Cardini F, Weixin H
JAMA. 1998 Nov 11;280(18):1580-4. doi: 10.1001/jama.280.18.1580.
Traditional Chinese medicine uses moxibustion (burning herbs to stimulate acupuncture points) of acupoint BL 67 (Zhiyin, located beside the outer corner of the fifth toenail), to promote version of fetuses in breech presentation. Its effect may be through increasing fetal activity. However, no randomized controlled trial has evaluated the efficacy of this therapy.
To evaluate the efficacy and safety of moxibustion on acupoint BL 67 to increase fetal activity and correct breech presentation.
Randomized, controlled, open clinical trial.
Outpatient departments of the Women's Hospital of Jiangxi Province, Nanchang, and Jiujiang Women's and Children's Hospital in the People's Republic of China.
Primigravidas in the 33rd week of gestation with normal pregnancy and an ultrasound diagnosis of breech presentation.
The 130 subjects randomized to the intervention group received stimulation of acupoint BL 67 by moxa (Japanese term for Artemisia vulgaris) rolls for 7 days, with treatment for an additional 7 days if the fetus persisted in the breech presentation. The 130 subjects randomized to the control group received routine care but no interventions for breech presentation. Subjects with persistent breech presentation after 2 weeks of treatment could undergo external cephalic version anytime between 35 weeks' gestation and delivery.
Fetal movements counted by the mother during 1 hour each day for 1 week; number of cephalic presentations during the 35th week and at delivery.
The intervention group experienced a mean of 48.45 fetal movements vs 35.35 in the control group (P<.001; 95% confidence interval [CI] for difference, 10.56-15.60). During the 35th week of gestation, 98 (75.4%) of 130 fetuses in the intervention group were cephalic vs 62 (47.7%) of 130 fetuses in the control group (P<.001; relative risk [RR], 1.58; 95% CI, 1.29-1.94). Despite the fact that 24 subjects in the control group and 1 subject in the intervention group underwent external cephalic version, 98 (75.4%) of the 130 fetuses in the intervention group were cephalic at birth vs 81 (62.3%) of the 130 fetuses in the control group (P = .02; RR, 1.21; 95% CI, 1.02-1.43).
Among primigravidas with breech presentation during the 33rd week of gestation, moxibustion for 1 to 2 weeks increased fetal activity during the treatment period and cephalic presentation after the treatment period and at delivery.
中医采用艾灸（燃烧草药以刺激穴位）足太阳膀胱经67穴（至阴，位于第五趾甲外侧角旁）来促进臀位胎儿转正。其作用可能是通过增加胎儿活动来实现的。然而，尚无随机对照试验评估该疗法的疗效。
评估艾灸足太阳膀胱经67穴增加胎儿活动及纠正臀位的疗效和安全性。
随机、对照、开放临床试验。
中华人民共和国江西省妇幼保健院门诊、南昌市及九江市妇幼保健院。
妊娠33周、单胎妊娠且超声诊断为臀位的初产妇。
随机分配至干预组的130名受试者接受艾条（日本术语，指艾蒿）刺激足太阳膀胱经67穴7天，若胎儿仍为臀位则再治疗7天。随机分配至对照组的130名受试者接受常规护理，但不针对臀位进行干预。治疗2周后仍为臀位的受试者可在妊娠35周与分娩之间的任何时间接受外倒转术。
母亲在1周内每天1小时的胎动计数；妊娠35周时及分娩时头位的数量。
干预组平均胎动数为48.45次，而对照组为35.35次（P<0.001；差异的95%置信区间[CI]为10.56 - 15.60）。在妊娠35周时，干预组130例胎儿中有98例（75.4%）为头位，而对照组130例胎儿中有62例（47.7%）为头位（P<0.001；相对危险度[RR]为1.58；95%CI为1.29 - 1.94）。尽管对照组有24名受试者和干预组有1名受试者接受了外倒转术，但干预组130例胎儿中有98例（75.4%）出生时为头位，而对照组130例胎儿中有81例（62.3%）为头位（P = 0.02；RR为1.21；95%CI为1.02 - 1.43）。
在妊娠33周的臀位初产妇中，艾灸1至2周可在治疗期间增加胎儿活动，并在治疗后及分娩时增加头位率。
