First Clinical Medical School of Henan University of CM, Zhengzhou 450000, China.
Department of Obstetrics and Gynecology.
Zhongguo Zhen Jiu. 2023 Sep 8;43(11):1257-1260. doi: 10.13703/j.0255-2930.20230228-k0006.
To observe the clinical effect of wrist-ankle acupuncture on postpartum abdominal pain and its influence on serum beta-endorphin (β-EP) level in puerpera.
Seventy patients with postpartum abdominal pain were randomly divided into an acupuncture + herbal medication group (35 cases, 1 case dropped out) and a herbal medication group (35 cases, 2 cases dropped out). In the herbal medication group, 1 day after delivery, modified decoction was taken orally, one dose a day. In the acupuncture + herbal medication group, on the basis of herbal medication, wrist-ankle acupuncture was given at the Lower 1 and Lower 2 of the ankles, once daily. The duration of treatment was 3 days in the two groups. Before and after treatment, the score of visual analogue scale (VAS) for pain, serum β-EP level, uterine fundus height, postpartum conditions of lochia and the uterine recovery at 42 days postpartum were compared in the patients of the two groups.
At each time point after treatment (24 h, 48 h and 72 h after delivery), VAS scores and the uterine fundus height were reduced as compared with those before treatment (2 h after delivery) in the two groups (<0.05); these indexes in the acupuncture + herbal medication group were lower than those in the herbal medication group (0.05). After treatment (72 h after delivery), β-EP levels in the serum were increased when compared with those before treatment in the two groups (<0.05), and the β-EP level in the acupuncture + herbal medication group was higher than that in the herbal medication group (<0.05). The volume of postpartum lochia discharge in the acupuncture + herbal medication group was higher than that in the herbal medication group (<0.05), while the duration of postpartum lochia discharge and the total time of lochia discharge were shorter (<0.05). Regarding the recovery of the uterus at 42 days postpartum, there was no statistical significance between the two groups (>0.05).
Wrist-ankle acupuncture obviously reduces the degree of postpartum abdominal pain and promotes the lochia discharge and the uterine recovery. The effect mechanism may be related to the up-regulation of serum β-EP level and the increase of pain threshold so that analgesia is obtained.
观察腕踝针治疗产后腹痛的临床疗效及其对产妇血清β-内啡肽(β-EP)水平的影响。
将 70 例产后腹痛患者随机分为针刺+中药组(35 例,脱落 1 例)和中药组(35 例,脱落 2 例)。中药组产后 1 天开始口服加味生化汤,1 剂/d。针刺+中药组在中药组的基础上给予腕踝针,在踝下 1、2 点进针,每日 1 次。两组治疗 3 天。比较两组患者治疗前后视觉模拟评分法(VAS)疼痛评分、血清β-EP 水平、宫底高度、产后恶露情况及产后 42 天子宫恢复情况。
与治疗前(产后 2 h)比较,两组患者治疗后(产后 24、48、72 h)VAS 评分和宫底高度均降低(<0.05),且针刺+中药组均低于中药组(<0.05);两组患者治疗后(产后 72 h)血清β-EP 水平均高于治疗前(<0.05),且针刺+中药组高于中药组(<0.05);针刺+中药组产后恶露量多于中药组(<0.05),恶露持续时间和恶露总时间均短于中药组(<0.05);两组患者产后 42 天子宫恢复情况比较,差异无统计学意义(>0.05)。
腕踝针可明显减轻产后腹痛程度,促进恶露排出和子宫恢复,其作用机制可能与上调血清β-EP 水平、提高痛阈而达到镇痛效果有关。