针刺分娩镇痛的临床研究  

Research on electro-acupuncture analgesia(EA) for labor

作　　者：杨咏梅[1] 黄醒华[2] 黄涛[3] 

机构地区：[1]首都医科大学宣武医院,北京100053 [2]首都医科大学附属北京妇产医院 [3]中国中医科学院针灸研究所

出　　处：《北京中医药大学学报》2009年第1期65-68,共4页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家中医药管理局中医药科学技术研究专项中医临床研究基金项目(No.04-05LQ04)

摘　　要：目的探索针刺穴位分娩镇痛的新技术手段,根据不同证候筛选最佳穴位组合,了解镇痛效果的影响因素,并将电针辨证取穴镇痛与目前所了解的其他有效镇痛方法比较,评定各方法效果的优劣。方法将391例初产妇,随机分为4组,其中电针辨证取穴镇痛组92例,经皮神经电刺激(TENS)镇痛组114例,腰麻-硬膜外联合阻滞镇痛组92例,空白对照组93例,并于分娩当时及产后3～5d跟踪调查。观察了解疼痛指标及母血中β-内腓肽的改变。结果电针辨证取穴治疗组镇痛效果显著提高,镇痛后0.5～2h视觉模拟疼痛量表(VAS)评分亦明显改变,差异显著(P<0.05),产妇对镇痛治疗的满意度升高,但与腰麻-硬膜外联合治疗组比较,镇痛效果及满意度较低,差异显著(P<0.05)。结论电针辨证取穴镇痛治疗较TENS治疗效果显著提高,满意度增加。镇痛效果以镇痛后0.5～1h最好,至活跃期末,效果基本消失。不同证候分型产妇镇痛效果不同。Objective To explore a new therapy of electro-acupuncture analgesia （EA）for labor, which uses choosing acupuncture points combination according tO differentiation syndromes; to assess this new therapy versus other analgesic methods; and to investigate the factors associated with efficacy. Methods 391 precipitous women were randomized to four groups. The first group contained 92 cases who received labor analgesia using electro-acupuncture by choosing acupoints according to differentiation syndromes. The second group contained 114 cases that received TENS（ transcutaneous electrical nerve stimulation） the period of 30 min. to 2 hours after treatment were statistically significant lower （ P 〈 0.05 ） ; and the maternal satisfaction was also elevated. But compared with the combined spinal-epidural analgesia, the effectiveness and the satisfaction in EA were distinctly lower （ P 〈 0. 05 ）. Conclusions acupuncture analgesia with acupoints according to differentiation syndromes is more effective Electroin pain control and has higher maternal satisfaction than TENS. The optimal analgesia period was 30 min. to 1 hour, and the effect disappeared after the active phase. The therapeutic effects are different for differentdifferentiation syndromes.

关 键 词：分娩镇痛 电针 辨证取穴 

分 类 号：R246.2[医药卫生—针灸推拿学]