Electro-acupuncture in relieving labor pain

Fan Qu, Jue Zhou, Fan Qu, Jue Zhou

Abstract

To study the efficacy of electro-acupuncture for the relief of labor pain, and to build a better understanding of how electro-acupuncture might influence the neuroendocrine system, 36 primiparas were randomly divided into an electro-acupuncture group and a control group. Assessments of pain intensity and degree of relaxation during labor were analyzed. The differences between the electro-acupuncture group and the control group on the concentration of beta-endorphin (beta-EP) and 5-hydroxytryptamine (5-HT) in the peripheral blood were compared. The electro-acupuncture group was found to exhibit a lower pain intensity and a better degree of relaxation than the control group (p = 0.018; p = 0.031). There existed a significant difference in the concentration of beta-EP and 5-HT in the peripheral blood between the two groups at the end of the first stage (p = 0.037; p = 0.030). Electro-acupuncture was found to be an effective alternative or complementary therapy in the relief of pain during labor. The benefit of electro-acupuncture for relieving labor pain may be based on the mechanism of producing a synergism of the central nervous system (CNS) with a direct impact on the uterus through increasing the release of beta-EP and 5-HT into the peripheral blood.

Figures

Figure 1.
Figure 1.
Study design

References

    1. Ayman A, Olah K. The sharp end of medical practice: the use of acupuncture in obstetrics: Acupuncture and gynaecology. Br J Obstet Gynaecol. 2002;109:1–4.
    1. Ternov N, Buchhave P, Svensson G, Akeson J. Acupuncture during childbirth reduces use of conventional analgesia without major side effects: A retrospective study. Am J Acupuncture. 1998;26:233–9.
    1. Skilnand E, Fossen D, Heiburg E. Acupuncture in the management of pain in labor. Acta Obstet Gynecol Scand. 2002;81:943–8.
    1. Ramnero A, Hanson U, Kihlgren M. Acupuncture treatment during labour—a randomized controlled trial. Br J Obstet Gynaecol. 2002;109:637–44.
    1. Nesheim B, Kinge R, Berg B, Alfredsson B, Allgot E, Hove E, et al. Acupuncture during labor can reduce the use of meperidine: A controlled clinical study. Clin J Pain. 2003;9:187–91.
    1. Ma SX. Review:Neurobiology of Acupuncture: Toward CAM,Evidence-based Complementary and Alternative Medicine. 2004;1(1):41–47.
    1. Huang LX. Beijing, China: Hua-xia press; 1997. Series of ancient classics on Acu-moxibustion Science.
    1. Liu JY, Bian DL, Han Y, et al. Progress of acupuncturing Hegu (LI 4) during labour Chinese Journal of Information on TCM. 2005;12(5):108–110. Yang ZX Treatment with acupuncturing at Hegu and Sanyinjiao, Zejiang Journal of Chinese Medicine, 2004, (10):445–446.
    1. Yang ZX. Treatment with acupuncturing at Hegu and Sanyinjiao, Zejiang Journal of Chinese Medicine. 2004;10:445–446.
    1. Yang ZX. Clinical experience in treating diseases with acupuncturing at Hegu and Sanyinjiao Zejiang Journal of Sichuan of Traditional Chinese Medicine. 2002;20(7):75–76.
    1. Jin CL, Zhu J. On the prohibition of acupuncture of Hegu (LI 4) and Sanyinjiao (SP 6) during pregnancy, Acupuncture Research. 2005;30(3):187–190.
    1. Zhu J, Wang MQ, Zhang LF, et al. 2. Vol. 26. Journal of Beijing University of Chinese Medicine; 2003. Effects on uterine contraction of electroacupuncturing Hegu and Sanyinjiao with electric needles in the rats in pregnancy at late stage; pp. 73–75.
    1. Zhong JY, Cui HS. Review of clinical researches on acupuncturing Hegu (LI 4) and Sanyinjiao (SP 6) during labour Journal of Yunnan College of Traditional Chinese Medicine. 2005;28(2):64–66.
    1. Wang MQ, Zhu J, Zhang LF, et al. Experimental study on the mechanism of electroacupuncture at LI 4 and SP 6 points for promoting labor China Acupuncture. 2003;23(10):593–596.
    1. Li XH, Ma WZ, Xu SY. 9. Vol. 11. Journal of Beijing University of Chinese Medicine; 1996. Clinical research on the effect of acupoints of Hegu, Sanyinjiao on the first labour stage; p. 38.
