五行音乐配合电针对分娩疼痛的镇痛效应及作用机制

Analgesic effects and mechanisms of five-element music with electroacupuncture in treating labor pain

目的:探讨五行音乐配合电针对分娩镇痛作用及机制。方法:对产妇在分娩过程中应用五行音乐加电针分娩镇痛,并与对照组、药物组及电针组进行对照观察镇痛效果、产程时间,产后2h内出血量及对新生儿Apgar评分及脐动脉血气分析的影响,Western blot、Real-time PCR检测胎盘组织C-Raf、P-ERK、P-CREB及DYN蛋白与基因表达;ELISA检测产妇血清DYN含量。结果:五行音乐加电针组在镇痛效果、总产程时间、产后2h内子宫出血量及对新生儿的影响等方面优于其他3组,组间差异有统计学意义(P<0.01,P<0.05)。ERK信号分子Raf、ERK及CREB磷酸化蛋白与mRNA在各组产妇胎盘组织表达,与对照组比较,电针组、五行音乐加电针组及药物组C-Raf、ERK、CREB的表达量降低,DYN的表达量显著提高,组间差异有统计学意义(P<0.01),由高到低依次为对照组>电针组>五行音乐加电针组>药物组。结论:五行音乐加电针对产妇分娩疼痛具有明显的镇痛效果,可有效缩短产妇产程时间,减少产后2h内子宫出血量,提高新生儿出生后1、5min的Apgar评分及增加新生儿血氧含量;Raf/ERK/CREB通路分子蛋白与效应分子DYN蛋白存在负相关性。揭示,五行音乐配合电针对分娩镇痛作用及ERK信号通路介导DYN释放产生镇痛机制。

Objective: To explore the effects and mechanisms of five-elements music on labor analgesia. Methods: During the delivery process, the women were given five-elements music for labor analgesia, and the control group, the drug group, and the electroacupuncture group were compared to observe the labor time, the amount of bleeding within 2 hours after birth and the effect on the newborn. Western blot and real-time PCR were used to detect C-Raf, P-ERK, P-CREB and DYN protein and gene expression in placenta. ELISA was used for detecting maternal venous blood DYN content. Results: The five-elements music group was superior to the other three groups in terms of duration of analgesia, total labor time, uterine bleeding within 2 hours postpartum, and effects on neonates. The difference between the groups was statistically significant(P<0.01, P<0.05). ERK signaling molecules Raf, ERK and CREB phosphorylated protein and mRNA were expressed in four groups of maternal placenta tissues. Compared with the control group, the expression of C-Raf, ERK, CREB decreased while the expression of DYN increased, the electroacupuncture group, five-elements music group, and drug group were significantly lower, and the differences among these groups were statistically significant(P<0.01). Significance from high to low: control group>electroacupuncture group>five-elements music group>drug group. Conclusion: Five-elements music has obvious analgesic effect on maternal labor pain, which can effectively shorten the maternal labor time, reduce the amount of uterine bleeding within 2 hours after birth, improve the Apgar score of 1 minute and 5 minutes after birth, and increase the blood oxygen content of newborns;There is a negative correlation between the Raf/ERK/CREB pathway molecular protein and the effector molecule DYN protein. It is revealed that the five elements of music combined with electroacupuncture have an analgesic effect on labor analgesia and ERK signaling pathway mediated DYN release.