在怀孕期间治疗恶心和吐的针:系统性审查和元分析
Bao Jin1, Yanhua Han2, Yue Jiang2
1Department of Obstetrics and Gynecology, Heilongjiang University of Chinese Medicine, Harbin, China.
Complementary therapies in medicine
|August 30, 2024
概括
针与西方医学 (WM) 结合,似乎比单独使用WM更有效地治疗怀孕时的恶心和吐 (NVP). 针也是安全的,可能和WM一样有效,PC6,ST36和CV12是常见的针点.
科学领域:
- 综合医学是一个整体的医学.
- 生殖健康 生殖健康
- 基于证据的实践.
背景情况:
- 怀孕期间的恶心和吐 (NVP) 显著影响孕妇的健康.
- 传统药物可能无法完全缓解NVP症状,需要补充疗法.
- 针是一种公认的NVP补充治疗方法.
研究的目的:
- 系统地评估针治疗NVP的有效性和安全性.
- 为了为纳入针治疗的NVP治疗提供临床指南.
- 基于传统的午线和针点理论来分析针的结果.
主要方法:
- 在2024年5月1日之前发表的随机对照试验 (RCT) 的系统综述和元分析.
- 搜索了多个数据库,包括PubMed,Embase,Web of Science和中国数据库.
- 使用Cochrane工具评估偏差风险,并使用GRADE评估证据质量.
主要成果:
- 与单独使用西医相比,针加西医 (WM) 显著降低了NVP症状得分 (PUQE) 和无效率.
- 针在减少无效率方面表现出优于WM的优势,并且在减轻症状得分方面表现出可比的有效性.
- 通常使用的针点包括Neiguan (PC6),Zusanli (ST36) 和Zhongwan (CV12);严重的不良事件在不同组中没有显著差异.
结论:
- 与WM相结合的针可能为NVP提供比单独的WM更高的疗效.
- 针似乎是对NVP的安全和潜在有效的独立治疗.
- 建议进一步进行高质量的研究,但目前的证据支持针在NVP管理中的作用.
相关概念视频
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
154
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates...
154
Pathophysiology of Vomiting
342
Vomiting is a complex physiological response to expel harmful or irritating substances from the body. It's a defensive mechanism triggered by stimuli like poisons, microbial toxins, cytotoxic drugs, and mechanical abdominal distension. The process is centrally coordinated by the vomiting (or emetic) center located in the medulla of the brainstem. This area, rich in muscarinic M1, histamine H1, neurokinin 1 (NK1), and serotonin 5-HT3 receptors, coordinates the act of vomiting through...
342
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
181
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
181
Chemotherapy-Induced Nausea and Vomiting: Cannabinoids
204
Tetrahydrocannabinol (THC) is a phytocannabinoid that primarily interacts with the CB1 receptor, a type of G protein-coupled receptor (GPCR) predominantly in and around the chemoreceptor trigger zone (CTZ) and emetic center. THC also blocks the serotonin receptor activity in the dorsal vagal complex (DVC) by inhibiting serotonin release. THC exerts its anti-emetic effects through these interactions, which are beneficial for patients undergoing chemotherapy.
Two synthetic agonists of THC,...
Two synthetic agonists of THC,...
204


