1.眉山市妇幼保健院,四川省眉山市东坡区科四路868号,620010
2.成都中医药大学针灸推拿学院
pengfeizeng1010@163.com
收稿:2026-03-18,
修回:2026-04-20,
录用:2026-04-16,
纸质出版:2026-07-02
移动端阅览
张俊,曾鹏飞,杜海虹等.皮内针干预对早期人工流产术后宫内妊娠物残留的预防作用——随机、单盲、安慰针对照临床观察[J].中医杂志,2026,67(13):1409-1414.
ZHANG Jun,ZENG Pengfei,DU Haihong,et al.Preventive Effect of Intradermal Needle Therapy on Retained Products of Conception after Early Induced Abortion:A Randomized,Single-Blind,Placebo-Controlled Trial[J].Journal of Traditional Chinese Medicine,2026,67(13):1409-1414.
张俊,曾鹏飞,杜海虹等.皮内针干预对早期人工流产术后宫内妊娠物残留的预防作用——随机、单盲、安慰针对照临床观察[J].中医杂志,2026,67(13):1409-1414. DOI: 10.13288/j.11-2166/r.2026.13.010.
ZHANG Jun,ZENG Pengfei,DU Haihong,et al.Preventive Effect of Intradermal Needle Therapy on Retained Products of Conception after Early Induced Abortion:A Randomized,Single-Blind,Placebo-Controlled Trial[J].Journal of Traditional Chinese Medicine,2026,67(13):1409-1414. DOI: 10.13288/j.11-2166/r.2026.13.010.
目的
2
评价皮内针早期干预对人工流产术后宫内妊娠物残留(RPOC)的预防作用和安全性。
方法
2
采用随机、单盲、安慰针对照设计,将88例拟行人工流产术患者随机分为真针组与假针组各44例。两组均在全麻下行超声引导负压吸引术,并接受相同标准化药物治疗。真针组于术后立刻予皮内针治疗:取穴三阴交(双侧)、合谷(双侧)、至阴(双侧),留针3天,每日按压腧穴3次,每个穴位每次5 min,按压后步行5 min;假针组使用外观一致的钝头假揿针治疗。主要结局为术后第2周经彩超多普勒评估子宫内膜厚度,次要结局包括RPOC发生率、术后2 h疼痛视觉模拟量表(VAS)评分、术后2 h创伤后应激障碍量表平民版(PCL-C)评分、术后阴道流血量和持续时间、术后第2周/5周子宫体积、术后第5周/12周月经失血图(PBAC)评分、月经周期、经期,并记录不良反应。
结果
2
与假针组比较,真针组术后第2周子宫内膜厚度降低(
P
<0.05)。术后第2周经阴道超声复查显示,真针组子宫内膜厚度薄于假针组(
P
<0.05)。真针组发生1例(2.27%)、假针组发生9例(20.45%)RPOC,假针组RPOC发生率高于真针组(
P
<0.05)。与假针组比较,真针组术后阴道流血量更少,阴道流血持续时间更短(
P
<0.05)。术后2 h VAS评分、术后第2周/5周子宫体积、术后第5周/12周PBAC评分以及术后第12周月经周期等指标两组间差异均无统计学意义(
P
>0.05)。两组均未见明显不良反应。
结论
2
在早期人工流产术后立刻采用皮内针干预,可显著降低术后RPOC发生率,在减少术后阴道流血量、缩短持续时间、减轻创伤后应激症状方面具有一定优势,且安全性良好。
Objective
2
To evaluate the efficacy and safety of early intradermal needle therapy in preventing retained products of conception (RPOC) following induced abortion.
Methods
2
A randomized, single-blind, placebo-controlled trial design was applied. Eighty-eight patients scheduled for early induced abortion were randomly assigned to either an intradermal needle group (44 cases) or a sham control group (44 cases). Both groups underwent ultrasound-guided vacuum aspiration under general anesthesia and received standard postoperative pharmacological care. Immediately following the operation, the intradermal needle group received active intradermal needle therapy at bilateral Sanyinjiao (SP 6), Hegu (LI 4) and Zhiyin (BL 67), with needles retaining for 3 days, acupoint pressing three times daily for 5 minutes per acupoint, followed by 5 minutes of walking after each pressing session; while the sham control group received a visually identical, blunt-tipped sham needle intervention. The primary outcome was endometrial thickness measured by Doppler ultrasound at week 2 post-procedure. Secondary outcomes included the incidence of RPOC, visual analog scale (VAS) score and PTSD Checklist-Civilian Version (PCL-C) score at 2 hours post-procedure, volume and duration of vaginal bleeding, uterine volume, Pictorial Blood Loss Assessment Chart (PBAC) scores at weeks 5 and 12, menstrual cycle characteristics, and adverse events should be recorded.
Results
2
At week 2 post-procedure, endometrial thickness was significantly lower in the intradermal needle group compared to the sham control group (
P
<0.05). Transvaginal ultrasonography at postoperative week 2 showed thinner endometrium in the intradermal needle group than in the sham group (
P
<0.05). RPOC occurred 1 case (2.27%) in the intradermal needle group versus 9 cases (20.45%) in the sham control group, yielding a significantly higher RPOC incidence in the sham control group (
P
<0.05). Patients in the intradermal needle group had less postoperative vaginal bleeding volume and shorter bleeding du
ration than those in the sham control group (
P
<0.05). No statistically significant difference was found in 2-hour postoperative VAS pain score, uterine volume at postoperative week 2 and week 5, PBAC score at postoperative week 5 and week 12, or menstrual cycle at postoperative week 12 between groups(all
P
>0.05). No obvious adverse reactions were observed in either group.
