Vixner Linda, Schytt Erica, Mårtensson Lena B
Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institutet, Karolinska Institutet, Stockholm, Sweden.
School of Health and Social Studies, Dalarna University, Falun, Sweden.
Acupunct Med. 2017 Jun;35(3):180-188. doi: 10.1136/acupmed-2016-011164. Epub 2016 Dec 16.
Patient characteristics are modulators of pain experience after acupuncture treatment for chronic pain. Whether this also applies to labour pain is unknown.
To examine for associations between maternal characteristics and response to acupuncture in terms of labour pain intensity in close proximity to the treatment (within 60 min) and over a longer time period (up to 240 min), and whether or not epidural analgesia is used, before and after adjustment for obstetric status upon admission to the labour ward.
Cohort study (n=253) using data collected for a randomised controlled trial. Associations were examined using linear mixed models and logistic regression analyses. Tests of interactions were also applied to investigate whether maternal characteristics were influenced by treatment group allocation.
In close proximity to the treatment, advanced age and cervical dilation were associated with lower pain scores (mean difference (MD) -13.2, 95% CI -23.4 to -2.9; and MD -5.0, 95% CI -9.6 to -0.5, respectively). For the longer time period, labour pain was negatively associated with age (MD -11.8, 95% CI -19.6 to -3.9) and positively associated with dysmenorrhoea (MD 5.5, 95% CI 1.6 to 9.5). Previous acupuncture experience and advanced cervical dilatation were associated with higher and lower use of epidural analgesia (OR 2.7, 95% CI 1.3 to 5.9; and OR 0.3, 95% CI 0.1 to 0.5, respectively). No interactions with treatment allocation were found.
This study did not identify any maternal characteristics associated with women's responses to acupuncture during labour.
NCT01197950; Post-results.
患者特征是慢性疼痛针刺治疗后疼痛体验的调节因素。这是否也适用于分娩疼痛尚不清楚。
研究产妇特征与针刺治疗反应之间的关联,包括治疗后短时间内(60分钟内)和较长时间段(长达240分钟)的分娩疼痛强度,以及在进入产房产科情况调整前后是否使用硬膜外镇痛。
采用一项随机对照试验收集的数据进行队列研究(n = 253)。使用线性混合模型和逻辑回归分析来检验关联。还应用交互作用检验来研究产妇特征是否受治疗组分配的影响。
在治疗后短时间内,高龄和宫颈扩张与较低的疼痛评分相关(平均差(MD)分别为-13.2,95%可信区间-23.4至-2.9;以及MD -5.0,95%可信区间-9.6至-0.5)。在较长时间段内,分娩疼痛与年龄呈负相关(MD -11.8,95%可信区间-19.6至-3.9),与痛经呈正相关(MD 5.5,95%可信区间1.6至9.5)。既往针刺经验和宫颈高度扩张与硬膜外镇痛的较高和较低使用率相关(优势比(OR)分别为2.7,95%可信区间1.3至5.9;以及OR 0.3,95%可信区间0.1至0.5)。未发现与治疗分配的交互作用。
本研究未发现任何与女性分娩时对针刺治疗反应相关的产妇特征。
NCT01197950;结果公布后。