Objectives: 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.
Methods: 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 shenghua 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.
Results: 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 (P<0.05); these indexes in the acupuncture + herbal medication group were lower than those in the herbal medication group (P<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 (P<0.05), and the β-EP level in the acupuncture + herbal medication group was higher than that in the herbal medication group (P<0.05). The volume of postpartum lochia discharge in the acupuncture + herbal medication group was higher than that in the herbal medication group (P<0.05), while the duration of postpartum lochia discharge and the total time of lochia discharge were shorter (P<0.05). Regarding the recovery of the uterus at 42 days postpartum, there was no statistical significance between the two groups (P>0.05).
Conclusions: 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.
目的: 观察腕踝针治疗产后腹痛的临床疗效及对产妇血清β-内啡肽（β-EP）水平的影响。方法: 将70例产后腹痛患者随机分为针药组（35例，脱落1例）和中药组（35例，脱落2例）。中药组于产后第1天服用生化汤加味，每日1剂；针药组在中药组基础上予腕踝针治疗，穴取双侧踝部下1区、下2区，每日1次。均治疗3 d。比较两组患者治疗前后疼痛视觉模拟量表（VAS）评分、血清β-EP水平、子宫底高度，产后恶露情况及产后42 d子宫复旧情况。结果: 治疗后各时间点（产后24、48、72 h），两组患者疼痛VAS评分、子宫底高度较治疗前（产后2 h）降低（P<0.05），且针药组低于中药组（P<0.05）。治疗后（产后72 h），两组患者血清β-EP水平均较治疗前升高（P<0.05），且针药组高于中药组（P<0.05）。针药组患者产后血性恶露量多于中药组、产后血性恶露持续时间及总恶露持续时间短于中药组（P<0.05）。两组患者产后42 d子宫复旧情况比较差异无统计学意义（P>0.05）。结论: 腕踝针能明显减轻产后腹痛患者的疼痛程度、促进恶露排出和子宫复旧，其作用机制可能是上调血清β-EP水平，提高痛阈，从而达到镇痛效果。.
Keywords: acupuncture combined with herbal medication; analgesia; beta-endorphin ( β-EP); postpartum abdominal pain; wrist-ankle acupuncture.