电针三阴交对产程影响的临床观察

Clinical Observation on the Effect of Electroacupuncture of Sanyinjiao (SP 6) on Labor

目的:观察电针三阴交对分娩质量的影响,并评价其疗效。方法:随机将入选的349例病例分到空白组、安慰组和电针组。对全部病例用视觉模糊评分法量化针刺前后分娩疼痛的程度。同时剔除各组中剖宫产病例,观察286例自然分娩的病例各产程所需时间。针刺于宫口扩张2～3cm时进行。电针组选取三阴交穴,并接韩氏穴位神经刺激仪,刺激频率为2Hz/100Hz,电流强度约20mA,留针30min;安慰组是将套管中心的针取出,空弹套管,使产妇感觉到被针刺,然后迅速将已用胶布包住针尖的毫针贴于三阴交,用医用胶布固定,电针方式与电针组相同,但其中一根连接线被剪断;空白组不作任何治疗,仅在相应时间点观察记录。结果:分娩疼痛程度3组比较差异有统计学意义(P<0.05),电针组疼痛程度最轻。第一产程活跃期3组比较差异有统计学意义(P<0.05),电针组时间最短;第二产程和第三产程3组比较差异均无统计学意义(P>0.05)。结论:电针三阴交可以达到很好的镇痛效果,同时缩短第一产程活跃期,对减少产妇痛苦,提高分娩质量具有积极意义。

Objective To observe the effect of electroacupuncture （EA） of Sanyinjiao （SP 6） on labor in parturients. Methods Atotal of 349 parturients were randomly divided into EA （n=117）, sham-EA （n= 117） and control （n= 115） groups. The visual analog scale （VAS） was used to assess the pain intensity of puerperas with labor before and after acupuncture intervention. After excluding those puerperas with cesarean section, the time required for each stage of labor and the total duration of labor were observed in 286 cases of natural delivery women including 92 cases in the control group, 94 cases in the sham-EA group and 100 cases in the EA group. EA （2 Hz/100 Hz,20 mA） was given to the puerperas for 30 min after the needle in a cannula was tapped into Sanyinjiao（SP 6）and when the dilatation of cervix was about 2--3 cm wide. For puerperas of sham-EA group, the operation was similar, but no real acupuncture needle and no real electric current were given. Results The VAS score for child- birth pain intensity was significantly lower in EA group than in control group（P〈0.05） and had no significant difference between sham-EA and control group （P〉0.05）. The duration of the active phase of the first stage of labor was significantly lower in EA group than in sham-EA group （P〈0.05）, but had no significant difference between sham-EA and control groups （P〉0.05）. No significant differences were found among the 3 groups in the latency of the first stage of labor, in the duration of the 2nd and the 3rd stages of labor and in the total phase of labor （P〉0.05）. Conclusion EA of SP 6 can relieve the pain intensity of the labor and shorten the duration of the active period of first stage of labor in puerperas, suggesting an improvement of the quality of delivery after EA.