穴位按壓對產程時間與止痛劑使用之成效

Effects of Acupressure on Duration of Labor and Analgesic Use

按壓對生產有幫助的穴位，可幫助子宮頸擴張及減輕產痛。本研究旨在探討於待產過程中，施以按壓八髎穴及太衝穴比較產程時間、止痛劑使用及生產結果之成效。研究方法採準實驗性設計，以初產婦為研究對象並隨機分為實驗組與對照組，以結構式問卷為研究工具收集資料。自2005年8月至2006年1月止，共收案70位個案。實驗組(n=35)於待產中進行八髎穴及太衝穴按壓，對照組(n=35)採常規護理措施。結果顯示實驗組比對照組在第一產程時間縮短4.5小時(t=3.88, p< .001)，總產程縮短4.3小時(t=3.54, p= .001)；使用止痛劑的比率低34.3% (x2 =11.53, p= .001)；剖腹產的機率低20％(x2 =5.62, p< .05)，以真空吸引器協助自然生產低77.8％(x2 =8.788, p< .05)；會陰裂傷程度(x2 =0.36, p> .05)及新生兒出生Apgar score得分(t=0.50, p> .05; t=1.69, p> .05)兩組則無顯著差異。本研究顯示待產過程中按壓八髎穴及太衝穴位，似乎可以縮短第一產程待產時間，減少止痛劑的使用、剖腹生產及真空吸引器協助自然生產的機率。研究成果提供臨床護理人員緩解待產婦疼痛措施之選擇。

Acupressure could increase cervical dilatation and relieve labor pain. The purpose of this study was to determine the effects of acupressure massage on duration of labor, analgesic use, and other obstetric outcomes. In this quasi-experiment, 70 primiparas who delivered during August, 2005 to January, 2006 were assigned to experimental and control groups. Thirty five subjects were included in each group. Subjects in experimental group received LI3 and BL31-34 acupressure while subjects in the control group received regular nursing care. Data were collected by a structured questionnaire. The results of the study showed that: (1) the duration of the first stage of labor and total labor time of the experimental group were significantly shorter than those of the control group, in 4.5 hours (p< .001) and 4.3 hours (p= .001), correspondingly; (2) the proportion of analgesic used during labor in the experimental group was significantly lower (p= .001) than that of the control group; (3) the proportions of cesarean section and vacuum delivery of the experimental group were 20% (p< .05) and 77.8% (p< .05) lower than those of the control group. Neither degree of perineum laceration (p> .05) nor Apgar score of newborns (p> .05) was significantly different between these two groups. Results of this study supported the hypothesis that LI3 and BL31-34 acupressure may shorten the length of delivery time, and reduce the need for analgesic use and cesarean section. Acupressure massage may be considered in the regular nursing care.