PURPOSE: The purpose of this study was to determine the effects of Nei-Guan(P6) acupressure on nausea and vomiting in pregnant women having hyperemesis gravidarum. METHOD: The research design was a randomized control-group pretest-posttest repeated measure design with counter balancing. For the experimental treatment, P6 acupressure was carried out for ten minutes. Data was collected from April 1. 2003 to April 30. 2004. The participants were 66 patients admitted with hyperemesis gravidarum. They were divided into three groups, a P6 acupressure group, placebo point group and a control group. RESULT: Hyperemesis gravidarum patients who received P6 acupressure during admission experienced much less nausea and vomiting than the placebo acupressure and control group(F=8.259, p=.001). CONCLUSION: Nei-Guan(P6) acupressure is considered an effective intervention for reducing nausea and vomiting in pregnant women having hyperemesis gravidarum. Further more Nei-Guan(P6) acupressure maybe used as an independent nursing intervention method for pregnant women with severe nausea and vomiting.
Pregnancy ; Hyperemesis Gravidarum/*therapy ; Humans ; Female ; Adult ; *Acupressure

Hyperemesis gravidarum is characterized by severe nausea, vomiting followed by weight loss, dehydration, electrolyte imbalance and acid-base derangements. Its treatment was composed of adequate fluid therapy, electrolyte replacement and nutrient supply. In severe case, it also leads to a variety of neurological symptoms including confusion, gait disturbance and nystagmus, possibly due to thiamine deficiency and may result in so called Wernicke's disease. We have experienced a case of Wernicke's encephalopathy associated with severe hyperemesis gravidarum and this case is presented with a brief review of literature.
Dehydration ; Female ; Fluid Therapy ; Gait ; Hyperemesis Gravidarum* ; Nausea ; Pregnancy ; Thiamine Deficiency ; Vomiting ; Weight Loss ; Wernicke Encephalopathy*

OBJECTIVETo search for the best method for treatment of hyperemesis gravidarum.

METHODSOne hundred and fifty cases of hyperemesis gravidarum were randomly divided into 3 groups, acup-moxibustion group, Chinese drug group and Western medicine group, 50 cases in each group. The acup-moxibustion group were treated with acupuncture at Zhongwan (CV 12), Neiguan (PC 6), Zusanli (ST 36) and Yinlingquan (SP 9), and after arrival of qi, mild warming moxibustion of 10-15 min was added; the Chinese drug group with oral administration of modified Suye Huanglian Decoction , and the Western medicine group with oral administration of phenobarbital and supplement of water and electrolyte.

RESULTSThe total effective rate was 86.0% in the acup-moxibustion group, 42.0% in the Chinese drug group and 38.0% in the Western medicine group with a significant difference among the 3 groups (P < 0.05), the therapeutic effect in the acup-moxibustion group being the best.

CONCLUSIONAcup-moxibustion is the best method for hyperemesis gravidarum.

Acupuncture Points ; Acupuncture Therapy ; Administration, Oral ; Female ; Humans ; Hyperemesis Gravidarum ; Medicine, East Asian Traditional ; Moxibustion ; Pregnancy

Acupuncture Points ; Adult ; Female ; Humans ; Hyperemesis Gravidarum ; therapy ; Injections ; Pregnancy ; Thiamine ; administration & dosage ; Young Adult

Hypermesis gravidarum is a complication defined as vomiting severe enough to require hospital admission during early pregnancy. Thiamine deficiency is known to lead to certain neurological seguelae including Wernicke-Korsakoff syndrome. Wernicke's encephalopathy is an illness of acute onset characterized by global confusion, paralysis of eye ball movements, and gate ataxia due to a deficiency of thiamine. The immediate administration of thiamine prevents progression of the disease and reverses brain lesions that have not yet progressed to the point of fixed structural change. We have experienced a case of Wernicke-Korsakoff syndrome associated with hyperemesis gravidarum, which seemed to be developed by prolonged thiamine-free fluid therapy. We emphasize the need for thiamine supplementation in hyperemesis gravidarum patients.
Ataxia ; Brain ; Female ; Fluid Therapy ; Humans ; Hyperemesis Gravidarum* ; Korsakoff Syndrome* ; Paralysis ; Pregnancy ; Thiamine ; Thiamine Deficiency ; Vomiting ; Wernicke Encephalopathy

OBJECTIVETo explore a more effective therapy for treatment of hyperemesis gravidarum.

