تأثیر طب فشاری بر تسکین درد زایمان: مرور سیستماتیک کارآزمایی های بالینی

نوع مقاله : مروری

نویسندگان

1 دانشجوی دکترای بهداشت باروری، کمیته تحقیقات دانشجویی، دانشکده پرستاری مامایی، دانشگاه علوم پزشکی شاهرود، شاهرود، ایران.

2 دانشیار گروه بهداشت باروری، دانشکده پرستاری مامایی، دانشگاه علوم پزشکی شاهرود، شاهرود، ایران.

3 مربی گروه مامایی، دانشکده پرستاری مامایی، دانشگاه علوم پزشکی مازندران، ساری، ایران.

چکیده

مقدمه: تسکین درد زایمان، یکی از مراقبت های نوین مامایی است. امروزه روش های غیر دارویی تسکین درد زایمان ازجمله طب فشاری به دلیل اثرات جانبی کم، مورد توجه می باشند. مطالعه حاضر با هدف مروری بر مطالعات انجام شده در زمینه تأثیر طب فشاری بر تسکین درد زایمان انجام شد.
روش کار: تمام مقالات چاپ شده تا سال 2013 در پایگاه های اطلاعاتی SID، Iranmedex، Irandoc، Magiran، Google scholar، Pubmed، Medline، Embase، CINHAL، Cochrane و IRCT که بر روی زنان باردار گروه سنی 35-18 سال، بارداری 41-37 هفته، تک ‌قلو، سفالیک و آغاز فاز فعال زایمان انجام شده بود، بر اساس معیار جداد بررسی شدند. مطالعاتی که نمره مساوی یا بیشتر از 3 را گرفتند، انتخاب شدند. در نهایت نتایج به صورت کمی و کیفی گزارش شدند.
یافته ها: 18 کارآزمایی بالینی بررسی شد که 12 مقاله بر اساس معیار جداد نمره مساوی یا بیشتر از 3 را کسب کردند. نقاط استفاده شده در 7 مقاله 6 طحالی، 2 مقاله هوگو، 1 مقاله 21 کیسه صفرا و 6 طحالی، 1 مقاله هوگو و 67 مثانه ای و 1 مقاله هوگو و 6 طحالی بود. اکثر مطالعات مؤید اثربخشی مثبت طب فشاری بر کاهش درد زایمان بودند، اما عوارضی جانبی گزارش نشده بود.
نتیجه گیری: با توجه به اینکه مطالعات متعددی با اعتبار بالا در زمینه تأثیر طب فشاری صورت گرفته است، می توان این روش را برای کاهش درد زایمان پیشنهاد کرد. از نقاط 6 طحالی و هوگو در مقایسه با سایر نقاط (21 کیسه صفرا،32 مثانه،67 مثانه) با اطمینان بیشتری جهت کاهش درد زایمان می توان استفاده کرد، زیرا در بیشتر مطالعات دارای اعتبار قابل قبول، از این نقاط استفاده شده بود.  

کلیدواژه‌ها


عنوان مقاله [English]

Effect of acupressure on labor pain relief: a systematic review of clinical trials

نویسندگان [English]

  • Ghila Ganji 1
  • Afsaneh Keramat 2
  • Marjan Ahmad Shiravani 3
1 PhD student of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.
2 Associated Professor, Department of Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
3 Lecturer of Midwifery, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran.
چکیده [English]

Introduction: Relief of labor pain is one of midwifery the new cares. Nowadays, non-pharmacological pain relief methods such as acupressure are considered due to their low side effects. This study was performed with the aim to review the studies which evaluated the effect of acupressure on labor pain relief.
Methods: All of the published articles up to 2013 in SID, Iranmedex, Irandoc, Magiran, Googlescholar, Pubmed, Medline, Embase, CINHAL, Cochran and IRCT which were performed on pregnant women with age 18-35 years, 37-41 gestational week, single-pregnancy, cephalic, and onset of active phase were assessed by Jadad scale. The articles with score ≥3 were selected. Finally, the results were reported as qualitative and quantitative.
Results: 18 clinical trials were assessed that 12 articles obtained score≥ 3 based on Jadad scale. Acupressure points used were SP6 in 7 articles, L14 in 2 articles, GB21 and SP6 in 1 article, L14 and BL67 in 1 article and L14 and SP6 in 1 article. Most of the studies showed the positive effect of acupressure on labor pain relief, but the side effects were not reported.
Conclusion: Since many articles have been performed with high validity about the effect of acupressure, thus it can be suggested for labor pain relief. Since in the most of the high quality studies, SP6 and L14 were more used for labor pain relief compared to other points(GB21, L32, L67) thus this point can be suggested with more coefficient for labor pain relief.

