مقایسه اثر اندانسترون و طب فشاری K-K9 با اندانسترون در درمان تهوع و استفراغ بارداری

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، مرکز تحقیقات ارتقاء سلامت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران.

2 دکترای تخصصی بهداشت باروری، مرکز تحقیقات ارتقاء سلامت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، اهواز، ایران.

3 کارشناس ارشد آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران.

چکیده

مقدمه: تهوع و استفراغ بارداری، یکی از شایع­ترین مشکلات دوران بارداری می­باشد. با توجه به اینکه پژوهشی در مورد استفاده از یک روش ترکیبی از طب فشاری و داروی ضدتهوع و استفراغ در کاهش تهوع و استفراغ بارداری وجود ندارد، مطالعه حاضر با هدف مقایسه اثر اندانسترون و طب فشاری K-K9 با اندانسترون در درمان تهوع و استفراغ بارداری انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی تصادفی در سال 98-1397 بر روی 84 زن باردار مراجعه‌کننده به بیمارستان­های آموزشی اهواز انجام شد. افراد در دو گروه اندانسترون با طب فشاری K-K9 و اندانسترون به‌تنهایی قرار گرفتند. شدت و تعداد دفعات تهوع و استفراغ افراد توسط پرسشنامه رودز به‌مدت 8 روز ثبت شد. در روزهای 5-1 به هر دو گروه، قرص اندانسترون 4 میلی‌گرم هر 8 ساعت داده شد و برای گروه اندانسترون با طب فشاری K-K9 علاوه بر قرص اندانسترون، طب فشاری K-K9 توسط واحد پژوهش انجام شد. در روزهای 8-6 در دو گروه مداخله­ای صورت نگرفت. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار آماری SPSS (نسخه 22) و آزمون­های تی مستقل، کای دو، تی زوجی و اندازه­گیری تکراری انجام شد. میزان p کمتر از 05/0 معنادار در نظر گرفته شد.
یافته­ها: در مطالعه بین دو گروه در طول مداخله از نظر میانگین شدت تهوع (01/0=p) و استفراغ (001/0˂p) اختلاف معنی‌داری وجود داشت، ولی از نظر میانگین تعداد دفعات تهوع (08/0=p) و استفراغ (05/0=p) تفاوت معنی‌داری وجود نداشت. نیاز به بستری، داروی اضافی در گروه اندانسترون و طب فشاری K-K9 کمتر و رضایت از درمان بیشتر بود.
نتیجه­گیری: اندانسترون و طب فشاری K-K9 تأثیر بیشتری در کاهش شدت تهوع و استفراغ داشت، لذا توصیه می­شود جهت کاهش تهوع و استفراغ بارداری از اندانسترون و طب فشاری K-K9 استفاده شود.

کلیدواژه‌ها


عنوان مقاله [English]

The effect of ondansetron and K-K9 Acupressure with ondansetron in treatment of nausea and vomiting of pregnancy

نویسندگان [English]

  • Shohreh Kheiri Gharibvand 1
  • Mozhgan Javad Nouri 2
  • Parvaneh Mousavi 1
  • Mohammad Hosein Haghighizadeh 3
1 M.Sc. in Midwifery, Reproductive Health Promotion Research Center, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
2 Ph.D. in Reproductive Health, Reproductive Health Promotion Research Center, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
3 M.Sc. in Biostatistics, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
چکیده [English]

Introduction: Nausea and vomiting in pregnancy is one of the most common problems during pregnancy. Given that there is no research on the use of a combination method of acupressure and antiemetic drugs in reducing nausea and vomiting in pregnancy, therefor, this study was performed with aim to compare the effect of ondansetron and K-K9 Acupressure with ondansetron in nausea and vomiting of pregnancy.
Methods: This randomized clinical trial study was performed in 2018-2019 on 84 pregnant women referred to Ahvaz teaching hospitals. The subjects were randomly divided in two groups of ondansetron with K-K9 acupressure and ondansetron alone. The severity and frequency of nausea and vomiting were recorded by Rhodes questionnaire for 8 days. At days of 1-5 days, both groups received ondansetron tablets 4 mg and in the ondansetron with K-K9 acupressure group in addition to ondansetron tablets, K-K9 acupressure was performed by the research unit. There was no intervention in the two groups on days 6-8. Data were analyzed using SPSS software (version 22) and independent t-test, Chi-square, paired t-test, and repeated measures. P<0.05 was considered statistically significant.
Results: During the intervention, there was significant difference between the two groups in the mean severity of vomiting (P˂0.001) and the mean severity of nausea (P = 0.01), but no significant difference was found between the two groups in the mean number of nausea (P = 0.08) and the mean number of vomiting (P = 0.05). Need to hospitalization and additional drug was less in ondansetron with K-K9 acupressure group, and also satisfaction of treatment was higher.
Conclusions: Ondansetron and K-K9 acupressure is more effective in reducing the severity of nausea and vomiting. Therefore, it is recommended to use ondansetron and K-K9 acupressure to reduce nausea and vomiting during pregnancy.

