAI – 600106 OCTOBER-2019 GOVERNMENT YOGA AND NATUROPATHY MEDICAL COLLEGE AND HOSPITAL, CHENNAI, TAMILNADU. CERTIFICATE BY THE GUIDE This is to certify that the dissertation entitled “EFFICACY AURICULOTHERAPY IN STAGE I AND STAGE II HYPERTENSION -- RANDOMIZED CONTROL TRIAL” is a bonafide research work done by the post graduate Dr. N.LILLY, Department of Acupuncture & Energy Medicine, Government Yoga & Naturopathy Medical College & Hospital, Chennai – 600 106 under my guidance and supervision in partial fulfilment of regulations of The Tamilnadu Dr. M.G.R. Medical University, Chennai for the award of M.D. (Acupuncture & Energy Medicine) Branch –III during the academic period from 2016 to 2019. Date: SIGNATURE OF THE GUIDE Place: Chennai Dr.N.MANGAIARKARASI, B.N.Y.S,Msc (Psy),PGDHAN Head of the Department, Department of Acupuncture & Energy Medicine, Government Yoga & Naturopathy Medical College & Hospital, Arumbakkam, Chennai – 600 106. GOVERNMENT YOGA AND NATUROPATHY MEDICAL COLLEGE AND HOSPITAL, CHENNAI, TAMILNADU. ENDORSEMENT BY THE HEAD OF THE DEPARTMENT I certify that the dissertation entitled “EFFICACY AURICULOTHERAPY IN STAGE I AND STAGE II HYPERTENSION” -- RANDOMIZED CONTROL TRIAL” is the record of original research work carried out by Dr. N.LILLY, in the Department of Acupuncture & Energy Medicine, Government Yoga & Naturopathy Medical College & Hospital, Chennai – 600 106 submitted for the degree of DOCTOR OF MEDICINE (M.D) in Yoga and Naturopathy under my guidance and supervision, and that this work has not formed the basis for the award of any degree, associate ship, fellowship or other titles in this University or any other University or Institution of higher learning. Date: SIGNATURE OF THE H.O.D Place: Chennai Dr.N.MANGAIARKARASI, B.N.Y.S,Msc (Psy),PGDHAN Head of the Department, Department of Acupuncture & Energy Medicine, Government Yoga & Naturopathy Medical College & Hospital, Arumbakkam, Chennai – 600 106. GOVRNMENT YOGA AND NATUROPATHY MEDICAL COLLEGE AND HOSPITAL, ARUMBAKKAM, CHENNAI – 600106 ENDORSEMENT BY THE PRINCIPAL I certify that the dissertation entitled “EFFICACY OF AURICULOTHERAPY FOR STAGE 1 AND STAGE 2 HYPERTNSION – A RANDAMIZED CONTROL TRAIL” is the record of original research work carried out Dr.N.LILLY, in the Department of Acupuncture & Energy Medicine Government Yoga & Naturopathy Medical College & Hospital, Chennai – 600 106 submitted for the degree of DOCTOR OF MEDICINE (M.D) in Yoga and Naturopathy under my guidance and supervision, and that this work has not formed the basis for the award of any degree, associateship, fellowship or other titles in this University or any other University or Institution of higher learning. Date: SIGNATURE OF THE PRINCIPAL Place: Chennai Dr. N. MANAVALAN, N.D.(OSM),M.A(G.T),M.Sc(Y&N), M. Phil, P.G.D.Y,P.G.D.H.M,P.G.D.H.H, Government Yoga & Naturopathy Medical College & Hospital, Arumbakkam,Chennai-600106. GOVERNMENT YOGA AND NATUROPATHY MEDICAL COLLEGE AND HOSPITAL, CHENNAI, TAMILNADU. DECLARATION BY THE CANDIDATE I, Dr.N.LILLY solemnly declare that dissertation titled “EFFICACY OF AURICULOTHERAPY FOR STAGE 1 AND STAGE 2 HYPERTNSION – A RANDAMIZED CONTROL TRAIL ” is a bonafide and genuine research work carried out by me at Government Yoga & Naturopathy Medical College & Hospital, Chennai from June 2018 – May 2019 under the guidance and supervision of Dr.N.MANGAIARKARASI, Head of the Department, Department of Acupuncture and Energy Medicine, Govt. Yoga & Naturopathy Medical College & Hospital, Chennai. This dissertation is submitted to The Tamilnadu Dr. M.G.R. Medical University towards partial fulfilment of requirement for the award of M.D. Degree (Branch – III) in Acupuncture & Energy Medicine. Date: Signature of the Candidate Place: Chennai (Dr.N.LILLY) INSTITUTIONAL ETHICAL COMMITTEE GOVERNMENT YOGA AND NATUROPATHY MEDICAL COLLEGE AND HOSPITAL, CHENNAI – 600 106. CERTIFICATE OF APPROVAL The Institution Ethical Committee of Government Yoga & Naturopathy Medical College Hospital, Chennai reviewed and discussed the application for approval of “EFFICACY OF AURICULOTHERAPY FOR STAGE 1 AND STAGE 2 HYPERTNSION – A RANDAMIZED CONTROL TRAIL” for project work submitted by Dr.N.LILLY,3rd Year M.D. Acupuncture & Energy Medicine, Post Graduate, Government Yoga & Naturopathy Medical College & Hospital, Chennai – 600 106. The proposal is APPROVED. The Institutional Ethical Committee expects to be informed about the progress of the study and adverse drug reaction during the course of the study and any change in the protocol and patient information / informed consent and asks to be provided a copy of the final report. COPY RIGHT DECLARATION BY THE CANDIDATE I hereby declare that the Tamilnadu Dr. M. G. R. Medical University, Chennai, Tamilnadu shall have the rights to preserve, use and disseminate this Dissertation / Thesis in print or electronic format for academic / research purpose. Date: Signature of the Candidate Place: Chennai (Dr.N.LILLY) © Tamilnadu Dr. M. G. R. Medical University, Chennai ACKNOWLEDGEMENT Firstly I thank the Almighty for all that I am gifted with. I thank Dr. N. Manavalan N.D.