A randomized controlled trial of acupuncture for initiation of labor in nulliparous women
A randomized controlled trial of acupuncture for initiation of labor in nulliparous women
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DOI：
10.1080/14767050600730740
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发表时间：
2006-08-01
影响因子：
1.8
通讯作者：
Thorp, John M., Jr.
中科院分区：
文献类型：
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作者：
Harper, Terry C.;Coeytaux, Remy R.;Thorp, John M., Jr.
目标。目的：评价门诊针灸助产的有效性。将单胎妊娠、Bishop评分<7分、孕39 4/7周以上的未分娩妇女随机分为常规内科护理组(对照组)、常规护理组和三种门诊针灸治疗组(针刺组)。每种治疗方法包括8个针刺双侧LI4、SP6、UB31和UB32穴。主要结果是从随机化到分娩的时间。次要结果包括剖宫产率和引产率。医疗记录被提取用于母亲的人口统计、医疗和分娩结局数据。先验样本量计算显示，56名女性被要求检测72小时分娩时间的差异，能力为83%，阿尔法为0.05。组间比较采用t检验、卡方检验和Kaplan-Meier统计。56名女性被随机分组，并完成了研究程序。两组患者的种族、年龄、胎龄和宫颈Bishop评分相似。针刺组平均分娩时间提前21小时，但差异无统计学意义(P=0.36)。与对照组相比，针刺组妇女更有可能自然分娩(70%比50%，p=0.12)，更不可能通过剖腹产分娩(39%比17%，p=0.07)。在未被引产的妇女中，针刺组在入选后的任何时间点都比对照组更有可能分娩(p=0.05)。针灸在足月未分娩的妇女中耐受性很好，在减少足月妊娠后发生的干预方面有希望。
Objective. To evaluate the utility of outpatient acupuncture for labor stimulation.Methods. Nulliparous women at 39 4/7 weeks or greater with a singleton gestation and Bishop score of less than 7 were randomized to usual medical care (control group) versus usual care and three outpatient acupuncture treatments (acupuncture group). Each treatment consisted of eight needles applied to bilateral points LI4, SP6, UB31, and UB32. The primary outcome was time elapsed from the time of randomization to delivery. Secondary outcomes included rates of cesarean section and induction of labor. Medical records were abstracted for maternal demographic, medical, and delivery outcome data. A priori sample size calculation revealed that 56 women were required to detect a 72-hour difference in delivery time with a power of 83% and an alpha of 0.05. Student's t-test, Chi-square, and Kaplan-Meier statistics were used to compare groups.Results. Fifty-six women were randomized and completed the study procedures. Race, age, gestational age, and cervical Bishop score were similar in both groups. Mean time to delivery occurred 21 hours sooner in the acupuncture group, but this difference did not reach statistical significance (p = 0.36). Compared to controls, women in the acupuncture group tended to be more likely to labor spontaneously (70% vs. 50%, p = 0.12) and less likely to deliver by cesarean section (39% vs. 17%, p = 0.07). Of women who were not induced, those in the acupuncture group were more likely to be delivered than the controls at any point after enrollment (p = 0.05).Conclusion. Acupuncture is well tolerated among term nulliparous women and holds promise in reducing interventions that occur in post-term pregnancies.