Acupuncture versus pharmacological approach to reduce Hyperemesis gravidarum discomfort.
OBJECTIVE
Several reports have suggested the use of acupuncture as a useful treatment for hyperemesis gravidarum (HG), in particular the effects on nausea intensity was underlined. The aim of this study was to compare the efficacy of acupuncture sessions plus acupressure with a metoclopramide/vitamin B12 treatment.


METHODS
In this study we randomized 88 pregnant patients suffering from HG to receive either acupuncture sessions plus acupressure (acupuncture group) or metoclopramide infusion (metoclopramide group) supplemented by vitamin B12 complex. Somatic symptoms and the ability to achieve the daily routine activity (functioning) were evaluated. Acupuncture sessions were performed at the hospital twice a week for 2 weeks according to the traditional Chinese medicine criteria. Acupression was applied for 6-8 h/day. In the metoclopramide group, patients received at hospital metoclopramide infusion (20 mg/500 mL saline for 60 min) twice a week for 2 weeks. An oral supplementation with vitamin B12 complex (30 mg/day) was also prescribed.


RESULTS
Both treatments reduced vomiting episodes and then nausea intensity with a consequent improvement in the rate of food intake. The effect of acupuncture seems to be progressive, increasing at the end of treatment whereas pharmacological approach has a prompt effect in responders remaining stable thereafter. Moreover, acupuncture was significantly more effective than drugs in improving functioning.


CONCLUSIONS
In our study for the first time acupuncture, applied accordingly to Chinese formula, was compared to drugs demonstrating the same effect of both treatments on HG symptoms. Interestingly, functioning was significantly improved just by acupuncture. Even if the effect of acupuncture on HG discomfort remains to be confirmed, the reports on the effect of acupuncture on psychosocial variables could represent a further advantage of acupuncture application and provide an incentive to widen the base of the research.
Neri
I
I
Department of Obstetrics and Gynecology, University of Modena-Reggio Emilia, Modena, Italy. neri.isabella@unimo.it
Allais
G
G
Schiapparelli
P
P
Blasi
I
I
Benedetto
C
C
Facchinetti
F
F
D019050:Acupressure; D000284:Administration, Oral; D000328:Adult; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000188:drug therapy / Q000517:prevention & control / Q000523:psychology / Q000628:therapy*; D008787:Metoclopramide / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D011247:Pregnancy; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000008:administration & dosage / Q000627:therapeutic use*
D000932:Antiemetics; D008787:Metoclopramide; D014805:Vitamin B 12