تأثیر ژل حاوی عصاره گیاه انزروت بر شدت درد اپی‌زیاتومی در زنان نخستزا: کارآزمایی بالینی سه‌سوکور

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

2 استادیار گروه فارماکوگنوزی، مرکز تحقیقات علوم دارویی، دانشکده داروسازی و علوم دارویی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

3 دانشیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

4 استادیار گروه مامایی و بهداشت باروری، مرکز تحقیقات مراقبت های پرستاری و مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

5 دانشجوی کارشناسی ارشد شیمی دارویی، دانشکده داروسازی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

6 دانشجوی دکتری تخصصی اپیدمیولوژی، دانشکده بهداشت، دانشگاه علوم پزشکی تهران، تهران، ایران.

چکیده

مقدمه: اپی­زیاتومی، شایع­ترین برش جراحی مامایی است که جهت افزایش قطر خروجی لگن انجام می­شود. انزروت حاوی فلاونوئید، ساپونین، تری­ترپنوئید، تانن و سایر ترکیبات پلی­فنولی و دارای خاصیت ضد‌درد می­باشد. مطالعه حاضر با هدف بررسی تأثیر ژل حاوی عصاره گیاه انزروت بر شدت درد اپی­زیاتومی در مادران نخست­زا انجام شد.
روش‌کار: این مطالعه کارآزمایی­بالینی سه‌­سوکور در سال 1398 بر روی 72 زن نخست­زای مراجعه­کننده به بیمارستان شهید بهشتی اصفهان انجام شد. نمونه­ها به‌طور تصادفی در دو گروه دریافت­کننده ژل انزروت (آزمون) و دریافت­کننده ژل دارونما (کنترل) قرار گرفتند و به‌مدت 10 روز تحت درمان قرار گرفتند. ارزیابی شدت درد با استفاده از مقیاس دیداری درد (VAS) انجام شد. تجزیه و تحلیل داده­ها با استفاده از نرم­افزار آماری SPSS (نسخه 16) و آزمون‌های تی دو نمونه مستقل، آنالیز کواریانس و آنالیز اندازه‌های تکراری انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: دو گروه از نظر اطلاعات مامایی و دموگرافیک تفاوت آماری معنا­داری نداشتند (05/0<p). قبل از مداخله میانگین شدت درد بین دو گروه معنادار نبود (16/0=p). بعد از مداخله میانگین شدت درد در گروه آزمون به‌طور معناداری کمتر از گروه کنترل بود (05/0>p).
نتیجه‌گیری: ژل انزروت نسبت به دارونما در کاهش درد زخم از اپی­زیاتومی مؤثرتر است.
 

کلیدواژه‌ها


عنوان مقاله [English]

Effect of Astragalus fasciculifolius (Anzaroot) gel on episiotomy pain in primiparous women: A Triple Blind Randomized Controlled Trial

نویسندگان [English]

  • Arezoo Beiromvand 1
  • Afsaneh Yegdaneh 2
  • Safoura Rouholamin 3
  • Mahboubeh Valiani 4
  • niloofar Naghi Ganji 5
  • reza Biranvand 6
1 M.Sc. Student of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
2 Assistant professor, Department of Pharmacognosy, Pharmaceutical Sciences Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
3 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
4 Assistant Professor, Department of Midwifery and Reproductive Health, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
5 M.Sc. Student of Medicinal Chemistry, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran.
6 PhD student, Department of Epidemiology, School of Health, Tehran University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Episiotomy is the most common incision in midwifery to increase the diameter of pelvic outlet. Anzaroot contain flavonoid, saponin, tryptophanes, tannins and other polyphenolic compounds. So it has analgesic properties. This study was performed with aim to determine the effect of Astragalus fasciculifolius (Anzaroot) gel on episiotomy pain severity in primiparous mothers.
Methods:This three-blind clinical trial study was conducted on 72 primiparous women referred to Shahid beheshti hospital in Isfahan in 2019. They were randomly divided into two equal groups of experiment (Anzaroot) and control (Placebo gel). Severity of pain was assessed using the visual pain scale (VAS). Data were analyzed by SPSS software (version 16) and Independent Samples T Test, covariance analysis and repeated Measures analysis. P˂0.05 was considered statistically significant.
Results: There was no significant difference between two groups in demographic features and obstetric variables (P˃0.05). Before the intervention, no significant difference was observed between two groups in the severity of pain (P=0.16(. After the intervention, severity of pain in the experiment group was significantly less than the control group (p < 0.05).
Conclusion: Anzaroot gel is more effective than placebo in relieving of episiotomy pain.