کلیدواژه‌ها [English]

  • K-K9 Acupressure
  • Nausea and Vomiting
  • Ondansetron
  • Pregnancy
  1. Nazari S, Nazari S, Shayan A, Shobeiri F, Ahmadi Nia Tabesh R. Comparison of the Effects of Ondansetron, Vitamin B6 and Ginger Rhizome in Nausea and Vomiting of Pregnancy: A randomized clinical trial. Iran J Obstet Gynecol Infertil 2018; 21(7):29-35.
  2. Sabet B, Salkhordeh H, Hedayati Khalil M, Mahboobi M, Babajani S. A review of the ginger products use in reducing pregnancy nausea and vomiting. Paramedical Sciences and Military Health 2017; 11(4):50-6.
  3. Abedian Z, Abbaszadeh N, Latifnejad Roudsari R, Shakeri MT. The effect of telephone support on the severity of nausea and vomiting in the first trimester of pregnancy in the primiparous women. Iran J Obstet Gynecol Infertil 2014; 17(118):18-29.
  4. Bazarganipour F, Mahmoodi H, Shamsaee B, Taghavi A. The frequency and severity of nausea and vomiting during pregnancy and its association with psychosocial health. Journal of midwifery and reproductive health 2015; 3(3):401-7.
  5. Zhang R, Persaud N. 8-Way randomized controlled trial of Doxylamine, pyridoxine and dicyclomine for nausea and vomiting during pregnancy: restoration of unpublished information. PloS one 2017; 12(1):e0167609.
  6. Tara F, Bahrami-Taghanaki H, Ghalandarabad MA, Zand-Kargar Z, Azizi H, Esmaily H, et al. The effect of acupressure on the severity of nausea, vomiting, and retching in pregnant women: a randomized controlled trial. Complementary Medicine Research 2020; 27(4):252-9.
  7. Adlan AS, Chooi KY, Mat Adenan NA. Acupressure as adjuvant treatment for the inpatient management of nausea and vomiting in early pregnancy: A double‐blind randomized controlled trial. Journal of Obstetrics and Gynaecology Research 2017; 43(4):662-8.
  8. Einarson A, Maltepe C, Boskovic R, Koren G. Treatment of nausea and vomiting in pregnancy: an updated algorithm. Canadian family physician 2007; 53(12):2109-11.
  9. Steele NM, French J, Gatherer‐Boyles J, Newman S, Leclaire S. Effect of acupressure by sea‐bands on nausea and vomiting of pregnancy. Journal of Obstetric, Gynecologic, & Neonatal Nursing 2001; 30(1):61-70.
  10. Golmakani N, Soltani M, GhayourMobarhan M, Mazloom SR. The relationship between nausea and vomiting in pregnant women with social support and marital satisfaction. Journal of Torbat Heydariyeh University of Medical Sciences 2016; 3(4):25-31.
  11. Lee YH, Seo JH, Min KT, Lim YJ, Jeong SW, Lee EK, et al. Population pharmacokinetics and prophylactic anti‐emetic efficacy of ramosetron in surgical patients. British journal of clinical pharmacology 2016; 82(3):762-72.
  12. Alame MM, Chamsy DJ, Zaraket H. Pityriasis rosea‐like eruption associated with ondansetron use in pregnancy. British journal of clinical pharmacology 2018; 84(5):1077-80.
  13. Pasternak B, Svanström H, Hviid A. Ondansetron in pregnancy and risk of adverse fetal outcomes. New England Journal of Medicine 2013; 368(9):814-23.
  14. Shahraki Z, Hashemi Bonjar ZS, Forghani F, Nakhai R. Comparing neonatal outcome following the use of ondansetron versus vitamin B6 in pregnant females with morning sickness: a randomized clinical trial. Journal of Comprehensive Pediatrics 2016; 7(4).
  15. Khresheh R. How women manage nausea and vomiting during pregnancy: a Jordanian study. Midwifery 2011; 27(1):42-5.
  16. Hall HG, Griffiths DL, McKenna LG. The use of complementary and alternative medicine by pregnant women: a literature review. Midwifery 2011; 27(6):817-24.
