Biblioteca de los Sistemas de Salud de la OMS
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Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials
(87 pages)

Índice de contenido
Ver el documentoAcknowledgements
Abrir esta carpeta y ver su contenidoIntroduction
Abrir esta carpeta y ver su contenido1. General considerations
cerrar esta carpeta2. Review of clinical trial reports
Abrir esta carpeta y ver su contenido2.1. Pain
Ver el documento2.2. Infections
Ver el documento2.3. Neurological disorders
Ver el documento2.4. Respiratory disorders
Ver el documento2.5. Digestive disorders
Ver el documento2.6. Blood disorders
Ver el documento2.7. Urogenital disorders
Ver el documento2.8. Gynaecological and obstetric disorders
Ver el documento2.9. Cardiovascular disorders
Ver el documento2.10. Psychiatric disorders and mental disturbances
Ver el documento2.11. Paediatric disorders
Ver el documento2.12. Disorders of the sense organs
Ver el documento2.13. Skin diseases
Ver el documento2.14. Cancers
Ver el documento2.15. Other reports
Ver el documento3. Diseases and disorders that can be treated with acupuncture
Ver el documento4. Summary table of controlled clinical trials
Ver el documentoReferences
 

2.8. Gynaecological and obstetric disorders

Primary dysmenorrhoea, a painful condition, is one of the major indications for acupuncture in the field of gynaecological disorders. The beneficial effect of acupuncture on this condition has been repeatedly reported in controlled trials (153, 154). Acupuncture relieves pain and also regulates the motility of the uterus to facilitate menstrual discharge and further alleviate the pain.

Premenstrual syndrome is characterized by cyclical mood changes and is a common condition in women of fertile age. Acupuncture seems to be helpful to patients with this syndrome. In a controlled study, the majority of the patients receiving acupuncture gained relief from symptoms and no recurrence in the six-month follow-up (155).

Although acupuncture was reported to be effective in the treatment of female anovular infertility (156), no methodologically sound, controlled trials have been reported. However, the mechanism of acupuncture in regulating abnormal function of the hypothalamic-pituitary-ovarian axis has been demonstrated in experimental studies. The data suggest that electric acupuncture with relative specificity of acupuncture points could influence some genetic expression in the brain, thereby normalizing the secretion of certain hormones, such as gonadotropin-releasing hormone, luteinizing hormone and estradiol (157). Acupuncture is also worth trying in the treatment of female infertility due to inflammatory obstruction of the fallopian tubes, where it seems to be superior to conventional therapy with intrauterine injection of gentamicin, chymotrypsin and dexamethasone (158).

Acupuncture in pregnant women should be undertaken with care. Needling at some points (namely, on the abdomen and lumbosacral region), as well as strong stimulation of certain distant points, such as hég? (LI4), s?ny?nji?o (SP6) and zhìy?n (BL67), may cause miscarriage. However, this action is useful if induction of labour is desired, such as in prolonged pregnancy; the effect is comparable with that of oxytocin by intravenous drip (159-161).

In early pregnancy, acupuncture at the upper limb points can be used for the prevention and treatment of morning sickness. The efficacy of acupressure at nèigu?n (PC6) has been reported repeatedly in placebo-controlled studies (13, 162, 163). In order to prevent miscarriage induced by needling, acupressure is recommended for the treatment of morning sickness.

Various methods of acupuncture, such as pressure at ear points and moxibustion at zhìy?n (BL67) or zúlínqí (GB41), have been used to correct abnormal fetal position during the last three months of pregnancy. The success rates in groups treated with these methods were much higher than the occurrence of spontaneous version or in groups treated with knee-chest position or moxibustion at non-classical points (164-167).

Acupuncture stimulates milk secretion after childbirth and can be used to treat deficient lactation due to mental lability or depression. It has been observed that acupuncture elevates the blood prolactin level in women with deficient milk secretion after childbirth; in the majority of cases, lactation starts as the blood prolactin level increases (168). The clinical use of acupuncture to promote lactation has also been demonstrated in a randomized controlled study (169).

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Última actualización: le 4 mayo 2012