针药结合分娩镇痛的临床研究

Combination of Acupucture and Drugs for Pain Relief during Labor

目的 应用韩氏神经电刺激镇痛仪 (HANS) ,配伍用地西泮、曲马多 ,观察对分娩疼痛的镇痛效果和对母婴的影响。 方法 2 70例足月、单胎、正常初产妇在宫口开大 2～ 3cm时 ,随机分为 6组 ,即 HANS+地西泮 (10 m g iv)、HANS、地西泮 (10 mg iv)、HANS+曲马多 (10 0 mg im)、曲马多 (10 0 mg im)和对照组。采用 VAS疼痛评分方法分别在镇痛前后不同阶段评分。 结果 HANS+地西泮组镇痛有效率最高为 90 .3% ,其次 ,HANS+曲马多 78.9% ,HANS组 5 9.8%。针药复合组在镇痛后 1h、第一产程末期及第二产程时 VAS评分均较镇痛前明显降低 (P<0 .0 1)。与对照组各期相比 ,有非常显著的统计学差异。反映产程生理和胎婴儿状态的指标差异无显著性。 结论 应用电刺激镇痛仪加少量镇静镇痛药物 (地西泮或曲马多 ) ,有良好的镇痛效果 ,对母婴无不良影响 ,方法简便、经济 ,适于推广。

Objective To evaluate the effect of combination of HANS (Han's Acupoint Nerve Stimulator) and diazepam(D) or tramadol(T) on labor pain and influence on mother and infant. Methods Two-hundred and seventy normal term pregnancy and primipara with single vertex presentation were randomly divided into six groups, HANS+D ((HANS plus diazepam 10mg, iv), HANS, D(diazepam 10 mg, iv), HANS +T (HANS plus tramadol 100mg, im), T (tramadol 100mg, im) and control group . Pain relief methods were given when the cervix dilated to 2~3 cm. Labor pain was evaluated by VAS (visual analogue scale) at different stage. Results The effective rate of analgesia for HANS+D was the highest, 90.5%, for HANS+T and HANS were 78.9% and 59.8%, respectively. The VAS of the groups combination of HANS and drugs at the time one hour after analgesia, cervix dilating 7~8 cm, second stage, were much lower than that before analgesia and that of control group (P<0.01),and the index that reflecting the delivery physiology and situation of infant has no significant difference. Conclusions The combination of HANS and some sedative or analgesic drugs have good analgesic effect on labor pain. No side effects were found on mothers and babies. It is a simple and cheap method to be performed.