    1. Chen XH, Guo SF, Chang Chung G, et al. Optimal conditions for eliciting maximal electroacupuncture analgesia with dense-and disperse mode stimulation American Journal of Electroacupuncture. 1994;22(1):47–53.
    1. Zadina JE, Hackler L, Ge AJ, et al. Kastin, A potent and selective endogenous agonist for the μ-opiate receptor, Nature. 1997;386:499–501.
    1. Chavkin LF, James A. Goldstein, Dynorphin is a specific endogenous legend of the κ-opioid receptor, Science. 1982;215:413–415.
    1. Han JS, Ding XZ, Fan SG. The frequency as the cardinal determinant for electroacupuncture analgesia to be reversed by opioid antagonists, Acta Physiol. Sin. 1986;38:475–482.
    1. Chen XH, Han JS. All three types of opioid receptors in the spinal cord are important for 2/15 Hz electroacupuncture analgesia, Eur. J Pharmacol. 1992;211:203–210.
    1. Fei H, Xie GX, Han JS. Low, high frequency electroacupuncture stimulation release met-enkephalin and dynorphin A in rat spinal cord, Sci. Bull. China. 1987;32:1496–1501.
    1. He CM, Han JS. Attenuation of low rather than high frequency electroacupuncture analgesia following microinjection of beta-endorphin antiserum into the periaqueductal gray in rats, Acupunct. Sci Int J. 1990;1:19–27.
    1. Han Z, Jiang YH, Wan Y, et al. Endomorphin-1 mediates 2 Hz but not 100 Hz electroacupuncture analgesia in the rat, Neurosci. Lett. 1999;274:75–78.
    1. Han JS, Xie CW. Dynorphin: potent analgesic effect in spinal cord of the rat. Life Sci. 1982;31:1781–1784.
    1. Han JS, Xie GX. Dynorphin: important mediator for electroacupuncture analgesia in the spinal cord of the rabbit, Pain. 1984;18:367–376.
    1. Abboud TK, Sarkis F, Hung TT, et al. Effects of epidural anesthesia during labour on maternal plasma beta-endorphin level. Anesthesiology. 1983;59:1–5.
    1. Thomas TH, Fletcher JE, Hill RG. Influence of medication, pain and progress in labour on plasma beta-endorphin-like immunoreactivity. Br J Anaesth. 1982;54:401–408.
    1. Pomeranz B. Acupuncture analgesia-basic research. In: Stux G, Hammerschlag R, editors. Clinical Acupuncture Scientific Basis. Berlin, Heidelberg, New York: Springer-Verlag; 2001.
    1. Sim J. The mechanism of acupuncture analgesia: a review. Com Ther Med. 1997;5:102–111.
    1. Grant GZ, Yu CS, Lee WL, Ren LX. Brian M.Involvement of peripheral opioid mechanisms in electroacupuncture analgesia Explore. 2005;1(5):366–371.
    1. Lao L, Zhang G, Wei F, Berman BM, Ren K. Electroacupuncture attenuates hyperalgesia and modulates Fos protein expression in rats with unilateral persistent inflammation. J Pain. 2001;2:111–117.
    1. Lao L, Zhang RX, Zhang G, Wang X, Berman B, Ren K. A parametric study of electroacupuncture on persistent hyperglasia and Fos protein expression in rats. Brain Res. 2004;1020:18–29.
    1. Zhang RX, Lao L, Wang L, et al. Involvement of opioid receptors in electroacupuncture-produced antihyperalgesia in rats with peripheral inflammation. Brain Res. 2004;1020:12–17.
    1. Toda K. Response of raphe neurons after acupuncture stimulation in rat. Brain Res. 1982;242:350–353.
    1. Takeshige C, Sato T, Mera T, Hisamitru T, Fang JQ. Descending pain inhibitory system invovled in acupuncture analgesia. Brain Res Bull. 1992;29:617–634.
    1. Takeshige C, Oka K, Mizuno T, et al. The acupuncture point and its connecting central pathway for producing acupuncture analgesia. Brain Res Bull. 1993;30:53–67.
    1. Liu X, Zhu B, Zhang SX. Relationship between electroacupuncture analgesia and descending pain inhibitory mechanism of nucleus raphe magnus. Pain. 1986;24:383–396.
    1. Pomeranz B, Chiu D. Naloxone blocks acupuncture analgesia and causes hyperalgesia: endorphin is implicated. Life Sci. 1976;19:1757–1762.
    1. Cheng RS, Pomeranz B, Yu G. Dexamethaxone partially reduces and 2% saline treatment abolished electroacupuncture analgesia: these finding implicate pituitary endorphins. Life Sci. 1979;24:1481–1486.
    1. Cheng RS, Pomeranz B. Electro-acupuncture analgesia could be mediated by at least two pain-relieving mechanisms: endorphin and non-endorphin systems. Life Sci. 1979;25:1957–1962.
