腕踝针治疗产后腹痛的临床疗效及对产妇血清β-EP水平的影响  

Curative effect of wrist-ankle acupuncture on postpartum abdominal pain and its influence on serumβ-EP level in puerpera

作　　者：霍艳 陈萍[2] 朱俊楠 付雅琪 徐广立 HUO Yan;CHEN Ping;ZHU Jun-nan;FU Ya-qi;XU Guang-li(First Clinical Medical School of Henan University of CM,Zhengzhou 450000,China;Department of Obstetrics and Gynecology,First Affiliated Hospital of Henan University of CM,Zhengzhou 450099;Department of Reproductive Medicine,First Affiliated Hospital of Henan University of CM,Zhengzhou 450099)

机构地区：[1]河南中医药大学第一临床医学院,郑州450000 [2]河南中医药大学第一附属医院妇产科,郑州450000 [3]河南中医药大学第一附属医院生殖医学科,郑州450099

出　　处：《中国针灸》2023年第11期1257-1260,共4页Chinese Acupuncture & Moxibustion

基　　金：国家自然科学基金资助项目:82074167;河南省自然科学基金项目:202300410265。

摘　　要：目的:观察腕踝针治疗产后腹痛的临床疗效及对产妇血清β-内啡肽(β-EP)水平的影响。方法:将70例产后腹痛患者随机分为针药组(35例,脱落1例)和中药组(35例,脱落2例)。中药组于产后第1天服用生化汤加味,每日1剂;针药组在中药组基础上予腕踝针治疗,穴取双侧踝部下1区、下2区,每日1次。均治疗3 d。比较两组患者治疗前后疼痛视觉模拟量表(VAS)评分、血清β-EP水平、子宫底高度,产后恶露情况及产后42 d子宫复旧情况。结果:治疗后各时间点(产后24、48、72 h),两组患者疼痛VAS评分、子宫底高度较治疗前(产后2 h)降低(P<0.05),且针药组低于中药组(P<0.05)。治疗后(产后72 h),两组患者血清β-EP水平均较治疗前升高(P<0.05),且针药组高于中药组(P<0.05)。针药组患者产后血性恶露量多于中药组、产后血性恶露持续时间及总恶露持续时间短于中药组(P<0.05)。两组患者产后42 d子宫复旧情况比较差异无统计学意义(P>0.05)。结论:腕踝针能明显减轻产后腹痛患者的疼痛程度、促进恶露排出和子宫复旧,其作用机制可能是上调血清β-EP水平,提高痛阈,从而达到镇痛效果。Objective To observe the clinical effect of wrist-ankle acupuncture on postpartum abdominal pain and its influence on serum beta-endorphin(β-EP)level in puerpera.Methods Seventy patients with postpartum abdominal pain were randomly divided into an acupuncture+herbal medication group(35 cases,1 case dropped out)and a herbal medication group(35 cases,2 cases dropped out).In the herbal medication group,1 day after delivery,modified shenghua decoction was taken orally,one dose a day.In the acupuncture+herbal medication group,on the basis of herbal medication,wrist-ankle acupuncture was given at the Lower 1 and Lower 2 of the ankles,once daily.The duration of treatment was 3 days in the two groups.Before and after treatment,the score of visual analogue scale(VAS)for pain,serumβ-EP level,uterine fundus height,postpartum conditions of lochia and the uterine recovery at 42 days postpartum were compared in the patients of the two groups.Results At each time point after treatment(24 h,48 h and 72 h after delivery),VAS scores and the uterine fundus height were reduced as compared with those before treatment(2 h after delivery)in the two groups(P<0.05);these indexes in the acupuncture+herbal medication group were lower than those in the herbal medication group(P<0.05).After treatment(72 h after delivery),β-EP levels in the serum were increased when compared with those before treatment in the two groups(P<0.05),and theβ-EP level in the acupuncture+herbal medication group was higher than that in the herbal medication group(P<0.05).The volume of postpartum lochia discharge in the acupuncture+herbal medication group was higher than that in the herbal medication group(P<0.05),while the duration of postpartum lochia discharge and the total time of lochia discharge were shorter(P<0.05).Regarding the recovery of the uterus at 42 days postpartum,there was no statistical significance between the two groups(P>0.05).Conclusion Wrist-ankle acupuncture obviously reduces the degree of postpartum abdominal pain and promotes the lochia d

关 键 词：产后腹痛 腕踝针 镇痛 针药结合 Β-内啡肽 

分 类 号：R246.3[医药卫生—针灸推拿学]