Wu Lingling, Yin Yuzhu, Sun Ke, Wu Ling, Hou Hongying, Liu Xiaohui, Yi Wei, Li Shangrong
Department of Obstetrics and Gynecology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China.
Department of Rehabilitation and Physical Therapy, Guangdong No. 2 Provincial People's Hospital, Guangzhou 510317, China.
J Tradit Chin Med. 2017 Oct;37(5):629-635.
To evaluate the effectiveness of acupuncture analgesia (AA) compared with combined spinal-epidural anesthesia (CSEA) for labor pain relief and labor outcomes.
We evaluated 131 primiparous women who received respiratory guidance during maternal uterine contractions and received either AA (n = 43), CSEA (n = 45), or no additional treatment (control, n = 43). The groups were compared regarding visual analog scale (VAS) scores for abdominal and back pain, and labor outcomes.
The abdominal VAS scores of the AA and CSEA groups were significantly lower than that of the control group. In addition, the VAS scores of the CSEA group were significantly lower than that of the AA group at 10 and 60 min after intervention. The back pain VAS scores of the AA and CSEA groups were significantly lower than that of the control group at 5, 10, and 60 min after intervention. The duration of the active phase of labor in the CSEA group was significantly longer than that of the AA and control groups. The rates of oxytocin use (4.70%), urinary retention (4.70%), and postpartum hemorrhage [(273.7 ± 53.6) mL] in the AA group were significantly lower than in the CSEA group [46.70%, 24.20%, and (320.0 ± 85.6) mL, respectively].
Both AA and CSEA were effective for labor pain relief, CSEA provided more effective pain relief, while AA was associated with a shorter duration of labor and fewer adverse effects.and each has its advantages and disadvantages.
评估针刺镇痛（AA）与腰硬联合麻醉（CSEA）用于缓解分娩疼痛及分娩结局的有效性。
我们评估了131名初产妇，她们在产妇子宫收缩期间接受呼吸指导，并接受了AA（n = 43）、CSEA（n = 45）或不进行额外治疗（对照组，n = 43）。比较各组腹部和背部疼痛的视觉模拟量表（VAS）评分以及分娩结局。
AA组和CSEA组的腹部VAS评分显著低于对照组。此外，干预后10分钟和60分钟时，CSEA组的VAS评分显著低于AA组。干预后5分钟、10分钟和60分钟时，AA组和CSEA组的背部疼痛VAS评分显著低于对照组。CSEA组的活跃期分娩时间显著长于AA组和对照组。AA组的缩宫素使用率（4.70%）、尿潴留率（4.70%）和产后出血量[（273.7 ± 53.6）mL]显著低于CSEA组[分别为46.70%、24.20%和（320.0 ± 85.6）mL]。
AA和CSEA均对缓解分娩疼痛有效，CSEA提供了更有效的疼痛缓解，而AA与更短的产程和更少的不良反应相关，且各有优缺点。