کلیدواژه‌ها [English]

  • Acupressure
  • Clinical trial
  • Labor pain
  • Systematic review
  1. Abushaikha L, Oweis A.. Labor pain experience: a Jordanian perspective. Int J NursPract. 2005; 11(1): 33-8.
  2. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ,Spong CY. Williams Obstetrics.21thed. New York: Mc Grow Hill Medical; 2010.
  3. El-Wahab N, Robinson N. Analgesia and anesthesia in labor. Obstetrics, Gynecology & Reproductive Medicine. 2011; 21(5): 137-41.
  4. Lowe N. The nature of labor pain. Am J Obstet Gynecol. 2002; 186: S16-24.
  5. Green JM. Expectations and experiences of pain in labor findings from a large prospective study.Birth.1993; 20: 65-72.
  6. Brownridge P. The nature and consequences of childbirth pain.Eur J ObstetGynecolReprod Biol. 1995; 59:S9-15.
  7. Nerum H, Halvorsen L, Sorlie T. Maternal request for caesarean section due to fear of birth: can it be changed through crisis-oriented counseling?.Birth. 2006; 33(3):221-8.
  8. Kolas T, Hofoss D, Daltveirt AK,Nilsen ST, Henriksen T, Häger R, et al.Indications for caesarean deliveries in Norway.American Journal of Obstetrics and Gynecology.2003; 188: 864-70.
  9. Sercekus P, Okumus H. Fears associated with child birthing among nulliparous women in Turkey. Midwifery 2007; 25:155-62.
  10. Deepak AKR, Chopra S. Effect of acupressure on intensity of labor pains and duration of first stage of labor among primigravida mothers. Nursing of Midwifery Research Journal. 2013; 9(4): 178-86.
  11. Smith CA, Collins CT, Crowther CA, Levett KM. Acupuncture or acupressure for pain management in labour.Cochrane Database Syst Rev. 2011;6(7):CD009232.
  12. Lee EJ, Frazier SK. The efficacy of acupressure for symptom management: a systematic review.J Pain Symptom Manage. 2011; 42(4):589-603.
  13. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?.Controlled Clinical Trials. 1996; 17 (1): 1-12.
  14. Heidari P, Mojdeh F, Mazloom R, Tanbakoi K, Judaki K. Effect of acupressure on labor pain intensity. Hakim Research Journal. 2008; 11(2): 39- 46.[Persian]
  15. Kordi M, Firoozi M, Esmaili H. Effect of LI4 acupressure on labor pain in the first stage of labor in nulliparous women. The Journal of Faculty of Nursing and Midwifery. 2010; 16(3,4): 95-101.[Persian]
  16. Ozgoli G, Sedigh S, Heshmat R, AlaviMajd H. Effect of right hand hegu acupressure on pain intensity og active phase of labor in primiparous women. Kowsar Medical Journal. 2010; 14(4): 229-34.[Persian]
  17. Samadi P, Lamiyan M, Heshmat R, Faghihzadeh S. Effect of acupressure at SP6 point on labor pain intensity. Journal of Hormozgan University of Medical Sciences. 2010; 14(1): 55-64.[Persian]
  18. Hamidzadeh A, Shahpourian F, JamshidiOrak R. Effect of LI4 acupressure on labor pain in the first stage of labor. Koomesh. 2011; 12(2): 196-203.[Persian]
  19. Kashanian M, Shahali Sh. Effect of acupressure at the Sanyinjiao point (SP6) on the process of active phase of labor in nulliparous women. Journal of Babol University of Medical Sciences. 2010; 12(3): 7-11.[Persian]
  20. Kordi M, RohaniMashadi S, Fadaee A, ESmaili H. Effects of SP6 acupressure on reducing the labor pain during the first stage of delivery. The Iranian Journal of Obatetrics, Gynecology and Infertility. 2010; 12(4): 7-12. [Persian]
