艾灸三阴交穴对分娩宫缩痛影响的随机对照研究

Effect on moxibustion at Sanyinjiao (SP 6) for uterine contraction pain in labor:a randomized controlled trial

目的:探讨艾灸三阴交穴对分娩宫缩痛的影响,同时评价产妇及新生儿安全性。方法:选取单胎头位初产妇174名为研究对象,采用单盲、随机方法分成观察组(59例)、安慰组(57例)、空白组(58例)。宫口开大3cm时观察组艾灸三阴交、安慰组艾灸非穴点各30min,空白组行常规产程护理,比较3组产妇宫缩痛及母婴安全性差异。结果:①宫缩痛视觉模拟评分(VAS)比较,观察组灸后15min、30min VAS评分明显降低(均P<0.05),安慰组与空白组VAS评分无明显变化,灸后观察组VAS评分较其他两组降低明显(均P<0.05);②宫缩痛评级比较,艾灸30min,观察组分娩镇痛有效率为69.5%(41/59),高于安慰组、空白组的45.6%(26/57)、43.1%(25/58),差异有统计学意义(均P<0.05);③产后出血量,观察组明显少于安慰组和空白组(均P<0.05);④新生儿Apgar评分:观察组和安慰组高于空白组(均P<0.05)。结论:艾灸三阴交穴能减轻宫缩痛,对母婴无不良影响,是一种安全有效且简便的非药物镇痛方法。

Objective To investigate the effect of moxibustion at Sanyinjiao （SP 6） for uterine contraction pain in labor, and evaluate the safety of the parturient and newborn. Methods One hundred and seventy-four cases of singleton pregnancy and cephalic presentation primipara were single blinded and randomly divided into three groups： observation group（59 cases）, placebo treated group（57 cases） and blank group（58 cases）. The observation group was treated with moxibustion at Sanyinjiao （SP 6） for 30 rain when the uterus cervix openning at 3 cm,the placebo treated group was treated with moxibustion at no acupoint for 30 rain and the blank group was treated with routine labor nursing, the uterine contraction pain and the safety of the mother and infant were compared among three groups. Results ①The uterine contraction pain was tested by Visual Analogue Scale （VAS） ： the scores of VAS in the observation group were obviously decreased after 15 min and 30 min of moxibustion （both P〈0. 05）, there were no obvious changes of the VAS scores in placebo treated group and the blank group, the scores of VAS in observation group decreased much more obviously than those in the other two groups （all P〈0.05） ; ②Midwife rating of the uterine contraction pain： after 30 min of moxibustion, the effective rate of labor analgesia was 69.5%（41/59） in observation group, which was higher than that of 45.6%（26/57） in placebo treated group and 43.1% （25/58） in blank group, with significant differences between them （both P〈0.05）; ③The postpartum hemorrhage amount of the observation group was obviously lower than those of placebo treated group and blank group （both P〈0.05） ; （g）The Apgar score of newborn was higher in observation group and placebo treated group than that of blank group （both P〈0. 05）. Conclusion Moxibustion at Sanyinjiao （SP 6） can relieve the uterine contraction pain, and has no side effect to mother and infant, it is one of the safe, effective and simple non-drug analgesia methods.