维生素B12耳穴注射治疗妊娠剧吐的临床研究

关丽波　赵仁峰　张永兵

【摘要】 目的 探讨维生素B12耳穴注射中西医结合治疗妊娠剧吐的临床效果。方法 90例妊娠剧吐患者， 随机分为对照组、穴位组和肌注组， 各30例。对照组患者采用静脉补液治疗， 在对照组治疗的基础上， 穴位组予维生素B12注射两侧耳穴；肌注组予维生素B12肌内注射的治疗方法， 比较各组疗效。结果 穴位组平均治疗时间为（4.20±0.74）d， 均短于肌注组的（5.30±0.78）d、对照组的（5.43±0.82）d， 差异有统计学意义（P<0.05）；肌注组治疗时间与对照组比较， 差异无统计学意义（P>0.05）。穴位组治愈率均高于肌注组及对照组， 差异有统计学意义（P<0.05）；肌注组治愈率与对照组比较差异无统计学意义（P>0.05）。结论 维生素B12耳穴注射协同静脉补液治疗妊娠剧吐的临床效果， 整合了穴位的针刺和药物的药理作用， 疗效优于单纯针刺或药物疗效以及两者疗效的简单相加。

【关键词】 维生素B12 ；耳穴注射；妊娠剧吐

DOI：10.14163/j.cnki.11-5547/r.2017.18.055

【Abstract】 Objective To investigate clinical effect by combined traditional Chinese and Western medicine treatment by vitamin B12 auricular point injection in the treatment of hyperemesis gravidarum. Methods A total of 90 patients with hyperemesis gravidarum were randomly divided into control group， acupoint group and intramuscular injection group， with 30 cases in each group. The control group received intravenous infusion for treatment. On the basis of treatment in the control group， the acupoint group received vitamin B12 auricular point injection on both sides， and the intramuscular injection group received vitamin B12 through intramuscular injection. Curative effects were compared in three groups. Results The acupoint group had shorter mean treatment time as （4.20±0.74） d than （5.3±0.78） d in the intramuscular injection group and （5.43±0.82） d in the control group， and their difference had statistical significance （P<0.05）. The difference of treatment time between the intramuscular injection group and the control group had no statistical significance （P>0.05）. The acupoint group had higher cure rate than the intramuscular injection group and the control group， and their difference had statistical significance （P<0.05）. There was no statistically significant difference of cure rate between the intramuscular injection group and the control group （P>0.05）. Conclusion Combination of vitamin B12 auricular point injection and intravenous infusion in treating hyperemesis gravidarum provides its clinical effect through acupuncture and pharmacological effects， which is better than single treatment by acupuncture or drug， and simple sum of their respective effects.

【Key words】 Vitamin B12； Auricular point injection； Hyperemesis gravidarum

孕婦妊娠5～10周频繁恶心呕吐， 不能进食， 体重较妊娠前减轻>5%， 体液电解质失衡及新陈代谢障碍， 称为妊娠剧吐， 发生率0.5～2.0%[1]。妊娠早期合并妊娠剧吐会影响到孕晚期母婴结局， 胎儿生长受限（低体重儿及小于孕龄儿）、妊娠期高血压疾病发生率及剖宫产率增加， 故临床上要重视妊娠剧吐的发生和治疗[2]。长期以来妊娠剧吐多采用静脉补液支持治疗， 在静脉补液基础上， 分别予维生素B12耳穴注射、肌内注射， 通过三种治疗方法的临床疗效对比分析， 探讨临床治疗妊娠剧吐的最佳方法。现报告如下。

1 资料与方法

1. 1 一般资料 选择2013年6月～2015年12月本院妊娠剧吐患者90例为研究对象。诊断均符合《妇产科学》诊断标准[1]， 排除非妊娠所引起的呕吐， 并经 B超、肝功能、尿10项、血生化等检查， 排除葡萄胎、肝炎， 维生素 B12过敏史的患者。……