  21. Salehian T, Safdari-Dehcheshmehi F, Alavi A, Rahimi- Madiseh M. Effect of acupressure at the Sanyinjiao point (SP6) on labor pain and delivery time in nulliparous women. Shahrekord University of Medical Sciences Journal. 2011; 12(4): 8-14.[Persian]
  22. Akbarzadeh M, Moradi Z, Zare N, Hadiyanfard MJ, Jokar A. Comparing the effect of acupressure at two GB-21 and SP-6 points on the pain severity of active phase of delivery among primiparous women. Armaghan-danesh. 2012; 16(6): 498-506.[Persian]
  23. Hossein Pour N, Kaviani M, Razaghi M. Comparison of effect of transcutaneous electrical nerve stimulation and acupressure in decreasing labor pain in primiparous women. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2012; 15(12): 27-33. [Persian]
  24. Kaviani M, Ashoori M, Azima S, RajaeiFard A, HadianFard MJ. Comparing the effect of two methods of acupressure and ice massage on the pain, anxiety levels and labor length in the point LI-4.Journal of Shahid Sadoughi University of Medical Sciences. 2012; 20(2): 220-8. [Persian]
  25. SayyedzadehAghdam N, Vakilian K, Davood M. Effect Of Bladder 32 and Gall bladder 21 acupressure on labor pain in the first stage of labor. TebMokamel. 2012; 2: 29-35. [Persian]
  26. KhavandizadehAghdam S, Daryabakhsh A. Effect of acupressure at Hugo point on the process and outcomes of labor in nulliparous women. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2012; 15(27): 14-20. [Persian]
  27. Hajiamini Z, Masoud SN, Ebadi A, Mahboubh A, Matin AA.Comparing the effects of ice massage and acupressure on labor pain reduction.Complement TherClinPract. 2012; 18(3):169-72.
  28. Chung UL, Hung LC, Kuo SC, Huang CL. Effects of LI4 and BL 67 acupressure on labor pain and uterine contractions in the first stage of labor. J Nurs Res. 2003;11(4):251–60.
  29. Lee MK, Chang SB, Kang D. Effects of SP6 acupressure on labor pain and length of delivery time in women during labor. J Altern Complement Med. 2004;10(6):959–65.
  30. Hjelmstedt A, Shenoy ST, Stener-Victorin E, Lekander M, Bhat M, Balakumaran L, et al. Acupressure to reduce labor pain: a randomized controlled trial.ActaObstetGynecol Scand. 2010; 89(11):1453-9.
  31. El Hamid NAEF, Obaya HE, Gaafar HM. Effect of Acupressure on Labor Pain and Duration of Delivery among Laboring Women Attending Cairo University Hospital.Indian Journal of Physiotherapy and Occupational Therapy. 2013; 7(2): 71-6.
  32. Schulz KF, Chalmers 1, Hayes RJ, Altman DG.Empirical evidence of bias.JAMA.1995; 273: 408.
  33. Chalmers TC, Matta RJ, Smith J Jr, Kunzler AM. Evidence favoring the use of anticoagulants in the hospital phase of acute myocardial infarction. N Engl J Med. 1977; 297(20): 1091-6.
  34. McQuay H, Carroll D, Moore A. Variation in the placebo effect In randomized controlled trials of analgesics: all is as blind as it seems. Pain. 1996; 64(2): 331-5.
  35. Sercekus P, Okumus H. Fears associated with child birthing among nulliparous women in Turkey. Midwifery. 2007; 25(2):155-62.
  36. Chao AS, Chao A, Wang TH, Chang YC, Peng HH, Chang SD, et al. Pain relief by applying transcutaneous electrical nerve stimulation (TENS) on acupuncture points during the first stage of labor: a randomized double-blind placebo-controlled trial. Pain. 2007; 127(3): 214-20.