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针灸与药物治疗方法减轻妊娠剧吐不适的比较。

Acupuncture versus pharmacological approach to reduce Hyperemesis gravidarum discomfort.

作者信息

Neri I, Allais G, Schiapparelli P, Blasi I, Benedetto C, Facchinetti F

机构信息

Department of Obstetrics and Gynecology, University of Modena-Reggio Emilia, Modena, Italy.

出版信息

Minerva Ginecol. 2005 Aug;57(4):471-5.

Abstract

AIM

Several reports have suggested the use of acupuncture as a useful treatment for hyperemesis gravidarum (HG), in particular the effects on nausea intensity was underlined. The aim of this study was to compare the efficacy of acupuncture sessions plus acupressure with a metoclopramide/vitamin B12 treatment.

METHODS

In this study we randomized 88 pregnant patients suffering from HG to receive either acupuncture sessions plus acupressure (acupuncture group) or metoclopramide infusion (metoclopramide group) supplemented by vitamin B12 complex. Somatic symptoms and the ability to achieve the daily routine activity (functioning) were evaluated. Acupuncture sessions were performed at the hospital twice a week for 2 weeks according to the traditional Chinese medicine criteria. Acupression was applied for 6-8 h/day. In the metoclopramide group, patients received at hospital metoclopramide infusion (20 mg/500 mL saline for 60 min) twice a week for 2 weeks. An oral supplementation with vitamin B12 complex (30 mg/day) was also prescribed.

RESULTS

Both treatments reduced vomiting episodes and then nausea intensity with a consequent improvement in the rate of food intake. The effect of acupuncture seems to be progressive, increasing at the end of treatment whereas pharmacological approach has a prompt effect in responders remaining stable thereafter. Moreover, acupuncture was significantly more effective than drugs in improving functioning.

CONCLUSIONS

In our study for the first time acupuncture, applied accordingly to Chinese formula, was compared to drugs demonstrating the same effect of both treatments on HG symptoms. Interestingly, functioning was significantly improved just by acupuncture. Even if the effect of acupuncture on HG discomfort remains to be confirmed, the reports on the effect of acupuncture on psychosocial variables could represent a further advantage of acupuncture application and provide an incentive to widen the base of the research.

摘要

目的

多项报告表明,针灸可有效治疗妊娠剧吐(HG),尤其强调了其对恶心程度的影响。本研究旨在比较针灸联合指压疗法与甲氧氯普胺/维生素B12治疗的疗效。

方法

在本研究中,我们将88名患有妊娠剧吐的孕妇随机分为两组,一组接受针灸联合指压疗法(针灸组),另一组接受甲氧氯普胺输注(甲氧氯普胺组)并补充复合维生素B12。评估了躯体症状和日常活动能力(功能)。根据中医标准,在医院每周进行两次针灸治疗,持续2周。指压疗法每天应用6 - 8小时。在甲氧氯普胺组,患者在医院每周接受两次甲氧氯普胺输注(20毫克/500毫升生理盐水,输注60分钟),持续2周。同时还开了口服复合维生素B12(30毫克/天)。

结果

两种治疗方法均减少了呕吐发作次数,进而降低了恶心程度,从而使食物摄入量增加。针灸的效果似乎是渐进的,在治疗结束时增强,而药物治疗对有反应者有迅速的效果,此后保持稳定。此外,在改善功能方面,针灸比药物显著更有效。

结论

在我们的研究中,首次将按照中医配方应用的针灸与药物进行比较,结果表明两种治疗方法对妊娠剧吐症状的效果相同。有趣的是,仅通过针灸就能显著改善功能。即使针灸对妊娠剧吐不适的效果仍有待证实,但关于针灸对心理社会变量影响的报告可能代表了针灸应用的另一个优势,并为扩大研究基础提供了动力。

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