METHODSNinety cases were randomly divided into an acupuncture group, a western medicine group and a Chinese medicine group, 30 cases in each group. They were treated with same supplement of water and electrolyte, with acupuncture at Dazhu (BL 11), Shangjuxu (ST 37), Neiguan (PC 6), Gongsun (SP 4), etc. added in the acupuncture group, with oral administration of Luminal 30 mg thrice each day added in the western medicine group and with oral administration of Chinese herbal decoction according to syndrome differentiation of TCM added in the Chinese medicine group. The therapeutic effect, ketone bodies, carbon dioxide combining power (CO2-CP) and electrolyte imbalance situation in all the groups were observed.

RESULTSAfter treatment for 7 days, the total effective rate of 96.7% in the acupuncture group was better than 46.7% in the western medicine group and 60.0% in the Chinese medicine group (both P < 0.01). There were significant improvements in ketone bodies in the acupuncture group compared with those before treatment and those in the western medicine group (both P < 0.05), and improvements in CO2-CP and electrolyte imbalance in all the groups were following the recovery of disease.

CONCLUSIONAcupuncture has rapid and obvious therapeutic effect on hyperemesis gravidarum without adverse reactions.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hyperemesis Gravidarum ; drug therapy ; therapy ; Phenobarbital ; therapeutic use ; Pregnancy ; Treatment Outcome ; Young Adult

OBJECTIVETo study the clinical therapeutic effect of integrative Chinese and Western medicine on patients with hyperemesis gravidarum (HG) and its influence on serum level of motilin (MOT).

METHODSSixty patients with HG were randomized equally into two groups, the treated group and the control group. They all received the Western medical supportive treatment mainly by fluid infusion, but for patients in the treated group, Chinese herbal medicine, the Yuntu recipe was given orally in combination. The course of treatment was 6 days. Besides, a group of 30 women with regular pregnancy was set up for normal control. Serum levels of MOT and beta-HCG were measured before and after treatment. And patients were followed up for 2 weeks.

RESULTSThe curative rate and the relapse rate was 73.3% (22/30) and 16.7% (5/25) in the treated group; 56.7% (17/30) and 33.3% (10/20) in the control group respectively, the curative rate was significantly higher and the relapse rate was significantly lower in the treated group than those in the control group (P>0.05). Blood 3-HCG levels in the two HG groups were similar to that of the normal control, and changed insignificantly after treatment (P>0.05), while serum level of MOT in them were 67.15 +/- 15.94 ng/L and 70.28 +/- 13.56 ng/L respectively before treatment, significantly lowers than that of the normal control (145.35 +/- 30.12 ng/L, P<0.05), but it increased significantly after treatment in the treated and the control groups (P<0.05), being 151.50 +/- 54.84 ng/ L vs 103.28 +/- 38.31 ng/L and the increasing in the treated group was more significant than that in the control group (P<0.05).

CONCLUSIONThe occurrence of HG is correlated with the lowering of serum MOT level. Integrative medical treatment is effective in treating HG by way of increasing the serum level of MOT and promoting the peristalsis of stomach.

Adult ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hyperemesis Gravidarum ; blood ; therapy ; Medicine, Chinese Traditional ; methods ; Motilin ; blood ; Phytotherapy ; Pregnancy ; Young Adult

Wernicke's disease is a condition produced by thiamine deficiency; more than 90% of the cases are observed in chronic alcoholics. Other less frequent conditions associated with Wernicke disease are gastric disorders, prolonged parenteral nutrition, uremia, hemodialysis, hyperemesis gravidarum, prolonged starvation, and AIDS. We report a 41-year-old female patient of Wernicke disease associated with nausea and prolonged parenteral nutrition after chemotherapy of acute promyelocytic leukemia. She has got thiamine replacement therapy and most symptoms were improved. She was discharged after complete remission of leukemia and recovery of normal diet.
Adult ; Alcoholics ; Diet ; Drug Therapy ; Female ; Humans ; Hyperemesis Gravidarum ; Leukemia ; Leukemia, Promyelocytic, Acute* ; Nausea ; Parenteral Nutrition ; Pregnancy ; Renal Dialysis ; Starvation ; Thiamine ; Thiamine Deficiency ; Uremia ; Wernicke Encephalopathy*

