Mollart Lyndall J, Adam Jon, Foureur Maralyn
Faculty of Health, University of Technology Sydney, Broadway, Ultimo NSW 2007, Australia; Maternity Services, Central Coast Local Health District, Gosford NSW 2250, Australia.
Public Health, Faculty of Health, University of Technology Sydney, Broadway, Ultimo NSW 2007, Australia.
Women Birth. 2015 Sep;28(3):199-206. doi: 10.1016/j.wombi.2015.03.007. Epub 2015 Apr 21.
There is worldwide concern with increasing rates of pharmacologically induced labour and operative birth. Many women would like to avoid medical or surgical interventions in childbirth; a desire that may contribute towards the popularity of complementary and alternative medicine/therapies.
This systematic review examines the effects of acupressure on labour onset and duration of labour. We searched MEDLINE, CINAHL, AMED, Cochrane Collaboration, and Science Direct from 1999 to 2013 for published randomised controlled trials and controlled trials comparing acupressure with placebo and no treatment. Studies recruited primiparous and/or multiparous women with either spontaneous or induced onset of labour. The outcome measures were labour onset and duration of all stages of labour.
Seven trials with data reporting on 748 women using different acupressure points and methods of administration were included in the review. One study examined the initiation of labour and six studies examined labour duration and/or pain levels. The two most studied acupoints were Sanyinjiao/Spleen 6 and Hegu/Large Intestine 4. Results suggest acupressure may reduce the length of labour particularly in the first stage.
Further research is required on whether acupressure can shorten labour duration, augment prolonged labour or initiate onset of labour by stimulating uterine contractions. Clinical trials should report the basis for acupressure treatment described in the STRICTA (minus needling) and CONSORT non-pharmaceutical guidelines.
药物引产和手术分娩率不断上升，这引起了全球关注。许多女性希望避免分娩时的医学或手术干预；这种愿望可能促使补充和替代医学/疗法更受欢迎。
本系统评价考察了穴位按压对分娩发动及产程的影响。我们检索了1999年至2013年期间的MEDLINE、CINAHL、AMED、Cochrane协作网及Science Direct数据库，以查找已发表的随机对照试验以及将穴位按压与安慰剂和不治疗进行比较的对照试验。研究纳入了初产妇和/或经产妇，分娩发动方式为自然发动或引产。结局指标为分娩发动情况及各产程时长。
本评价纳入了7项试验，这些试验报告了748名使用不同穴位及给药方法的女性的数据。1项研究考察了分娩发动情况，6项研究考察了产程时长和/或疼痛程度。研究最多的两个穴位是三阴交/脾经6穴和合谷/大肠经4穴。结果表明，穴位按压可能会缩短产程，尤其是第一产程。
关于穴位按压是否能通过刺激子宫收缩来缩短产程、促进产程延长或发动分娩，还需要进一步研究。临床试验应报告STRICTA（不包括针刺）和CONSORT非药物指南中描述的穴位按压治疗依据。
