Wen Ting, Li Gan, Chen Shi-Biao, Liu Jia
Department of Anesthesiology, First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province,China.
Department of Laboratory, Mental Hospital of Jiangxi Province.
Zhongguo Zhen Jiu. 2020 Nov 12;40(11):1159-63. doi: 10.13703/j.0255-2930.20191118-0004.
To observe effect of magnetic beads auricular point sticking therapy on intrapartum fever in primipara with epidural labor analgesia and explore its possible mechanism.
A total of 160 primipara were randomly divided into an observation group (80 cases, 12 cases dropped off ) and a control group (80 cases, 15 cases dropped off ). The primipara in the control group received epidural labor analgesia. In the observation group, 15 min after epidural labor analgesia was performed, magnetic beads auricular point sticking therapy was given at shenmen (TF), neishengzhiqi (TF), neifenmi (CO) and jiaogan (AH), pressing and kneading once every 15 min, 1 min each time, until the end of first stage of labor. The tympanic temperature on T (before labor analgesia), T (2 h after labor analgesia), T (4 h after labor analgesia) and T (1 h after labor) was recorded, and the intrapartum fever incidence and level of serum cortisol and IL-6 between two groups were compared. The visual analogue scale (VAS) score before and after labor analgesia, the pressing times of patient controlled epidural analgesia (PCEA), and the dosage of sufentanil were observed. The active labor period, the second stage of labor, and the time of analgesia, the use of oxytocin, the number of vaginal examination and the rate of cesarean section were recorded in the two groups.
There was no significant difference in tympanic temperature in the observation group at each time point (>0.05), the tympanic temperature at T and T in the control group was higher than that at T (<0.05); the tympanic temperature at T and T in the observation group was lower than that in the control group (<0.05). The levels of serum cortisol and IL-6 at T in the two groups were higher than those at T (<0.05), and those in the observation group were lower than the control group (<0.05). The second stage of labor in the observation group was shorter than that in the control group (<0.05), and the pressing times of PCEA, the dosage of sufentanil, intrapartum fever incidence, usage rate and total amount of oxytocin and the number of vaginal examinations were all lower than those in the control group (<0.05).
Magnetic beads auricular point sticking therapy can reduce the amount of anesthetics, decrease the effect of epidural analgesia on primipara's body temperature regulation and labor progress, and lower the incidence of fever during labor analgesia by regulating the level of inflammatory response in the primipara.
观察磁珠耳穴贴压疗法对硬膜外分娩镇痛初产妇产时发热的影响，并探讨其可能机制。
将160例初产妇随机分为观察组（80例，脱落12例）和对照组（80例，脱落15例）。对照组初产妇接受硬膜外分娩镇痛。观察组在硬膜外分娩镇痛15分钟后，于神门（TF）、内生殖器（TF）、内分泌（CO）及交感（AH）耳穴进行磁珠贴压，每15分钟按压揉捻1次，每次1分钟，直至第一产程结束。记录分娩镇痛前（T）、分娩镇痛2小时后（T）、分娩镇痛4小时后（T）及产后1小时（T）的鼓膜温度，比较两组产时发热发生率及血清皮质醇和IL-6水平。观察分娩镇痛前后视觉模拟评分（VAS）、患者自控硬膜外镇痛（PCEA）按压次数及舒芬太尼用量。记录两组活跃期、第二产程及镇痛时间、缩宫素使用情况、阴道检查次数及剖宫产率。
观察组各时间点鼓膜温度差异无统计学意义（>0.05），对照组T及T时鼓膜温度高于T时（<0.05）；观察组T及T时鼓膜温度低于对照组（<0.05）。两组T时血清皮质醇和IL-6水平高于T时（<0.05），且观察组低于对照组（<0.05）。观察组第二产程短于对照组（<0.05），PCEA按压次数、舒芬太尼用量、产时发热发生率、缩宫素使用率及总量、阴道检查次数均低于对照组（<0.05）。
磁珠耳穴贴压疗法可减少麻醉药物用量，降低硬膜外镇痛对初产妇体温调节及产程的影响，通过调节初产妇炎症反应水平降低分娩镇痛期间发热发生率。
