三阴交配伍合谷穴艾灸对第一产程活跃期宫缩痛的影响

Effect of moxibusting at sanyinjiao hegu on the active period of the first stage of labor and the de livery analgesia

目的 观察艾灸三阴交、合谷穴对第一产程活跃期宫缩痛的影响.方法 选取2013年12月至2014年8月唐山市曹妃甸区医院收治的160例初产妇,采用单盲、随机方法分为三阴交组、三阴交加合谷组、非穴组、空白组4组,每组各40例.三阴交组、三阴交加合谷组分别在产妇出现规律性宫缩痛,宫口开大3 cm时行三阴交穴、合谷穴联合三阴交穴施灸30 min;非穴组在腕横纹桡侧端桡动脉搏动处至肘横纹肱二头肌腱桡侧端连线的中点处施灸30 min;空白组不做艾灸干预.分别对产妇第一产程活跃期时间及宫缩痛进行比较.结果 三阴交组、三阴交加合谷组、非穴组、空白组患者产程活跃期时间分别为(116.11±65.89)、(81.93±53.45)、(123.03±76.70)、(138.69±104.01) min,三阴交加合谷组与非穴组、空白组比较差异均有统计学意义(P均＜0.05),非穴组与空白组比较差异无统计学意义(P＞0.05).4组患者第一产程时间分别为(313.22±141.15)、(379.50±182.82)、(393.00±196.50)、(488.08±236.61) min,三阴交组、三阴交加合谷组与空白组比较差异均有统计学意义(P均＜0.05).4组患者停艾灸治疗后2h宫颈扩张程度分别为(8.37±2.19)、(8.14±2.74)、(7.64±2.91)、(6.29±3.05) cm;宫缩持续时间分别为(0.56±0.16)、(0.52±0.13)、(0.48±0.17)、(0.41±0.09) min;宫缩间隔时间分别为(2.98±1.45)、(2.56±1.02)、(3.89±1.54)、(3.41±1.32) min;宫缩强度增强有效率分别为60.0％(24/40)、75.0％(30/40)、17.5％(7/40)、10.0％(4/40).以上各指标三阴交组、三阴交加合谷组与非穴组、空白组比较差异均有统计学意义(P均＜0.05),非穴组与空白组比较差异无统计学意义(P均＞0.05).停艾灸治疗后2h4组患者分娩减痛有效率分别为52.5％ (21/40)、47.5％ (19/40)、22.5％(9/40)、20.0％(8/40),三阴交穴组、三阴交配伍合谷穴组分娩减痛有效率优于非穴组、空白组,差异均有统计学意义(P均＜0.05);非穴组与空白组比较,差异无统计学意义(P＞0.05).结论 艾灸三阴交穴与三阴交穴配伍合谷穴艾灸对产妇产程及宫缩影响效果相当,但联合穴位艾灸更能缩短产程活跃期时间,促进产程进展,是安全的催产方法.

Objective To observe the effect of moxibustion on Sanyinjiao, Hegu acupoint first active phase of labor contractions pain.Methods One hundred and sixty cases of primipara were divided into test group by single blind, randomized methods (the Sanyinjiao acupoint group, Sanyinjiao acupoint and hegu point group) and control group(non-acupuncturev points group and the blank group).Each group with 40 cases.The patients were exerted mxibustion therapy 30 min in the Sanyinjiao acupoint group and Sanyinjiao acupoint and hegu point group, respectively in the maternal appear regularity uterine contraction pain, after ostium of uterus opened 3 cm.The women of the non-acupuncturev points group were exerted moxibustion therapy in the wrist horizontal stripes of radial side radial pulse place to elbow horizontal stripes biceps tendon of the midpoint of the radial side of attachment 30 min.The blank group women didn' t conduct notcarry moxibustion intervention.On the first active stage of labor time and uterine contraction pain were compared.Results The active labor time of Sanyinjiao group, Sanyinjiao and Hegu group,non acupoint group and blank control group patients were (116.11 ±65.89) min, (81.93 ± 53.45) min, (123.03 ± 7.67) min, (138.69 ± 104.01) min respectively, there was significant difference among Sanyinjiao and Hegu group, non acupoint group and blank group (P＜ 0.05), while the difference between the non acupoint group and blank group without statistical significance (P＞0.05).The first time of production process of 4 groups were (313.22± 141.15) min, (379.50± 182.82) min, (393.00 ±196.50) min, (488.08±236.61) min respectively, there was significant difference among Sanyinjiao group,Sanyinjiao and Hegu group and blank group differences (P ＜ 0.05).Moxibustion therapy after stopping, 2 h degree of cervical dilation of 4 groups were (8.37±2.19) cm, (8.14±2.74) cm, (7.64±2.91) cm, (6.29 ±3.05) cm respectively;contractions lasting time were (0.56±0.16) min, (0.52±0.13) min, (0.:48±0.17) min, (0.41± 0.09) min respectively;uterine contraction interval (2.98± 1.45) min, (2.56± 1.02) min, (3.89 ±1.54) min, (3.41 ± 1.32) min respectively;contraction strength enhaucement efficiency were 60.0％ (24/40) ,75.0％ (30/40), 17.5％ (7/40), 10.0％ (4/40) respectively, there were significant differences among Sanyinjiao group,Sanyinjiao and Hegu group,the non acupoint group and blank control group in terms of above indexes (P ＜ 0.05), while difference between the non acupoint group and blank group without statistical significance(P＞0.05).After the withdrawal of the moxibustion treatment 2 h, the pain reduction in childbirth of 4 groups were 52.5 ％ (21/40), 47.5％ (19/40), 22.5％ (9/40), 20％ (8/40) respectively, the pain reduction in childbirth of Sanyinjiao group, Sanyinjiao and Hegu Point Group were higher than that of non acupoint group and blank group, the differences were statistically significant (P＜0.05);while non acupoint group and blank group compared without statistically significant (P＞0.05).Conclusion The effect of Moxibustion at Sanyinjiao and Sanyinjiao compatibility Hegu Acupoint moxibustion on maternal production process and uterine contraction are significant, but combine with Acupoint Moxibustion can shorten the time of the active phase of labor, increase contraction of the uterus, promote the production process.