Vixner Linda, Schytt Erica, Stener-Victorin Elisabet, Waldenström Ulla, Pettersson Hans, Mårtensson Lena B
Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institutet, Retzius väg 13A, 171 77 Stockholm, Sweden.
BMC Complement Altern Med. 2014 Jun 9;14:187. doi: 10.1186/1472-6882-14-187.
Acupuncture is commonly used to reduce pain during labour despite contradictory results. The aim of this study is to evaluate the effectiveness of acupuncture with manual stimulation and acupuncture with combined manual and electrical stimulation (electro-acupuncture) compared with standard care in reducing labour pain. Our hypothesis was that both acupuncture stimulation techniques were more effective than standard care, and that electro-acupuncture was most effective.
A longitudinal randomised controlled trial. The recruitment of participants took place at the admission to the labour ward between November 2008 and October 2011 at two Swedish hospitals . 303 nulliparous women with normal pregnancies were randomised to: 40 minutes of manual acupuncture (MA), electro-acupuncture (EA), or standard care without acupuncture (SC).
labour pain, assessed by Visual Analogue Scale (VAS).
relaxation, use of obstetric pain relief during labour and post-partum assessments of labour pain. The sample size calculation was based on the primary outcome and a difference of 15 mm on VAS was regarded as clinically relevant, this gave 101 in each group, including a total of 303 women.
Mean estimated pain scores on VAS (SC: 69.0, MA: 66.4 and EA: 68.5), adjusted for: treatment, age, education, and time from baseline, with no interactions did not differ between the groups (SC vs MA: mean difference 2.6, 95% confidence interval [CI] -1.7-6.9 and SC vs EA: mean difference 0.6 [95% CI] -3.6-4.8). Fewer number of women in the EA group used epidural analgesia (46%) than women in the MA group (61%) and SC group (70%) (EA vs SC: odds ratio [OR] 0.35; [95% CI] 0.19-0.67).
Acupuncture does not reduce women's experience of labour pain, neither with manual stimulation nor with combined manual and electrical stimulation. However, fewer women in the EA group used epidural analgesia thus indicating that the effect of acupuncture with electrical stimulation may be underestimated. These findings were obtained in a context with free access to other forms of pain relief.
ClinicalTrials.gov: NCT01197950.
尽管结果相互矛盾，但针灸仍常用于减轻分娩时的疼痛。本研究旨在评估手动刺激针灸和手动与电刺激相结合的针灸（电针）与标准护理相比在减轻分娩疼痛方面的有效性。我们的假设是，两种针灸刺激技术都比标准护理更有效，且电针最为有效。
一项纵向随机对照试验。2008年11月至2011年10月期间，在瑞典两家医院的分娩病房对参与者进行招募。303例正常妊娠的初产妇被随机分为：40分钟的手动针灸（MA）组、电针（EA）组或无针灸的标准护理（SC）组。
采用视觉模拟量表（VAS）评估分娩疼痛。
放松程度、分娩期间产科镇痛的使用情况以及产后分娩疼痛评估。样本量计算基于主要结局，VAS上15毫米的差异被视为具有临床相关性，每组得出101例，共303名女性。
经治疗、年龄、教育程度和自基线起的时间调整后，VAS上的平均估计疼痛评分（SC组：69.0，MA组：66.4，EA组：68.5），且无交互作用，各组之间无差异（SC组与MA组：平均差异2.6，95%置信区间[CI]-1.7至6.9；SC组与EA组：平均差异0.6[95%CI]-3.6至4.8）。与MA组（61%）和SC组（70%）相比，EA组使用硬膜外镇痛的女性人数较少（46%）（EA组与SC组：优势比[OR]0.35；[95%CI]0.19至0.67）。
无论是手动刺激针灸还是手动与电刺激相结合的针灸，都不能减轻女性分娩时的疼痛体验。然而，EA组使用硬膜外镇痛的女性较少，因此表明电刺激针灸的效果可能被低估。这些发现是在可免费获得其他形式镇痛方法的背景下获得的。
ClinicalTrials.gov：NCT01197950。