    1. Han JS, Tang J, Ren MF, et al. Central neurontrasmitters and acupuncture analgesia. Am J Chin Med. 1980;8:331–348.
    1. Han JS, Xie GX, Zhou ZF, Folkesson R, Terenius L. Enkephalin and B-endorphin as mediators of electroacupuncture analgesia in rabbits: an antiserum microinjection study. Adv Biochem Pharmacol. 1982;33:369–377.
    1. Han JS. Beijing: Chinese Medical and Technology Press; 1987. The Neurochemical Basis Of Pain Relief By Acupuncture.
    1. Mayer JD, Price DD, Rafii A. Antagonism of acupuncture analgesia in man by the narcotic antagonist naloxone. Brain Res. 1977;21:368–372.
    1. Chen XH, Geller EB, Adler MW. Electrical stimulation at traditional acupuncture sites in periphery produces brain opioid-receptor- mediated antinociception in rats. J Pharm Exp Ther. 1996;277:654–660.
    1. Ku YH, Zou CJ. beta-Endorphinergic neurons in nucleus arcuatus, and nucleus tractus solitarii mediated depressor-bradycardia effect of “Tinggong” 2Hz-electroacupuncture. Acupuncture, Electro-Ther Res. 1993;18:175–84.
    1. Guo HF, Tian J, Wang X, et al. Brain substrates activated by electroacupuncture of different frequencies (I): comparative study on the expression of oncogene c-fos and genes coding for three opioid peptides. Mol Brain Res. 1996;43:157–166.
    1. Sjflund BH, Terenius L, Ericksson M. Increased cerebrospinal fluid levels of endorphins after electro-acupuncture. Acta Physiol Scand. 1977;100:382–384.
    1. Pasternak GW. Pharmacological mechanisms of opioid analgesics. Clin Neuropharma. 1993;16:1–18.
    1. Bianchi M, Jotti E, Sacerdote P, Panerai AE. Traditional acupuncture increases the content of endorphin in immune cells and influences mitogen induced proliferation. Am J Chin Med. 1991;19:101–104.
    1. Chen XD, Wu GC, He QZ, et al. Effect of continued electroacupuncture on induction of interleukin-2 production of spleen lymphocytes from the injured rats. Acup Electro-Ther Res. 1997;22:1–8.
    1. Kasahara T, Wu Y, Sakurai Y, Oguchi K. Suppressive effect of acupuncture on delayed type hypersensitivity to trinitrochlorobenzene and involvement of opiate receptors. Int J Immunophar. 1992;14:661–665.
    1. Liu X, Sun L, Xiao J, et al. Effect of acupuncture and point-injection treatment on immunologic function in rheumatoid arthritis. J Trad Chin Med. 1993;13:174–178.
    1. Yu Y, Kasahara T, Sato T, et al. Enhancement of splenic interferongamma, interleukin-2, and NK cytotoxicity by S36 acupoint acupuncture in F344 rats. Jpn J Physiol. 1997;47:173–178.
    1. Yuan J, Zhou R. Effect of acupuncture on T-lymphocyte and its subsets from the peripheral blood of patients with malignant neoplasm. Chen Tzu Yen Chiu Acupunct Res. 1993;18:174–177.
    1. Zhao X. Effect of HC-3 on electroacupuncture-induced immunoregulation. Chen Tzu Yen Chiu Acupunct Res. 1995;20:59–62.
    1. Zhao J, Zhao X, Liu W, et al. The role sympathetic mechanism in the effect of electroacupuncture on immunoregulation. Chen Tzu Yen Chiu Acupunct Res. 1995;20:40–43.
    1. Zhao R, Ma C, Tan L, et al. The effect of acupuncture on the function of macrophages in rats of immunodepression. Chen Tzu Yen Chiu Acupunct Res. 1994;19:66–68.
    1. Sodipo JO, Gilly H, Pauser G. Endorphins: Mechanism of acupuncture analgesia. Am J Chin Med. 1981;9:249–58.
    1. Han JS, Chou PH, Lu CH, et al. The role of central 5-HT in acupuncture analgesia. Sci. Sin. 22. 1979:91–104.
    1. Ernberg M, Hedenberg-Magnusson B, Alstergren P, Kopp S. The level of serotonin in the superficial masseter muscle in relation to local pain and allodynia. Life Sci. 1999;65:313–25.
    1. Ernberg M, Alstergren P, Lundeberg T, Kopp S. Plasma and serum serotonin levels and their relation to orofacial pain and anxiety in fibromyalgia. J Orofac Pain. 2000;14:37–46.
    1. Liu XN. The effect of electroacupuncture on the BBB of rats with ischemia. Journal of Mudanjiang Medical University. 2002;23(2):1–4.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir