经皮穴位电子灸对硬膜外自控镇痛产妇细胞因子及泌乳功能的影响

Effects of percutaneous acupoints electronic moxibustion on cytokines and lactation function of parturients receiving patient controlled epidural analgesia

目的研究经皮穴位电子灸合谷、三阴交、足三里对硬膜外自控镇痛(PCEA)产妇细胞因子(IL-6、IL-8、IL-10)及产妇泌乳功能、子宫复旧的影响。方法行硬膜外自控镇痛(PCEA)并经阴道顺产产妇80例,随机分为对照组(PCEA)和治疗组(电子灸+PCEA),每组40例,分别于镇痛前(T0)、宫口开全时(T1)、胎儿娩出后24 h(T2)、胎儿娩出后72 h(T3)抽取肘静脉血测定IL-6、IL-8、IL-10浓度;记录泌乳始动时间,治疗后子宫高度及恶露量,于分娩前及分娩后24 h、72 h抽肘静脉血检测催乳素(PRL)浓度。结果治疗组在T1、T2时IL-6、IL-8升高幅度低于对照组(P<0.05),而IL-10升高幅度高于对照组(P<0.05)。治疗组泌乳始动时间明显短于对照组(P<0.05);分娩前2组PRL浓度差异无统计学意义(P>0.05),分娩后24、72 h治疗组显著高于对照组(P<0.05);宫底降低幅度明显大于对照组、恶露量显著少于对照组(P<0.01)。结论电子灸合谷、三阴交、足三里复合PCEA减轻产妇免疫功能抑制,使泌乳始动时间提前,泌乳量显著增加,促进子宫规律收缩,减少产褥期并发症,且经济方便,值得临床推广。

Objective To investigate the effects of percutaneous acupoints electronic moxibustion on cytokines and lactation function of parturients receiving patient controlled epidural analgesia（ PCEA）. Methods Eighty parturients who received PCEA were randomly divided into two groups,control group（ PCEA only） and treatment group（ PCEA ＋ percutaneous acupoints electronic moxibustion）,with 40 parturients in each group. The serum levels of IL-6,IL-8,IL-10 before analgesia（ T0）,opening of uterus（ T1）,24 h after fetal childbirth（ T2）,72 h after fetal childbirth（ T3） were detected for both groups,moreover,the lactation initiating time,uterine height and lochia volume after treatment were recorded,besides blood levels of prolactin（ PRL） before and after delivery were detected and compared between two groups. Results The serum levels of IL-6,IL-8 at T1,T2 in treatment group were significantly lower than those in control group（ P 〈0. 05）,however,the serum levels of IL-10 were obviously higher than those in control group（ P 〈0. 05）. The lactation initiating time in treatment group was obviously shorter than that in control group（ P〈 0. 05）,There was no significant difference in PRL concentration before delivery between two groups（ P〉 0. 05）,however,the PRL levels on 24 h,72 h after delivery in treatment group were significantly higher than those in control group（ P 〈0. 05）. The decrease degree of uterine height in treatment group was significantly greater than that in control group（ P 〈0. 05）,but the lochia volume was significantly less than that in control group（ P 〈0. 01）. Conclusion The percutaneous acupoints electronic moxibustion in the acupoints including Hegu,Sanyin jiao,Zusanli combined with patient controlled epidural analgesia can relieve maternal immune function inhibition,which can advance the initial time of lactation,increase lactation volume,promote the uterus contract regularly and decrease puerperal complications,moreover,which is economical and convenient.