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噁心嘔吐之臨床療效評估及其自律神經機制之探討 黃升騰長庚紀念醫 |
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| 針刺內關穴以預防噁心嘔吐於1980年代末期開始，首先由Dundee等人提出，迄今10餘年對於預防噁心嘔吐的效果，有正反兩面的意見，但整體來說，絕大部份的報告都認為針刺內關穴具有治療噁心嘔吐的效果。其範圍涵蓋了手術後，化療後，妊娠初期，及偏頭痛等所引發之噁心嘔吐。針刺在臨床上的應用，是既經濟又安全。因此証明內關穴在治療噁心嘔吐的效用，不僅可以免於藥物止嘔所引發的副作用外，也可以節省不必要的醫療資源浪費。而在過去所有的臨床研究中，多僅提到其治療之效果。但少有人具體的指出其影響針刺治療噁心嘔吐之機制為何。因此本研究之目的即在於前人所作的研究下，針刺內關穴以雙盲隨機方式，應用於婦科接受內視鏡治療或檢查的患者，觀察手術前後及出院後噁心嘔吐是否和未針刺，及偽針刺組間有明顯之差異，同時我們也利用心律變異度分析這些患者在手術前後其自律神經中，交感及副交感神經的活性是否有明顯的變化。藉此以瞭解針刺內關穴對於婦科內視鏡後所引發之噁心嘔吐的療效評估及其相關機理之研究探討。 | |
| 關鍵字：針刺、內關、內視鏡、心律變異度 |
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Clinical evaluation of postoperative nausea and vomiting in the patients with minor gynecological laparoscopic surgery by acupuncturing Neiguan and evaluate the mechanism of autonomic nervous system Sheng Teng HuangChang Gung Memorial Hospital |
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| In the past two decades, Dundee and his co-workers concluded that acupuncture at Neiguan (P6) had the effect to prevent nausea and vomiting. However, there were both opposite opinions in several studies whether acupuncture at P6 had the effect to prevent nausea and vomiting or not. In general, most of studies considered that acupuncture at P6 could have a good treatment in nausea and vomiting induced by post operation, post chemotherapy, first trimester and migraine etc. The application of acupuncture in clinics is economic and saves. Therefore, how to approve the effect of acupuncture at P6 to prevent nausea and vomiting is necessary. It is not only to prevent the side effect induced by pharmacological drugs but also to save the unnecessary waste in medical sources. In the past clinical studies, they just mentioned about the effect of acupuncture at P6, but not pinpoint out the real mechanism of acupuncture at P6 in prevention of nausea and vomiting. The aim of this study is following | |
| 關鍵字：acupuncture, Neiguan (P6), gynecological laparoscope, heart rate variability |
