| Objective: Study the analgesic effect of electric acupuncture with various acupoint,then investigate the clinical effect of labor analgesia and the safety to maters and infants,and then further investigate the changes of pain threshold and expression of dynorphin and prostaglandin E2 in different time of labor rats were observed,to provide scientific and theoretical basis for the clinical application of electro-acupuncture in labor pain,also provide a new perspective for labor analgesia.Methods:Clinical study: 120 puerperas in accordance with the inclusion criteria were randomly divided into the blank group(n=30),medicine group(n=30),dialectical acupoints group group and Sanyinjiao combined with Hegu point group.The medicine group was used intravenous injection diazepam 10 mg during first stage latent period of labor.Corresponding points were used to electro-acupuncture treatment in the hold stage in the EA groups,and the blank group only gave breathe-guidance and local massage.The analgesic effect and labor progress,vital signs of parturient,amount of postpartum hemorrhage within 2h,Apgar scores and amniotic fluid were compared between the four groups.Animal study: 120 successful modeling SD pregnant rats were randomly divided into the blank group,medicine group,Jiaji point group and Sanyinjiao combined with Hegu point group,30 cases each group.EA groups gave electro-acupuncture analgesia according to the rats' acupuncture point map localization on the beginning of labor,remifentanil hydrochloride was sustainable pump-injection through the tail vein in medicine group,and blank group gave natural delivery without any processing.Hot water tail flick test assay was used to determination the changes in pain threshold before and after treatment in four groups,and using ELISA method to detect changes in DYN and PGE2 in rats serum after electro-acupuncture analgesia 30 min,60 min and 120 min.Results:Clinical study:1,Analgesia effect value:(1)There were no significant difference in VAS scores before treatment in four groups(P>0.05).(2)After treatment,the VAS scores in four groups have significant differences in one hours after analgesia,cervix was dilated 7-8cm and cervix whole opened(P<0.01)and in order of increasing was: medicine group<dialectical acupoints group/Sanyinjiao combined with Hegu point group <blank group.(3)Compared before with after treatment in each groups,the VAS scores in the medicine group,dialectical acupoints group and Sanyinjiao combined with Hegu point group after treatment were significantly lower than before(P<0.01),and the VAS scores in blank group after treatment was significantly higher than before(P<0.05).(4)There was significant difference in total rate of analgesia effects in four groups(P<0.01),and in order of increasing was: blank group(18.5%)<Sanyinjiao combined with Hegu point group(60.7%)/dialectical acupoints group(64.3%)< medicine group(79.3%).2,Labor progress value:(1)There was significant difference in the first labor stage in four groups(P < 0.01),and in order of increasing was: dialectical acupoints group/Sanyinjiao combined with Hegu point group< medicine group<blank group.(2)There was significant difference in the second labor stage in four groups(P<0.01),and in order of increasing was: dialectical acupoints group/Sanyinjiao combined with Hegu point group< medicine group<blank group.(3)There was no significant difference in the third labor stage in four groups(P>0.05).3,The safety to maters and infants value:There were no significant differences in vital signs of parturient,Apgar scores and amniotic fluid in four groups(P > 0.05).The amount of postpartum hemorrhage within 2 hours in medicine group was significantly more than blank EA groups and group.Animal study:1,Pain threshold value:(1)No significant difference in pain threshold were found before treatment among each rat groups(P>0.05).(2)There was significant difference in pain threshold after treatment(P<0.01),and in order of increasing was: blank group< Jiaji point group/Sanyinjiao combined with Hegu point group< medicine group.(3)Compared before with after treatment in each groups,the pain threshold in medicine group,Jiaji point group and Sanyinjiao combined with Hegu point group after treatment were significantly higher than before(P<0.01).while blank group there was no significant difference(P>0.05).2,DYN and PGE2 in rats serum:(1)DYN:the rats serum DYN expression level was negatively correlated with time after electro-acupuncture,and there was significantly difference(P<0.01).There was no significant difference between the two groups(P>0.05).(2)PGE2:the rats serum PGE2 expression level was positively correlated with time after electro-acupuncture,and there was significantly difference(P<0.01).There was no significant difference between the two groups(P>0.05).Conclusion(s):(1)Electro-acupuncture can decrease the VAS scores and improve the rate of labor analgesia,meanwhile can relief labor pain for puerperas.Compared with drug analgesia,electro-acupuncture is not better on the effects but better on the sustainability.(2)Electro-acupuncture analgesia can significantly shorten labor time and accelerate the progress of labor,avoiding the adverse consequences due to prolonged labor.(3)Electro-acupuncture analgesia does not cause abnormal vital signs and not increase amount of postpartum hemorrhage within 2 hours,also have no bad effect on the Apgar scores and amniotic fluid,which is a safety analgesia method.(4)Electro-acupuncture can raise pain threshold of rats and have analgesia effect.(5)Electro-acupuncture can increase DYN level and negatively correlated with time,while can decrease PGE2 level and positively correlated with time. |
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