毫针针刺联合对症支持疗法治疗顽固性妊娠剧吐患者20例临床观察

Clinical Observation on Filiform Needling Combined With Symptomatic and Supportive Therapy for 20 Cases of Intractable Hyperemesis Gravidarum

目的观察毫针针刺联合西医对症支持疗法治疗顽固性妊娠剧吐的临床疗效。方法将40例顽固性妊娠剧吐患者随机分为治疗组与对照组各20例。对照组采用西医对症支持疗法,包括卧床休息、心理疏导、流质饮食或禁食,每日补充液体总量3000ml等。治疗组在对照组基础上加用毫针针刺治疗,取内关(双侧)、足三里(双侧)、中脘、建里、下脘,采用平补平泻法,每日1次,每次30min,两组均连续治疗5天。治疗后观察两组患者临床疗效及平均住院时间,终止妊娠情况,尿酮体转阴率及血钾水平变化。结果治疗组患者临床疗效总有效率、妊娠终止率、尿酮体转阴率分别为90%、10%、90%,对照组分别为55%、45%、65%,总有效率、尿酮体转阴率治疗组均高于对照组,妊娠终止率治疗组低于对照组(P<0.05)。治疗组住院时间为(6.40±2.39)天,明显短于对照组的(11.35±3.89)天(P<0.01)。两组治疗后血钾水平比较差异无统计学意义(P>0.05)。结论毫针针刺联合西医对症支持疗法治疗顽固性妊娠剧吐疗效良好,能明显改善患者临床症状、缩短住院时间。

Objective 3＇o observe the efficacy of filiform needling combined with symptomatic and supportive therapy for intractable hyperemesis gravidarum. Methods Forty cases of intractable hyperemesis gravidarum were randomized into treatment group and control group, with 20 in each. Both groups were given western medicine symp- tomatic and supportive therapy such as bed rest, psychological counseling, liquid diet or fasting and a total daily liq- uid supplement of 3 000 ml. The treatment group was added with filiform needling on Neiguan （PC6, bilateral）, Zusanli （ST36, bilateral）, Zhongwan （CV12）, Jianli （CVll） and Xiawan （CV10） with even reinforcing-reducing method for 30 minutes once daily. The treatment lasted for 5 consecutive days in both groups. The efficacy, average hospital stay, pregnancy termination, after treatment. Results The total the changes of urine ketone and serum effective rate and negative rate of urine potassium in both groups were observed ketone was 90% and 90% in the treat- ment group, which was significantly higher than 55 % and 65 % in the control group （P 〈 0.05 ）. The pregnancy ter- mination rate was 10% in the treatment group, which was significantly lower than 45% in the control group （P 〈 0. 05 ）. The average hospital stay in the treatment group was （6. 40 ± 2. 39） days, significantly shorter than （ 11.35± 3.89 ） days in the control group （P 〈 0.01 ）. There was no significant difference between groups in the serum potassi- um level （P 〉 0.05 ）. Conclusion The filiform needling combined with western medicine symptomatic and sup- portive therapy is effective for intractable hyperemesis gravidarum, which can obviously relive symptoms and shorten the hospital stay.