The effect of P6 acupressure on nausea and vomiting of pregnancy: A randomized, single-blind, placebo-controlled trial

Abstract

Background

Nausea and vomiting of pregnancy are common complaints that affect the quality of life significantly, even in mild cases. Although pharmacological treatments are available for these ailments, concerns about their effects on fetal health make healthcare providers and recipients prefer non-pharmacological therapies.

Objectives

This study examines the effect of Pericardium 6 (P6) acupressure with Sea-Band on the severity and frequency of nausea and vomiting of pregnancy and compares it with a placebo and a control group.

Design and participants

In this randomized, single-blind, placebo-controlled trial, 75 pregnant women with symptoms of mild to moderate nausea and vomiting of pregnancy with a gestational age of <20 weeks were assigned to three equal groups (n = 25).

Setting

The participants were selected from five healthcare centers in Ardebil, Iran.

Interventions

Pressure was applied to the P6 in the acupressure group using Sea-Band button for three days; in the placebo group, sea-band was applied without pressure on the P6; the control group did not receive any interventions, except for dietary recommendations similar to the other two groups.

Main outcome measures

Nausea and vomiting frequency and severity were recorded for six days, twice a day, with the intervention starting on the fourth day. Data were analyzed using the ANOVA, Kruskal-Wallis test, Chi-square test, Fisher’s exact test and Mann-Whitney’s U-test.

Results

There was a significant reduction in the frequency, duration and severity of nausea and also in the frequency of vomiting in the acupressure and placebo groups but not in the control group after three days of the intervention. A significant difference was observed between the acupressure and placebo groups in terms of the frequency and severity of nausea but not its duration or the frequency of vomiting after the intervention.

Conclusion

Acupressure on the P6 applied using a wristband for at least three days appears to be effective in the relief of nausea and vomiting of pregnancy; however, this finding may be due in part to the placebo effect. Acupressure on the P6 with Sea-Band button can be used for the management of nausea and vomiting of pregnancy.

Introduction

Approximately 50–80% of pregnant women experience nausea and vomiting of early pregnancy (NVP) as common complaints that range from reluctance to eat certain foods to severe and recurrent vomiting [[1], [2], [3]]. Women may experience physical, social and psychological disturbances from these complaints. Since NVP can have significant effects on the quality of life, even in mild cases, it should not be neglected and its early detection and management are crucial [4].

Many pharmacological treatments are available for NVP, but concerns about their effect on fetal outcomes make many healthcare providers and pregnant women wish to avoid or minimize the use of medications and prefer non-pharmacological therapies [5,6]. One of the most commonly applied non-pharmacological approaches in this regard is acupressure, which is a modality of Traditional Chinese Medicine (TCM).

According to TCM, a vital energy in the human body provides strength to the body. This energy, Chi, flows in invisible channels under the skin, called the Meridians. The quality of Chi depends on the balance among the sensory, mental, physical and psychological aspects of the body. Disturbances in any of these components cause imbalance in the energy and could lead to disease. The most common method of acupressure is to apply pressure to particular points in these energy channels to treat diseases [7,8]. The stimulation of the P6 point or Neiguan is commonly used in TCM to relieve nausea and vomiting [5]. Applying pressure on the P6 point relieves chest and abdominal congestion, relaxes the mind and helps reduce excitement, nausea and motion sickness [7,8]. The P6 point is located on the medial surface of the forearm, three finger-widths up from the wrist crease, between the long flexor tendons (Fig. 1) [2].

Several studies have evaluated the effect of P6 stimulation on NVP [[9], [10], [11], [12], [13], [14], [15]]. The results of trials on the subject are rather mixed. Some clinical studies have demonstrated the beneficial effects of P6 stimulation for NVP [9,10,13,[10], [11], [12], [13], [14], [15]]. Other studies, however, could not find any significant effects [5,16,17]. The lack of control groups, the application of pressure on non-P6 points in placebo groups, adopting different approaches for P6 stimulation and underreporting dietary modifications have been some of the reasons for the disparity in the results of these studies. More clinical studies are therefore needed to overcome these weaknesses.

The present randomized, placebo-controlled trial was carried out to determine the effect of P6 acupressure (wristband with a pressure button) on the severity and frequency of NVP in comparison with a placebo group (wristband without a pressure button) and a control group (no intervention) with dietary modifications being the same across all three groups.