Success of Acupuncture and Acupressure of the Pc 6 Acupoint in the Treatment of Hyperemesis Gravidarum

Abstract

Objective: The aim of this study was to evaluate the antiemetic effect of acupuncture (AP) and acupressure (APr) of the Pc 6 acupoint in pregnant women with hyperemesis gravidarum (HG). Methods: A prospective, placebo-controlled trial included 36 pregnant women with HG. Two methods of acupuncture were used: bilateral manual AP of the Pc 6 (Neiguan) acupoint (group 1, n = 10) and bilateral APr of the Pc 6 acupoint (group 2, n = 11); furthermore, superficial intracutaneous placebo AP (group 3, n = 8) and placebo APr (group 4, n = 7) was carried out. Results: Anxiodepressive symptoms occurred in 9 pregnant women with HG from group 1, 8 women from group 2, 7 women from group 3, and 5 women from group 4 (p < 0.001). The average gestation age at the occurrence of HG symptoms and the beginning of treatment was 7 weeks in group 1 and 8 weeks in groups 2, 3, and 4. Four women from group 1 and 7 women from groups 2, 3, an 4 needed intravenous compensation of liquid and electrolytes. The antiemetic metoclopramide was given intravenously to 1 woman from group 1, 2 women from group 2, 6 women from group 3, and 4 women from group 4. Promethazine was given to 1 woman from group 2, 1 woman from group 3, and to 3 women from group 4. The efficiency of the HG treatment with AP of the point Pc 6 was 90%, with APr of the Pc 6 63.6%, with placebo AP 12.5%, and with placebo APr 0%. Conclusion: Acupuncture (p < 0.0001) and acupressure (p < 0.1) are effective, nonpharmacologic methods for the treatment of HG.

The Efficacy of Acupressure for Symptom Management: A Systematic Review

“…Thus, the risk for bias of these studies was moderate to high and only two studies (5%) earned scores of 6, indicating the lowest risk of bias and highest quality RCT. Of 43 RCTs, the randomization strategy was unclear in 14 studies, 12–25 16 studies did not use double-blinding, 13,14,16,24,26–37 and four of 27 studies that used double blinding 17,38–40 did not describe the method employed. Nine studies did not report the attrition rate and reasons for attrition.…”

“…To measure the efficacy of acupressure on nausea and vomiting, outcome measures included a visual analogue scale (VAS) for nausea and vomiting, 18 the incidence and severity of nausea and vomiting, 12 hospital length of stay, dose of medication required and the Rhodes Index of Nausea, Vomiting and Retching. 41 To measure the efficacy of acupressure for pain, a VAS for pain 35 and the Short-Form McGill Pain Questionnaire 13 were primarily used.…”

“…12,18,32,33,38,41 Investigators used nausea self-report and objective measurement of emesis, total dose of anti-emetic medications, and hospital length of stay as indicators of efficacy. Habek and colleagues 12 reported that acupressure for 30 minutes daily for seven days significantly improved nausea and vomiting compared to placebo acupressure in patients with hyperemesis gravidarum ( n =36). In women with gestational age 8–12 weeks, investigators tested four days of acupressure using Sea-Bands and compared the duration and intensity of nausea and vomiting with a control group who wore wrist bands with a felt patch for the same time period.…”

Acupressure as adjuvant treatment for the inpatient management of nausea and vomiting in early pregnancy: A double‐blind randomized controlled trial

“…3). 1,4 The system comprises three subscales covering nausea, vomiting and retching during the past 24 h, measured using a five-point Likert scale with a possible range of [3][4][5][6][7][8][9][10][11][12][13][14][15] representing no symptoms to maximal symptoms, with a cut-off point of 13 for severe symptoms. The scale was validated in 2005 using the Rhodes Index Score.…”

Standardization of Individualized Treatments in a Randomized Controlled Trial of Acupuncture for Stroke Rehabilitation

“…The use of fixed acupuncture treatment protocols may be appropriate for some types of acupuncture research (e.g., single points to target specific physiologic processes) 29,30 or certain conditions (e.g., knee pain, emesis) for which fixed protocols have been proved effective. [31][32][33] However, for complex clinical conditions such as stroke, treatment individualization is the standard clinical approach, and the use of fixed protocols for these conditions lacks ecologic validity. Manualized protocols offer a solution for balancing the need for treatment individualization with objective standardization and replicability required for clinical trials.…”