干预正常产程进展的针刺方法临床应用概况

Overview of the clinical application about acupuncture intervention methods in the progression of normal stage of labor

文章从针刺干预正常产程的时机和针刺方法两个方面对相关文献进行回顾性研究,以期为产科临床诊治提供参考。针刺干预方式以毫针、电针、腕踝针、揿针、头针、穴位注射为主。其中,毫针针刺对针刺手法要求较高;电针在毫针针刺基础上联合电频脉冲刺激,扩大毫针针刺使用效应;腕踝针、揿针、头针等针刺疗法作用时间久,便于产妇活动;穴位注射利用穴位与药物的双重作用干预分娩过程,操作简便,安全性更高。根据干预目的、针具使用特性的不同,针刺介入时机以潜伏期开始、宫口开至3 cm、宫口开至10 cm、胎儿娩出等节点为主。其中毫针、电针多用于潜伏期开始、宫口开至3 cm左右及第二产程结束,留针时间以30 min为主,在少量研究中第二产程亦有使用,针刺效应时长有所限制;腕踝针、揿针、头针等其他针刺疗法作用时间久,可以满足全产程干预的需求。

This paper will review the relevant literature on the timing and methods of acupuncture intervention in normal stage of labor,in order to provide a reference for the clinical diagnosis and treatment of childbirth.The acupuncture interventions are mainly acupuncture needle,electric needle,wrist-ankle needle,press needle,scalp needle and acupoint injection.Among them,Regarding the acupuncture technique,the use of acupuncture needle have higher requirements.Electroacupuncture is combined with electric frequency pulse stimulation to expand the effect of acupuncture needle.Wrist-ankle acupuncture,press acupuncture and scalp acupuncture are easy to relax for a long time.Acupoint injection intervenes in the stage of labor under the dual action of acupoints and drugs,which is simpler and safer.According to the different purpose of intervention and the use of needling tools,the time of needling intervention was mainly at the beginning of incubation period,3 cm,10 cm of uterine opening and fetal delivery.The filiform needle and electroacupuncture are mostly used for the beginning of incubation period,about 3 cm of uterine opening and the end of the second stage of labor,the needle retention time is mainly 30 minutes,at the same time,the second stage of labor has also been used in a small number of studies,and the duration of acupuncture effect is limited.Wrist-ankle acupuncture,press acupuncture,scalp acupuncture and other acupuncture therapy work for a long time,and can meet the needs of thewhole stageof labor intervention.