(Osm), Principal, Govt. Yoga and Naturopathy Medical College, Chennai for creating an opportunity to pursue M.D in Yoga and Naturopathy. It is a great pleasure to express my deep sense of thanks and gratitude to my mentor, philosopher and guide(Late)Dr.R.S.Himeshwari N.D.(Osm),H.O.D, Dept. of Acupuncture and Energy Medicine, GYNMC, Chennai, for her constant guidance and tireless motivation all the way. I extend my sincere gratitude to guide Dr.N.Mangaiarkarasi B.N.Y.S, M.Sc(PSY),PGDHAN, H.O.D, Department of Acupuncture and Energy Medicine, Government Yoga and Naturopathy Medical College, Arumbakkam for her support for the completion of this dissertation. I also extend my gratitude towards them for their constant support and encouragement. I thank Dr.R.Jainraj B.N.Y.S,MPH. Assistant medical officer in Yoga Naturopathy Department, District Government hospital of Ramanathapuram for helping me throughout the statistical analysis and its interpretations needed for this study. I thank Dr.P.Prabu B.N.Y.S, MD (yoga), Assistant medical officer and Incharge for the Department of Acupuncture and Energy Medicine in Government Yoga and Naturopathy Medical college and Hospital, Arumbakkam, Chennai. I also thank my mother Mrs.N.Malarvizhi and my father Mr.M.Newton for their immense support in my life. I also thank friends for extending their support at all times. I also acknowledge the subjects co-operation and support who participated in the study. Date: Place: DR.N.LILLY ABSTRACT Background: Hypertension is not only a well-known risk factor for cardiovascular disease but also a public health challenge worldwide. Some auricular acupuncture treatment research papers shows reduction in blood pressure in patients with hypertension and helps as preventive aspect in pre- hypertensive patients. Objective: The aim of the study to determine the efficacy of auriculotherapy in stage 1 and stage 2 hypertensive patients. Methodology: Through RCT method 82 patients only fulfilling inclusion and exclusion criteria with age ranges from 30 to 60 years old and they were selected for this research project. From that by simple randomization method 41 patients participated in intervention group and 41 patients participated in control group. They were given auriculotherapy daily 30 minutes for 5 days in a week for a month and blood pressure and pulse rate monitored an assessed pre and post intervention. Result: There was significant improvement in auriculotherapy intervention group with P<0.0001 when compared to control medicine group. Conclusion: Giving auriculotherapy separately in shenmen and heart point reduces high blood pressure in stage 1 and stage 2 hypertensive patients due to vagal parasympathetic activation capacity. Key words: Auriculotherapy, shenmen point, heart point, Blood pressure. SL.NO CONTENT 1 INTRODUCTION 2 AIM AND OBJECTIVES 3 REVIEW OF LITERATURE 4 MATERIALS AND METHODS 5 RESULTS 6 DISCUSSION 7 CONCLUSION 8 SUMMARY 9 REFERENCE 10 ANNEXURE LIST OF TABLES SL NO INDEX PAGENO 1. Descriptive statistics values for auriculotherapy 57 intervention group 2. Descriptive statistics values for anti-hypertensive drug 58 control group 3. Tests of within-subjects effects-for case group 59 4. Tests of within -subjects effects -for control group 60 5. Pairwise comparisons 61 LIST OF FIGURES SL NO INDEX PAGENO 1 Risk Factors Of Hypertension 8 2 Measuring Normal Blood Pressure 11 3 Stages Of Blood Pressure 12 4 Regulation Of Blood Pressure By Baroreceptors 14 5 Renin Angiotensin Aldosterone- Function In HTN 15 6 ANP-Regulation Of Blood Pressure 18 7 Pathophysiology Of Hypertension 23 8 Management Of Hypertension 26 9 Classification Of Anti-Hypertensive Drugs 27 10 Allopathic Treatment For Hypertension 33 11 Complications Of Hypertension 34 12 Vagus Nerve Activation On Heart And Blood 36 Pressure 13 Auriculotherapy Divisions And Points 41 14 Study Plan 47