针刺对分娩镇痛及母婴保护作用研究进展

Research Progress on Acupuncture for Labor Analgesia in Maternal and Child Protection

针刺作为一种创伤小、副作用少的非药物技术,已被广泛应用于分娩镇痛。已有的研究认为针刺具有镇痛、抗焦虑、抗抑郁、抑制应激反应,以及催产、加强宫缩、缩短产程、减少分娩出血、增加宫内胎儿氧供血供等多重效应,在提高产妇满意度同时,也保护了母胎和新生儿的安全。但国内外也有些研究对针刺的疗效、机制提出质疑,认为实验设计不要,统计资料可靠性不高等,需针对以上问题加以改进并得出更加科学严谨的结论。目前针刺对分娩的干预时间都集中在活跃期,而用于潜伏期甚至潜伏期前一段时间的研究还未见报道,另外针刺联合其他方法如椎管内阻滞、药物镇痛等研究较少。本文从针刺对分娩过程的镇痛和母婴保护整体出发,总结其作用机制的研究进展。

Acupuncture as a non-pharmacological method with small trauma and less side effects,has been widely used in the management of labor analgesia.The existed researches showed that acupuncture had the effects of analgesia,anxiolytic,anti-depression,inhibition on stress response.Acupuncture also had the multiple effects on expediting child delivery,strengthening the uterine contraction,reducing bleeding,and increasing the intrauterine fetal blood and oxygen supply.Acupuncture can increase maternal satisfaction as well as the protection of maternal and neonatal safety.However,there were also domestic and foreign literatures questioned the effects and mechanisms of acupuncture,such as the experimental design was inadequate,the statistical data was not reliable enough,which should be improved to receive more rigorous scientific conclusions.At present,the interventions of acupuncture on labor were concentrated in the active phase,and no research concentrated in the latency and prenatal period.In addition,there was less study on acupuncture combined with other methods such as spinal canal block,drug analgesia and so on.This article reviewed the mechanism and the research progress of acupuncture in analgesia as well as maternal and infant protection.