艾灸三陰交、合谷穴對宮縮痛的影響

馬樹祥 金子環(huán) 霍桂霞 楊建玲 陳依林

【摘要】目的：觀察艾灸三陰交、合谷穴對第一產(chǎn)程活躍期宮縮痛的影響。方法：160例初產(chǎn)婦，采用單盲、隨機(jī)方法分為三陰交組、三陰交加合谷組、非穴組、空白組四組，每組各40例。三陰交組、三陰交加合谷組分別在產(chǎn)婦出現(xiàn)規(guī)律性宮縮痛，宮口開大3cm時(shí)行三陰交穴、合谷穴聯(lián)合三陰交穴施灸30min；非穴組在腕橫紋橈側(cè)端橈動(dòng)脈搏動(dòng)處至肘橫紋肱二頭肌腱橈側(cè)端連線的中點(diǎn)處施灸30min；空白組不做艾灸干預(yù)。分別對產(chǎn)婦第一產(chǎn)程活躍期時(shí)間及宮縮痛進(jìn)行比較。結(jié)果：三陰交組、三陰交加合谷組、非穴組、空白組患者產(chǎn)程活躍期時(shí)間分別為（116.11±65.89）min、（81.93±53.45）min、（123.03±76.70）min、（138.69±104.01）min，三陰交加合谷組與非穴組、空白組比較差異均有統(tǒng)計(jì)學(xué)意義（P均<0.05）；非穴組與空白組比較差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。四組患者第一產(chǎn)程時(shí)間分別為（313.22±141.15）min、（379.50±182.82）min、（393.00±196.50）min、（488.08±236.61）min，三陰交組、三陰交加合谷組與空白組比較差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。四組患者停艾灸治療后2h宮頸擴(kuò)張程度分別為（8.37±2.19）cm、（8.14±2.74）cm、（7.64±2.91）cm、（6.29±3.05）cm，三陰交組、三陰交加合谷組與非穴組、空白組比較差異均有統(tǒng)計(jì)學(xué)意義（P均<0.05）；非穴組與空白組比較差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。停艾灸治療后優(yōu)于非穴組、空白組，差異均有統(tǒng)計(jì)學(xué)意義（P均<0.05）；非穴組與空白組比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論：艾灸三陰交穴與三陰交穴配伍合谷穴艾灸對產(chǎn)婦產(chǎn)程的影響效果相當(dāng)，但聯(lián)合穴位艾灸更能縮短產(chǎn)程活躍期， 促進(jìn)產(chǎn)程進(jìn)展，降低宮縮痛，是安全的催產(chǎn)方法。

【關(guān)鍵詞】三陰交；合谷；艾灸；產(chǎn)程；活躍期；宮縮痛

Effects of moxibustion on Sanyinjiao Hegu on stages of contractions painMA Shuxiang1，JIN Zihuan2△，HUO Guixia3，YANG Jianling3， CHEN Yilin2. 1.College of Traditional Chinese Medicine， Huabei Polytechnic University， Tangshan 063000， Hebei， China； 2. College of Clinical Medicine， Huabei Polytechnic University， Tangshan 063000， Hebei， China； 3.Department of Obstetrics and Gynaecology， Tangshan Caofeidian District Hospital， Tangshan 063200， Hebei， China

【Abstract】Objectives： To observe the effect of moxibustion on Sanyinjiao， Hegu acupoint on labor contractions pain at first active phase. Methods： 160 primipara， using single blind， randomized methods were divided into test group （the Sanyinjiao acupoint group， the hegu point group， both Sanyinjiao acupoint and hegu point group） and control group （non-acupuncture points group and the blank group）， each group with 40 cases. The patients were exerted mxibustion therapy for 30min in the Sanyinjiao acupoint and hegu point respectively when the maternal appeared regularity uterine contraction pain and ostium of uterus opened larger than 3cm. The women of the non-acupuncture points group were exerted moxibustion therapy in the wrist horizontal stripes of radial side radial pulse place to elbow horizontal stripes biceps tendon of the midpoint of the radial side of attachment for 30min； The blank group did not receive moxibustion intervention. The time and uterine contraction pain of the first active labor stage were compared. Results： In the Sanyinjiao group， Sanyinjiao and Hegu group， non acupoint group， blank group： the labor active periods were respectively （11.611 ± 65.89） （81.93± 53.45）， 123.03± 7.67） （138.69 ±104.01） min， with significant difference between Sanyinjiao and Hegu group and non-acupuncture group/blank group （P<0.05） but no significant difference between non-acupuncture group and blank group （P>0.05）. The duration of first active stage were （313.22±141.15）， （ 379.50±182.82）， （393.00±196.50）， （488.08±236.61）min， with significant difference between Sanyinjiao group， Sanyinjiao and Hegu group and blank group （P<0.05）. The cervical dilatation 2 h after treatment were （8.37± 2.19）， （8.14 ± 2.74）， （7.64± 2.91） and （6.29± 3.05） cm， with significant difference between Sanyinjiao group/Sanyinjiao and Hegu group and non-acupuncture group/blank group （P<0.05） but no significant difference between non-acupuncture group and blank group （P>0.05）. After the termination of treatment， the effect of Sanyinjiao group and Sanyinjiao and Hegu group was better than the non-acupuncture group and blank group （P<0.05） but no significant difference between non-acupuncture group and blank group （P>0.05）. Conclusions： Sanyinjiao and Hegu acupoint moxibustion can shorten the duration of the active labor period and promote the production process， while reduce uterine contraction pain， while is a relatively safe method of oxytocin.

【Key words】Sanyinjiao acupoint； Hegu point； Moxibustion； Labor stages； Active period； Uterine contraction pain

【中圖分類號】R245.81【文獻(xiàn)標(biāo)志碼】A

分娩過程中宮縮痛可使產(chǎn)婦情緒焦慮，體內(nèi)兒茶酚胺釋放增加，宮縮乏力，產(chǎn)程延長，母嬰并發(fā)癥增加[1]，給產(chǎn)婦帶來痛苦和恐懼，而且恐懼在一定程度上加劇陣痛。為幫助產(chǎn)婦降低分娩疼痛，近年來國內(nèi)外學(xué)者對分娩減痛做了大量研究，相關(guān)研究[2]報(bào)道通過針灸或按摩刺激穴位等能夠達(dá)到分娩減痛。……