  17. Baggley A, Navioz Y, Maltepe C, Koren G, Einarson A. Determinants of women’s decision making on whether to treat nausea and vomiting of pregnancy pharmacologically. Journal of midwifery & women's health 2004; 49(4):350-4.
  18. Slotnick RN. Safe, successful nausea suppression in early pregnancy with P-6 acustimulation. Journal of reproductive medicine 2001; 46(9):811-4.
  19. Yusuf S, Sleight P, Pogue JF, Bosch J, Davies R, Dagenais G. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The New England journal of medicine 2000; 342(3):145-53.
  20. Beal MW. Acupuncture and acupressure: applications to women’s reproductive health care. Journal of Nurse-Midwifery 1999; 44(3):217-30.
  21. Bertalanffy P, Hoerauf K, Fleischhackl R, Strasser H, Wicke F, Greher M, et al. Korean hand acupressure for motion sickness in prehospital trauma care: a prospective, randomized, double-blinded trial in a geriatric population. Anesthesia & Analgesia 2004; 98(1):220-3.
  22. Schlager A, Boehler M, Pühringer F. Korean hand acupressure reduces postoperative vomiting in children after strabismus surgery. British Journal of Anaesthesia 2000; 85(2):267-70.
  23. Ho CM, Tsai HJ, Chan KH, Tsai SK. P6 acupressure does not prevent emesis during spinal anesthesia for cesarean delivery. Anesthesia & Analgesia 2006; 102(3):900-3.
  24. Nourani S, Aparnak F, Sadr Nabavi R, Ebrahimzadeh S. Comparison of K-K9 and P6 points acupressure on nausea and vomiting in the first half of pregnancy. Studies in Medical Sciences 2011; 22(4):369-78.
  25. Emara HM, Saleh AM, Morsey MM, El-Begawy AF. The Effectiveness of Korean Hand Acupressure on Postoperative Nausea and Vomiting after Gynecological Surgery. Bull. Fac. Ph. Th. Cairo Univ 2006; 11(2):145-51.
  26. Lua PL, Salihah N, Mazlan N. Effects of inhaled ginger aromatherapy on chemotherapy-induced nausea and vomiting and health-related quality of life in women with breast cancer. Complementary therapies in medicine 2015; 23(3):396-404.
  27. Salehian T, Tadayon M, Delaram M, Abbaspour Z. The comparison of the acupressure and pyridoxine effect on severity of both nausea and vomiting in primigravida women. Journal of Shahrekord Uuniversity of Medical Sciences 2005; 7(3):55-60.
  28. Ghahiri AA, Abdi F, Mastoo R, Ghasemi M. The Effect of Ondansetron and Metoclopramide in Nausea and Vomiting of Pregnancy. Journal of Isfahan Medical School 2011; 29(131):259-65.
  29. Rhodes VA, McDaniel RW. The Index of Nausea, Vomiting, and Retching: a new format of the lndex of Nausea and Vomiting. InOncology nursing forum 1999; 26(5):889-94.
  30. Norani Saaededin SH. Evaluation related factors to nausea and vomiting during first trimester of pregnancy. Iran Journal of Nursing 2003; 17(37):8-11.
  31. Kim TH, Choi BM, Chin JH, Lee MS, Kim DH, Noh GJ. The reliability and validity of the Rhodes index of nausea, vomiting and retching in postoperative nausea and vomiting. Korean J Anesthesiol 2007; 52(6):S59-65.
  32. Ozgoli G, Shahbazzadegan S, Rasaeian N, Alavi MH. Effect of acupressure with wristband on nausea and vomiting of pregnancy. Journal of Ardabil University of Medical Sciences (JAUMS) 2007; 7(3):247-53.
  33. Agarwal A, Bose N, Gaur A, Singh U, Gupta MK, Singh D. Acupressure and ondansetron for postoperative nausea and vomiting after laparoscopic cholecystectomy. Canadian Journal of Anesthesia 2002; 49(6):554-60.
  34. Yin CY, Braz JR, Colares WT, de Carvalho LR, Módolo MP, do Nascimento Junior P, et al. A Randomized Controlled Trial Comparing the Efficacy of P6 Acupuncture Plus Ondansetron versus Ondansetron or P6 Acupuncture in the Prevention of Nausea and Vomiting after Bupivacaine-Morphine Spinal Anesthesia. Open Journal of Anesthesiology 2017; 7(8):253-63.