Karimi Leila, Mahdavian Mitra, Makvandi Somayeh
Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Department of Midwifery, School of Nursing and Midwifery, Islamic Azad University Bojnourd Branch, Bojnourd, Iran.
Iran J Nurs Midwifery Res. 2020 Nov 7;25(6):455-462. doi: 10.4103/ijnmr.IJNMR_257_19. eCollection 2020 Nov-Dec.
Numerous studies have been conducted on the effect of acupressure on labor pain, some of which have reported conflicting results. Thus, the present study was performed to critically review the previous studies related to the effect of acupressure administered during labor for relieving labor pain.
In this study, databases of the Cochrane Central Register of the Controlled Trials, PubMed/MEDLINE, Scopus, and Web of Science were searched from their establishment until November 5, 2019. All the Randomized Controlled Trials (RCTs) that had compared the use of acupressure with either placebo or nonintervention for relieving the labor pain were included in the study. Meta-analysis was performed using the Comprehensive Meta-Analysis (CMA) software Version 2. The random-effects model was used for pooling the effect sizes across the included studies. The value <0.05 was considered as statistically significant.
Totally, 5853 primary papers were identified in the search, which were narrowed down to 22 studies. The results of meta-analysis showed that the acupressure decreased the labor pain in the intervention group vs. control (-1.67 [-2.29 to -1.05], z = -5.25, < 0. 001) (Q-value = 788.98, < 0.001, I-squared = 96.83). No publication bias was found in the included studies (Egger's regression intercept = -1.02, = 0.76).
Although the findings of this meta-analysis showed that the acupressure significantly reduced the labor pain during the active phase of labor compared to the nonintervention or placebo; considering that the quality of the included studies was generally moderate, rigorous RCTs with better design and higher quality are needed to obtain definitive conclusions.
关于指压对分娩疼痛的影响已开展了大量研究,其中一些研究报告的结果相互矛盾。因此,本研究旨在严格审查先前有关分娩期间实施指压以减轻分娩疼痛效果的研究。
在本研究中,检索了Cochrane对照试验中央注册库、PubMed/MEDLINE、Scopus和Web of Science数据库,检索时间从各数据库建立至2019年11月5日。所有比较指压与安慰剂或不干预以减轻分娩疼痛的随机对照试验(RCT)均纳入本研究。使用综合Meta分析(CMA)软件版本2进行Meta分析。采用随机效应模型汇总纳入研究的效应量。P值<0.05被认为具有统计学意义。
在检索中总共识别出5853篇原始论文,最终筛选出22项研究。Meta分析结果显示,与对照组相比,指压可减轻干预组的分娩疼痛(-1.67[-2.29至-1.05],z=-5.25,P<0.001)(Q值=788.98,P<0.001,I²=96.83)。纳入研究中未发现发表偏倚(Egger回归截距=-1.02,P=0.76)。
尽管本Meta分析的结果表明,与不干预或安慰剂相比,指压在分娩活跃期可显著减轻分娩疼痛;但考虑到纳入研究的质量总体中等,需要设计更好、质量更高的严格RCT来得出确切结论。