Wernicke,s encephalopathy(WE), a neurological disorder caused by thiamine deficiency, is characterized by the triad of ocular symptoms, ataxia, and mental confusion. More than 90% of the cases are observed in chronic alcoholics. Other conditions less frequently associated with WE are anorexia nervosa, prolonged parenteral nutrition, hemodialysis, uremia, hyperemesis gravidarum, gastroplasty for morbid obesity, and acquired immunodeficiency syndrome(AIDS). One of the rare diseases associated with WE is tumors of the lymphoid-hemopoietic systems. We experienced a case of WE in a 15-year-old girl presented with bilateral horizontal nystagmus, bilateral abducens nerve palsy, mental confusion, disorientation, and ataxia after suffering anorexia, persistent vomiting, and watery diarrhea for 30 days following chemotherapy for acute myeloblastic leukemia. The serum thiamine level was 13.4 ng/mL(normal : 18.4-53.1). Brain MR T2-weighted image revealed a high signal intensity lesions bilaterally at the medial thalamus, pons, tectum, mammilary body, lateral wall of third ventricle, and putamen. Bilateral abducens nerve palsy, ataxia, and mental confusion improved dramatically following thiamine 100 mg/day replacement for 4 days. After two monthly follow-up, she was left with a residual fine bilateral horizontal nystagmus. We confirmed this case by clinical symptoms, brain MR findings, low thiamine level, and clinical response following thiamine replacement, and report with a brief review of the literature.
Abducens Nerve Diseases ; Adolescent ; Alcoholics ; Anorexia ; Anorexia Nervosa ; Ataxia ; Brain ; Child* ; Diarrhea ; Drug Therapy* ; Female ; Follow-Up Studies ; Gastroplasty ; Humans ; Hyperemesis Gravidarum ; Leukemia, Myeloid, Acute* ; Nervous System Diseases ; Nystagmus, Pathologic ; Obesity, Morbid ; Parenteral Nutrition ; Pons ; Pregnancy ; Putamen ; Rare Diseases ; Renal Dialysis ; Thalamus ; Thiamine ; Thiamine Deficiency ; Third Ventricle ; Uremia ; Vomiting ; Wernicke Encephalopathy*

Wernicke's encephalopathy is a neuropsychiatric condition generally caused by acute thiamine deficiency. Although it is common in the severe alcoholics, several other causes also have been identified, such as total parenteral nutrition (TPN) use, persistent vomiting, hyperemesis gravidarum, anorexia nervosa and malnutrition. The classic triad of Wernicke's encephalopathy are ataxia, altered mentation and ophthalmoplegia. A 19-year-old boy had been treated with high dose Ara-C and mitoxantrone for acute myelogenous leukemia and intravenous hyperalimentation due to persistent vomiting. He suddenly complained of diplopia, gait disturbance and generalized weakness at 36th day after chemotherapy. Physical examinations showed disorientated mentality, oculomotor palsy and horizental nystagmus. The diagnosis of Wernicke's encephalopathy was made with classical brain MRI and decreased thiamine level. The patient was successfully treated with vitamin B1. We presented a case of acute Wernicke's encephalopathy developed after high dose Ara-C chemotherapy followed by intravenous hyperalimentation in a patient with acute myelogenous leukemia.
Alcoholics ; Anorexia Nervosa ; Ataxia ; Brain ; Cytarabine ; Diagnosis ; Diplopia ; Drug Therapy* ; Female ; Gait ; Humans ; Hyperemesis Gravidarum ; Leukemia, Myeloid, Acute ; Magnetic Resonance Imaging ; Male ; Malnutrition ; Mitoxantrone ; Ophthalmoplegia ; Paralysis ; Parenteral Nutrition ; Parenteral Nutrition, Total* ; Physical Examination ; Pregnancy ; Thiamine ; Thiamine Deficiency ; Vomiting ; Wernicke Encephalopathy* ; Young Adult