کلیدواژه‌ها [English]

  • Astragalus fasciculifolius (Anzaroot)
  • Episiotomy
  • Pain
  • Primiparous Women
  1. Patel S, Roberts S, Rogers V, Zink A, Duryea E, Morgan J. Williams Obstetrics, study guide. 25nd ed. New York: McGraw-Hill Education; 2018
  2. Jiang H, Qian X, Carroli G, Garner P. Selective versus routine use of episiotomy for vaginal birth. Cochrane Database of Systematic Reviews 2017(2).
  3. Huy NV. Pelvic floor and sexual dysfunction after vaginal birth with episiotomy in vietnamese women. Sexual Medicine 2019; 7(4):514-21.
  4. Venus D, Rao PS, Prajwal S. Comparison of use of restrictive episiotomy versus routine episiotomy in primigravidae undergoing vaginal birth at a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol 2017; 6(5):1770-6.
  5. Muhleman MA, Aly I, Walters A, Topale N, Tubbs RS, Loukas M. To cut or not to cut, that is the question: A review of the anatomy, the technique, risks, and benefits of an episiotomy. Clinical Anatomy 2017; 30(3):362-72.
  6. Kartal B, Kızılırmak A, Calpbinici P, Demir G. Retrospective analysis of episiotomy prevalence. Journal of the Turkish German Gynecological Association 2017; 18(4):190.
  7. Roy P, Sujatha M, Biswas B, Chatterjee A, Roy P. A comparative study of perineal morbidity in vaginal delivery with and without episiotomy. Int J Reprod Contracept Obstet Gynecol 2015; 4:1442-5.
  8. Blondel B, Alexander S, Bjarnadóttir RI, Gissler M, Langhoff‐Roos J, Novak‐Antolič Ž, et al. Variations in rates of severe perineal tears and episiotomies in 20 European countries: a study based on routine national data in Euro‐Peristat Project. Acta obstetricia et gynecologica Scandinavica 2016; 95(7):746-54.
  9. Aradmehr M, Azhari S, Shakeri MT. Study of factors associated with postoperative pain following episiotomy in primiparous women at Mashhad Omalbanin hospital in 2012. Journal of Midwifery and Reproductive Health 2015; 3(1):305-14.
  10. Shahrahmani H, Kariman N, Jannesari S, Ghalandari S, Asadi N. A systematic review on the type of treatment methods to reduce pain and improve wound healing in Iran. Iran J Obestet Gynecol Infertil 2016; 19(9):17-31.
  11. Khajavi Shojae K, Dawati A, Zayeri F. Frequency and Side Effect of Episiotomy in Primiparous Women: A Three- Month Longitudinal Survey. Qom Univ Med Sci J 2009; 3(2):47-50 (Persian(.
  12. Masoumi Z, Keramat A, Hajiaghaee R. Systematic review on effect of herbal medicine on pain after perineal episiotomy and cesarean cutting. Journal of Medicinal Plants 2011; 10(40):1-6. (Persian(.
  13. Khani S, Zare K, Ramezannezhad SE. The Frequency of Episiotomy and Its Related Factors. Iran Journal of Nursing (2008-5923) 2012; 24(74):45-52.
  14. Rasouli M, Keramat A, Khosravi A, Mohabatpour Z. Prevalence and factors associated with episiotomy in Shahroud City, northeast of Iran. Int J Womens Health Reprod Sci 2016; 4(3):125-9.
  15. Laki E, Torkzahrani S, Mojab F, Heydari A, Soltani Kermanshahi M. The effect frankincense ointment on pain intensity and episiotomy wound healing in primiparous women. Iran J Obestet Gynecol Infertil 2019; 22(2):42-51.
  16. Kaur P, Prakasam A, Kaur V. A study to evaluate the effectiveness of infrared lamp therapy on healing of episiotomy wound among postnatal mothers admitted in Adesh Hospital, Bathinda, Punjab, India. IOSR Journal of Nursing and Health Science 2019; 8(2):61-9.
  17. Moradi M, Niazi A, Mazloomi E, Mousavi SF, Lopez V. Effect of lavender on episiotomy wound healing and pain relief: A systematic review. Evidence Based Care Journal 2020; 10(1):61-9.
