不同穴组穴位注射治疗妊娠剧吐疗效观察

Therapeutic Observation of Acupoint Injection at Different Groups of Acupoints for Hyperemesis Gravidarum

目的观察不同穴组穴位注射治疗妊娠剧吐的临床疗效。方法 120例妊娠剧吐患者随机分为肌注组、内关组、足三里组、内关加足三里组,每组30例。肌注组肌肉注射维生素B_1注射液2 m L(100 mg),每日1次;内关组取双侧内关穴,每穴注射维生素B_1注射液1 m L(50 mg),每日1次;足三里组取双侧足三里,每穴注射维生素B_1注射液1 m L(50 mg),每日1次;内关加足三里组取单侧内关和足三里,药物和操作方法同内关组、足三里组,每穴注射药物1 m L(50 mg),每日1次,两侧内关、足三里隔日交替进行穴位注射。7 d为1个疗程,4组均治疗1个疗程。观察治疗前后24 h呕吐次数、尿酮体的变化,并对4组患者进行疗效评定。结果肌注组总有效率为60.0%,内关组、足三里组总有效率分别为86.7%、83.3%,内关加足三里组总有效率为96.7%。内关组、足三里组、内关加足三里组治疗效果明显优于肌注组(P<0.05),内关组和足三里组疗效比较差异无统计学意义(P>0.05),内关加足三里组治疗效果优于内关组、足三里组(P<0.05)。结论内关加足三里组治疗妊娠剧吐的效果优于肌注组、内关组和足三里组。

Objective To observe the clinical efficacy of acupoint injection at different groups of acupoints in treating hyperemesis gravidarum（HG）. Method A total of 120 HG patients were randomized into an intramuscular injection group, a Neiguan（PC6） group, a Zusanli（ST36） group, and a Neiguan（PC6） plus Zusanli（ST36） group, with 30 cases in each group. The intramuscular injection group received intramuscular injection of vitamin B1 2 m L（100 mg）, once a day; the Neiguan（PC6） group received injection of vitamin B1 1 m L（50 mg） at bilateral Neiguan, once a day; the Zusanli（ST36） group received injection of vitamin B1 1 m L（50 mg） at bilateral Zusanli, once a day; the Neiguan（PC6） plus Zusanli（ST36） group received injection of vitamin B1 1 m L（50 mg） at unilateral Neiguan and Zusanli, once a day, and the two sides of acupoints were treated alternately. Seven-day treatment made up a course, and the 4 groups all received one course of treatment. The 24-h vomiting frequency before and after the treatment and change in urine ketone body were observed, and the therapeutic efficacies of the four groups were evaluated. Result The total effective rate was 60.0% in the intramuscular injection group, 86.7% in the Neiguan（PC6） group, 83.3% in the Zusanli（ST36） group and 96.7% in the Neiguan（PC6） plus Zusanli（ST36） group. The therapeutic efficacy in the Neiguan（PC6） group, Zusanli（ST36） group and Neiguan（PC6） plus Zusanli（ST36） group was significantly superior to that in the intramuscular injection group（P0.05）, there was no significant difference in the therapeutic efficacy between the Neiguan（PC6） and Zusanli（ST36） groups（P0.05）, and the efficacy in the Neiguan（PC6） plus Zusanli（ST36） group was more significant than that in the Neiguan（PC6） and Zusanli（ST36） groups（P0.05）. Conclusion Neiguan（PC6）plus Zusanli（ST36） group can produce a more significant efficacy than intramuscular injection group, Neiguan（PC6） group and Zusanli（ST36） group in treating HG.