| Objective:1.To explore the clinical characteristics of nausea and vomiting in early pregnancy with qi depression by investigating the clinical symptoms and personality types of nausea and vomiting in early pregnancy with qi depression2.On this basis,the patients with moderate and severe NVP were selected.The PUQE score,nausea and vomiting score,systemic symptom score and laboratory index recovery before and after acupoint application treatment were observed and compared with the conventional treatment control group to determine the clinical effect of Acupoint Application in the treatment of pregnancy nausea and vomiting,In order to provide certain clinical data support for external treatment of traditional Chinese medicine in the intervention of pregnancy nausea and vomitingMethods:1.From December 2019 to September 2020,114 cases of early pregnancy women with qi stagnation were admitted to the outpatient and inpatient department of Obstetrics and Gynecology of the Affiliated Hospital of Shanxi University of traditional Chinese medicine.The PUQE issued by the American Association of Obstetricians and gynecologists in 2018 was used to determine the pregnancy nausea and vomiting,The clinical information collection table developed by the research group was used to collect symptoms,and epq-rsc was used to determine personality types,so as to explore the clinical characteristics of nausea and vomiting in pregnancy with qi stagnation syndrome2.According to the basic principles of evidence-based medicine,60 patients with NVP who met the inclusion criteria were divided into treatment group and control group,30 cases in each group.The control group was given routine rehydration therapy,and the treatment group was given Acupoint Application on the basis of the control group for 1 week.PUQE score,nausea and vomiting score,systemic symptom score and laboratory index recovery were observed before and one week after medication to determine the clinical efficacy.Result:1.Clinical characteristics of nausea and vomiting during pregnancy1.1 general informationThis study collected 114 cases of early pregnancy women with qi stagnation,the average age was(30.31 1±20)years old,of which the oldest is 40 years old and the youngest is 20 years old.In terms of occupation,the number of employees was the largest(63,55.30%),and in terms of educational level,those who received tertiary education or above(72,63.2%)1.2 History characteristics and associated diseases1.2.1 Past and operative historyFour patients had a history of disease,including hypothyroidism,adenomyosis,endometriosis and polycystic ovary syndrome.In addition to cesarean section,abortion,only one patient had a history of surgery for ovarian cyst exfoliation1.2.2 History of marriage and abortionThe 114 pregnant women in this study were all married,48 cases of first pregnancy,accounting for 42.11%of the total number;There were 52 cases of previous delivery,including 38 cases of spontaneous delivery,accounting for 73.08%of the number of deliveries;The other 14 cases were cesarean section.There were 37 pregnant women with previous abortion history,accounting for 32.46%of the total number.In terms of the number of abortions,24 cases had one abortion,accounting for 64.86%,9 cases had two abortions,accounting for 34.32%,and 4 cases had three abortions,accounting for 10.81%;In terms of abortion methods,there were 21 cases of induced abortion,accounting for 56.76%,12 cases of drug abortion,accounting for 32.43%,and 4 cases of spontaneous abortion,accounting for 10.81%1.2.3.PUQE scoreThe total PUQE scores were mostly at the moderate level,with mild(39,34.2%),moderate(69,61.31%)and severe(6,4.49%)1.2.4 TCM related symptomsIn the aspect of appetite change,the number of anorexia was the most(109,95.61%);Among them,the number of sour eaters was the most(28,45.16%),and the number of greasy eaters was the most(32,45.07%);Thirsty for drinking(61,53.51%),and thirsty for hot drinking(56,91.80%);There were cold and hot symptoms(93,81.58%),of which 78,68.42%were afraid of cold;Dizziness(68,59.65%),mental fatigue(82,71.93%),fatigue(80,70.18%),salivation(16,14.03%);There were sleep changes(67,58.77%),mainly insomnia(38,33.33%);Abnormal stool(69,60.52%),constipation was the most common(31,27.19%);Abnormal urination(61,53.51%),including frequent urination(58,95.08%),frequent nocturia(45,77.59%).1.2.5 Personality distribution resultsThe descending order of personality types was:bile and blood(31,27.19%);Bile depression(25,21.93%);Bile(24,21.05%);Intermediate personality(11,9.64%);Depression(9,7.89%);Mucus depression(5,4.38%);Mucinous(3,2.63%).2.Study on the curative effect of acupoint application2.1 PUQE score:before treatment,there was no significant difference between the two groups(z=-1.67,P=0.095>0.05).After treatment,PUQE scores of the two groups were significantly decreased(z=-4.84,P=0.000<0.05;z=-4.85,P=0.000<0.05);After treatment,the improvement of symptoms and signs in the treatment group was better than that in the control group(z=-2.84,P=0.005<0.05).The results show that both methods can improve the nausea and vomiting during pregnancy,and the effect of acupoint application is better than that of Western medicine alone.2.2Nausea and vomiting score:before treatment,there was no significant difference between the two groups(z=-1.22,P=0.221>0.05).After treatment,the scores of nausea and vomiting were decreased in both groups(z=-4.85,P=0.000<0.05;z=-4.79,P=0.000<0.05);After treatment,the difference between the two groups was statistically significant(z=-3.62,P=0.000<0.05).The results show that both methods can improve the nausea and vomiting during pregnancy,and the effect of acupoint application is better than that of Western medicine alone.2.3 Systemic symptom score:before treatment,there was no significant difference between the two groups(z=-1.32,P=0.187>0.05).The scores of systemic symptoms were significantly decreased between the two groups(z=-4.81,P=0.000<0.05);After treatment,the difference between the two groups was statistically significant(z=-2.08,P=0.037<0.05).The results showed that both methods could improve the general symptoms of dizziness,fatigue and fatigue caused by nausea and vomiting,and the effect of acupoint application was better than that of Western medicine alone.2.4 Urinary ketone body:before treatment,there was no significant difference between the two groups(z=-6.10,P=0.542>0.05).After treatment,the urine ketone body of the two groups were reduced(z=-4.84,P=0.000<0.05);However,there was no significant difference between the two groups(z=-0.907,P=0.364>0.05).It can not be considered that the treatment group was better than the control group2.5 Comparison of total effective rate:in the treatment of patients with nausea and vomiting during pregnancy,the total effective rate of the treatment group was 96.67%,and that of the control group was 80%,which proved that acupoint application had obvious curative effect in the treatment of nausea and vomiting during pregnancy,and had significant effect in relieving the symptoms of patients and maintaining their normal pregnancy.Conclusion1.The main nausea and vomiting of NVP patients with qi depression were moderate,and the symptoms were diversified,mainly manifested in appetite loss,thirst and hot drink,constipation,frequent night urination,etc.the mental and emotional symptoms were typical.In clinical treatment,in addition to relieving the symptoms of nausea and vomiting,we should pay attention to regulating the psychological mood of pregnant women2.In the early stage,pregnant patients with nausea and vomiting,through physical identification of traditional Chinese medicine,combined with physical characteristics,targeted group formula and acupoint selection,and the external treatment method of acupoint application to improve the safety and effectiveness of nausea and vomiting symptoms,and improved in PUQE score,nausea and vomiting score,systemic symptom score,urinary ketosis and other aspects. |
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