  18. Davami B, Amini L, Kashanian M. Investigating the effect of chamomile-marigold ointment on episiotomy pain in nulliparous women. Complementary Medicine Journal of faculty of Nursing & Midwifery 2018; 8(2):2254-64.
  19. Essa R, Mohamed AP, Kandeel H. Effect of Aloe Vera Gel versus Normal Saline on Pain Relief and Healing Process of Episiotomy. Journal of Health, Medicine and Nursing 2020; 70.
  20. Steen M, Cummins B. How to alleviate perineal pain following an episiotomy. Nursing Standard (2014+) 2016; 30(31):34.
  21. Katzung BG, Trevor AJ. Basic & Clinical Pharmacology. 13nd ed. New York: McGraw-Hill Education New York; 2015.
  22. Baharvand-Ahmadi B, Bahmani M, Rafieian-kopaei M. A summary on the prominent herbal medicine effective for beauty, skin hygiene and wound healing in Iran. J Chem Pharm Sci 2016; 9(1):28-33.
  23. Niazi A, Yousefzadeh S, Rakhshandeh H, Esmaeili H. Comparison of purslane cream and lanolin on nipple pain among breastfeeding women: a randomized clinical trial. Iran J Obestet Gynecol Infertil 2018; 20(12):77-85.
  24. Moudi Z, Edozahi M, Emami SA, Asili J, Pour MS. Effects of mastic oleoresin on wound healing and episiotomy pain: A mixed methods study. Journal of Ethnopharmacology 2018; 214:225-31.
  25. Ghahramani Dehbkordi SH, Saeediani S, Mohammadzadeh R, Shoja ghareh bagh M, Asalforosh rezaeia A, Ekradi L. Comparison of the effects of topical calendula ointment and aqueous extract of Anzrot gum on wound healing in rabbit skin. Journal of Veterinary Medicine, Islamic Azad University 2009; 3(9):51-62.(persian).
  26. Li X, Qu L, Dong Y, Han L, Liu E, Fang S, et al. A review of recent research progress on the astragalus genus. Molecules 2014; 19(11):18850-80.
  27. Mohammadi A, Maghsoudlou Y, Aryaei P. Antioxidant effect of hydroalcoholic extract of Anzerrot. Iranian National Congress of Food Science and Technology. Twenty-third National Congress of Food Science and Technology of Iran; Ghouchan; 2015.
  28. Shojaii A, Motevalian M, Rahnama N. Evaluation of anti-inflammatory and analgesic activities and the phytochemical study of Astragalus arbusculinus gum in animal models. Journal of basic and clinical physiology and pharmacology 2015; 26(4):369-74.
  29. Jafarzadeh-Kenarsari F, Torkashvand S, Gholami-Chaboki B, Donyaei-Mobarrez Y. The effect of olea ointment on post-episiotomy pain severity in primiparous women: A paralleled randomized controlled clinical trial. Iranian journal of nursing and midwifery research 2019; 24(5):348.
  30. Rodrigues M, Kosaric N, Bonham CA, Gurtner GC. Wound healing: a cellular perspective. Physiological reviews 2019; 99(1):665-706.
  31. Buso P, Manfredini S, Reza Ahmadi-Ashtiani H, Sciabica S, Buzzi R, Vertuani S, et al. Iranian Medicinal Plants: From Ethnomedicine to Actual Studies. Medicina 2020; 56(3):97.
  32. Riaz M, Zia-Ul-Haq M, Jaafar HZ. Common mullein, pharmacological and chemical aspects. Revista brasileira de farmacognosia 2013; 23(6):948-59.
  33. Luo X, Huang P, Yuan B, Liu T, Lan F, Lu X, et al. Astragaloside IV enhances diabetic wound healing involving upregulation of alternatively activated macrophages. Int Immunopharmacol 2016; 35:22-28.
  34. Jahdie F, Eghdampour F, Haselie A, Kheyrkhah M, Hagani H, Abasi Z. Effect of Calendula ointment in wound healing of episiotomy among primiparous women admitted in Lolagar hospital of Tehran, 2010. JNKUMS 2013; 4(5):117-23.
  35. Mirzaee F, Jannesari S, Kariman N, Mojab F, Nasiri M. The effect of Myrtus communis cream on wound healing and severity of episiotomy pain: Double-blind clinical trial. Iran J Obestet Gynecol Infertil 2019; 22(8):52-61.