Conclusion
2
Immediate intradermal needle intervention after early induced abortion can significantly reduce the incidence of postoperative RPOC, exert beneficial effects on reducing the volume and duration of postoperative vaginal bleeding as well as alleviating post-traumatic stress symptoms, with good safety.
孔北华 , 马丁 , 段涛 . 妇产科学 [M]. 10版 . 北京 : 人民卫生出版社 , 2024 .
Sundararajan S , Roy S , Polanski L T . The accuracy of ultrasound scan in diagnosing retained products of conception: a systematic review and meta-analysis [J]. Am J Obstet Gynecol , 2024 , 230 ( 5 ): 512 - 531 .
Foreste V , Gallo A , Manzi A , et al . Hysteroscopy and retained products of conception: an update [J]. Gynecol Minim Invasi , 2021 , 10 ( 4 ): 203 - 209 .
中华医学会计划生育学分会 , 中国优生优育协会生育健康与出生缺陷防控专委会 . 早期妊娠手术流产围术期女性生育力保护中国专家共识(2023年版) [J]. 中国实用妇科与产科杂志 , 2023 , 39 ( 4 ): 440 - 444 .
严大宇 , 曾向阳 , 徐大宝 , 等 . 宫内妊娠物残留的治疗进展 [J]. 中南大学学报(医学版) , 2025 , 50 ( 1 ): 91 - 98 .
中华医学会计划生育学分会 . 不全流产保守治疗专家共识 [J]. 中华生殖与避孕杂志 , 2019 , 39 ( 5 ): 345 - 348 .
中华医学会计划生育学分会第八届委员会中西医结合学组 . 中医药治疗不全流产专家共识 [J]. 中华中医药杂志 , 2019 , 34 ( 8 ): 3625 - 3629 .
苑鸿雯 , 马良宵 , 陈滢如 , 等 . 近9年针灸抗早孕研究进展 [J]. 中国针灸 , 2012 , 32 ( 9 ): 860 - 864 .
唐亚 , 林思睿 , 吴巧凤 , 等 . 皮内针的优势病种及运用前景分析 [J]. 医学信息 , 2019 , 32 ( 6 ): 32 - 34 .
山东中医药学会妇科专业委员会 , 山东中西医结合学会生殖外科专业委员会 , 山东省疼痛医学会妇产科专业委员会 . 中西医结合诊治妊娠胚物残留专家共识(2024年版) [J]. 山东中医杂志 , 2025 , 44 ( 1 ): 1 - 11 .
王金梅 , 钱芳波 , 沈晔 . 雌二醇凝胶在重复人工流产术后应用临床效果研究 [J]. 中国实用妇科与产科杂志 , 2025 , 41 ( 5 ): 557 - 560 .
Scott J , Huskisson E C . Measurement of functional capacity with visual analogue scales [J]. Rheumatol Rehabil , 1977 , 16 ( 4 ): 257 - 259 .
Brown L C , Murphy A R , Lalonde C S , et al . Posttraumatic stress disorder and breast cancer: risk factors and the role of inflammation and endocrine function [J]. Cancer , 2020 , 126 ( 14 ): 3181 - 3191 .
Hald K , Lieng M . Assessment of periodic blood loss: interindividual and intraindividual variations of pictorial blood loss assessment chart registrations [J]. J Minim Invasive Gynecol , 2014 , 21 ( 4 ): 662 - 668 .
世界中医药学会妇科专业委员会 , 中国医师协会妇产科医师分会宫腔镜工作组 , 全国卫生产业企业管理协会妇科智能诊疗分会 . 宫腔粘连中西医结合诊疗中国专家共识(2024年版) [J]. 中国实用妇科与产科杂志 , 2024 , 40 ( 8 ): 819 - 825 .
冯晓玲 张婷婷 . 中医妇科学 [M]. 北京 : 科学出版社 , 2021 : 202 - 204 .
Alimoradi Z , Kazemi F , Gorji M , et al . Effects of ear and body acupressure on labor pain and duration of labor active phase: a randomized controlled trial [J]. Complement Ther Med , 2020 , 51 : 102413 . DOI: 10. 1016/j.ctim.2020. 102413 http://dx.doi.org/10.1016/j.ctim.2020.102413 .
Mirzaee F , Hasaroeih F E , Mirzaee M , et al . Comparing the effect of acupressure with or without ice in LI-4 point on labour pain and anxiety levels during labour: a randomised controlled trial [J]. J Obstet Gynaecol , 2021 , 41 ( 3 ): 395 - 400 .
程子潇 , 宋子雲 , 冯小丽 , 等 . 针刺合谷、太冲、三阴交对初产妇产程的影响 [J]. 中国针灸 , 2025 , 45 ( 7 ): 927 - 931,966 .
林蕾 , 李丹 , 许金榜 , 等 . 合谷-三阴交穴组催产效应影响因素的思考 [J]. 中华养生保健 , 2024 , 42 ( 7 ): 54 - 57 .
叶吴洁 , 林咸明 , 周志刚 . 艾灸至阴穴纠正胎位的临床与机制研究进展 [J]. 江西中医药 , 2021 , 52 ( 10 ): 76 - 80 .
0
浏览量
0
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010102007558号