بررسی تأثیر نقطه فشاری 3 کبدی بر شدت پسدرد زایمان: کارآزمایی بالینی تصادفی شده

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد مامایی، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 متخصص طب سوزنی، انجمن طب سوزنی ایران، تهران، ایران.

3 دانشجوی دکترای آمار زیستی، دانشکده پیراپزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

4 استادیار گروه آمار زیستی، دانشکده پیراپزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

5 دانشیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی شهید صدوقی یزد، یزد، ایران.

6 استادیار گروه جراحی لاپاراسکوپی زنان، دانشکده پزشکی، دانشگاه علوم پزشکی شهید صدوقی یزد، یزد، ایران.

7 دانشیار گروه مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: کنترل دردهای بعد از زایمان طبیعی بر مراقبت مادر از نوزاد و برگشت مادر به زندگی عادی تأثیر دارد. مطالعات نشان‌دهنده تأثیر فشار بر نقطه 3 کبدی در کاهش درد با منشأ رحمی، مانند درد قاعدگی است، لذا مطالعه حاضر با هدف بررسی تأثیر نقطه فشاری 3 کبدی بر شدت پس­درد زایمان انجام شد.
روش­کار: این مطالعه کارآزمایی بالینی تصادفی شاهددار در سال 97-1396 بر روی 150 نفر از مادرانی که در بخش مراقبت­های پس از زایمان بیمارستان شهید صدوقی یزد زایمان طبیعی داشته و از پس­درد شکایت داشتند، انجام گرفت. مادران به روش تخصیص تصادفی به سه گروه 50 نفری نقطه فشاری 3 کبدی، گروه شم و ایبوپروفن تقسیم شدند. به هر سه گروه در صورت شدت درد متوسط و شدید، دوز خوراکی ایبوپروفن 400 میلی­گرم هر 6 ساعت تا 24 ساعت داده شد. در گروه نقطه فشاری 3 کبدی (گروه مداخله)، فشار روی نقطه 3 کبدی به­‌مدت 10 دقیقه روی هر پا انجام شد، در گروه شم نیز فشار به همین صورت در نقطه نابجا انجام شد. گروه شاهد (مراقبت معمول) فقط دارو دریافت کردند. درد هر 6 ساعت قبل از هر دفعه مداخله، 30 و 120 دقیقه بعد از هر دفعه مداخله اندازه­گیری شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 16) و آزمون‌های کای­دو، فریدمن، کروسکال والیس، ویلکاکسون و مدل معادلات برآورد تعمیم یافته انجام گرفت. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته­ها: شدت پس­درد بعد از مداخله نسبت به قبل از مداخله در هر گروه، تفاوت آماری معناداری داشت و با گذشت زمان به طور متوسط میانگین نمره درد 34/0 کمتر شد (001/0>p). میانگین نمره درد در گروه نقطه 3 کبدی نسبت به گروه شاهد به طور متوسط 23/0±8/0 کمتر بود (001/0=p) و میانگین نمره درد در گروه نقطه 3 کبدی نسبت به شم 3/64±0/0کمتر بود (035/0=p)، اما بین دو گروه شم و شاهد اختلاف معناداری وجود نداشت (468/0=p).
نتیجه‌گیری: طب فشاری در نقطه 3 کبدی در تسکین پس­درد زایمان مؤثر است و می­توان در بالین از نقطه فشاری 3 کبدی مانند دیگر نقاط فشاری مؤثر بر پس­درد، کمک گرفت.

کلیدواژه‌ها


عنوان مقاله [English]

The Effect of 3-Liver Pressure Point on Postpartum Severity of Pain: randomized clinical trial

نویسندگان [English]

  • Mahdieh Abouei Mehrizi 1
  • Reza Heshmat 2
  • Parisa Reza Nezhad 3
  • Malihe Nasiri 4
  • Afsar Tabatabaie Bafghi 5
  • Atiyeh Javaheri 6
  • Giti Ozgoli 7
1 M.Sc. Student of Midwifery, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Acupuncturist, Iranian Acupuncture Association, Tehran, Iran.
3 PhD Student of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4 Assistant Professor, Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 Associate Professor, Department of Obstetrics & Gynecology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
6 Assistant Professor, Department of Gynecology Laparoscopy Surgery, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
7 Associate Professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Controlling postpartum pain affects maternal care of baby and mother's return to normal life. Studies have shown the effect of pressure on the 3- liver point in reducing uterine-induced pain, such as menstrual pain. Therefore, this study was performed with aim to evaluate the effect of 3-liver pressure point on postpartum severity of pain.
Methods: This controlled randomized clinical trial study was performed on 150 mothers who had normal delivery and complained of postpartum pain in the postpartum ward of Shahid Sadoughi Hospital in Yazd in 2017-2018. Mothers were randomly divided into three groups of 3-liver pressure point (n=50), Sham group (n=50) and Ibuprofen group (n=50). All three groups received oral Ibuprofen 400 mg every 6 hours up to 24 hours if they had moderate or severe pain. In the 3-liver pressure point group (intervention group), the pressure was applied to the 3-liver point for 10 minutes on each foot, and in the Sham group, the same pressure was applied to the ectopic point. The Control group received medication only (routine care). Pain was measured every 6 hours before, 30 and 120 minutes after each intervention. Data analysis was performed using SPSS software (version 16) and tests of Chi-square, Friedman, Kruskal Wallis, Wilcoxon, and GEE)Generalized Estimation Equations (. P<0.05 was considered statistically significant.
Results: The postpartum pain severity after the intervention were statistically significantly different in each group (p <0.001). The mean of postpartum pain severity decreased as 0.34 over time. The mean pain score in the 3-liver point group was 0.8±0.23 lower than the control group (p=0.001). The mean pain score in the 3-liver point group was 0.0±64.3 lower than the sham group (p = 0.035). But there was no significant difference between the sham and control groups (p = 0.468).
Conclusion: Acupressure at 3-liver point is effective in relieving postpartum pain and it can be used like other pressure points affecting postpartum pain.

کلیدواژه‌ها [English]

  • Acupressure
  • postnatal care
  • Postpartum Pain
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