Cui Shu Li¹, Lee Jia Yi², Yu Chunyan², Tee Yong Wei², Diana Chia², Ho Lee Mee², Yu Su Ling² 

1Department of Pain Management Centre, Acupuncture Services Clinic, Singapore General Hospital; 2Department of Obstetrics and Gynaecology, Centre for Assisted Reproduction, Singapore General Hospital. Singapore 169608 

Abstract: 

Background and Objective: Acupuncture is widely used in clinical treatment for many years, and more and more popularity in the West as a form of pain relief, vomiting control, etc. Acupuncture compared with conscious sedation during oocyte retrieval (OR) has been studied in various centres internationally, but there are currently no local hospitals engaging the use of acupuncture for in vitro fertilization (IVF) procedures. We conducted a randomized control trial to evaluate the effect of acupuncture for OR during IVF. 

Method: 50 women undergoing IVF were randomised to 2 groups, with 25 women in each group. Prior to OR, the women in the acupuncture group (group A) received electro-acupuncture for 20 minutes, while those in sedation group (groups B) underwent routine conscious sedation. 

The outcomes assessed included pain scores, stress levels, and satisfaction using a self-reported questionnaire during OR and 1 hour after OR. Pain scores were evaluated using the visual analog scale. Stress levels was measured using a numerical scale from 0 to 10. Data was analysed using Graphpad. Unpaired t test was used to calculate significance between the pain scores and stress levels between the 2 groups. Fischers exact test was used to compare satisfaction and pregnancy rates in this study. 

Results: The median age was 34.2 years (18-39), with an average BMI of 24 (18-39). Acupuncture group women has the same function for the pain relieve as conscious sedation group during and post OR, there was no statistically significant difference in pain scores between both groups, Pregnancy rate was higher in the acupuncture group (65%) compared to the sedation group (40%). Vital signs such as blood pressure, heart rate, SpO2 and respiration were also similar in both groups. All patients in the acupuncture group were diagnosed as with kidney difficiency condition, with 1/3 women plus liver yin deficiency. 

Conclusions: This preliminary study found that Acupuncture can be as a safe and equally 

effective alternative to conscious sedation. And the patients who received electro-acupuncture had higher pregnancy rates compared with sedation treatment. 

Key wards: Electro-Acupuncture, Pain, Sedation, Oocyte Retrieval, IVF. 

摘要:

背景和研究目的：针灸广泛用于临床治疗已有两千多年的历史，并且，越来越多的受到世界各国医疗界的欢迎，尤其在治疗疼痛呕吐等方面的疗效，得到了广泛研究证明和应用。国际上许多医疗中心进行了对比针灸和镇静药物在取卵中作用的研究，但新加坡没有医院进行这样的研究。我们在过去两年进行随机观察两组病人，来评估电针在体外授精取卵中的作用。

研究方法：把将要进行体外授孕的50名孕龄妇女分成两组，每组各25名，第一电针组，在电针20分钟后进行取卵；第二常规药物组，静脉注射镇静药后，病人仍然清醒，即可进行取卵。

在取卵，及取卵完成一小时后评估疼痛，满意度和紧张程度，疼痛程度是采用国际承认的疼痛测试图尺（the visual analog scale）来评估，用问卷的形式评估病人的满意程度和紧张程度。问卷中列有数值刻度0-10，任病人选择。数据用曲线图来分析（Graphpad）. 用Unpaired t test 计算出电针组和常规药物组在疼痛和紧张程度两组的区别意义。用Fischers exact test评估出病人的满意度及受孕率。

研究结果：参加该科研的病人的平均年龄在34.2岁（18-30岁），平均体重指数为24（18-39），电针组和静脉注射镇静药组在取卵时和取卵后有相同的止痛效果。电针组的受孕率为65%，静脉注射镇静药组受孕率为40% 。

所有病人取卵时和取卵前后，健康指数如血压，心率，氧分压和呼吸变化两组对比基本相同，没有意义上的区别。针灸组的病人均为肾虚体质，约30%兼肝阴虚。

结论：电针在取卵过程中有根常规静脉注射镇静药相同的止痛作·用，由此说明电针可以作为另一种安全的替代止痛方法，电针组妇女的受孕率高于常规静脉注射镇静药。

关键词：电针，疼痛，镇静药，取卵，体外授孕。