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Acupoint Prescription for Hyperemesis Gravidarum (Nausea and Vomiting)

Acupoint Prescription for Hyperemesis Gravidarum (Nausea and Vomiting): ST36, PC6, CV13
妊娠惡阻配穴解析:足三里、內關、上脘
Clinical Focus|臨床重點: This prescription targets the core mechanism of “Stomach Qi Rebellion” (Stomach Qi ascending instead of descending) and tonifies the Spleen, balancing the body’s reaction to pregnancy hormones.
此配方針對「胃氣上逆」的核心機制,同時兼顧健脾益氣,以平衡身體對妊娠荷爾蒙的反應。
Overview: Harmonizing the Stomach and Lowering Rebellious Qi

Hyperemesis Gravidarum (HG), or severe nausea and vomiting in pregnancy, is attributed in TCM to the failure of Stomach Qi to descend (Qi Rebellion), often coupled with Spleen Deficiency. The combination of PC6, ST36, and CV13 synergistically addresses both the acute symptom (vomiting) and the constitutional root (Spleen/Stomach weakness).

妊娠惡阻(HG),即懷孕期間嚴重的噁心嘔吐,中醫歸因於胃氣不能下降(胃氣上逆),常伴隨脾胃虛弱。**內關**、**足三里**和**上脘**的組合,能協同作用,同時治療急性症狀(嘔吐)和體質根源(脾胃虛弱)。

Mechanism Analysis by Acupoint Function
依穴位功能劃分的機制解析
I. Central Anti-Emesis and Cardiopulmonary Regulation
I. 中樞止吐與心肺調節
  • **Neiguan (PC6):** The most validated acupoint for nausea. Its stimulation is believed to modulate the **Nucleus Tractus Solitarius (NTS)** and **Vomiting Center** in the brainstem.
    **內關(PC6):** 止吐最有效的穴位。刺激此穴被認為可調節腦幹中的**孤束核(NTS)**和**嘔吐中樞**。
  • Mechanism: Regulates gastrointestinal motility and suppresses the visceral afferent signals that trigger the vomiting reflex, effectively reducing the frequency and severity of emesis.
    機制:調節胃腸蠕動,抑制引發嘔吐反射的內臟傳入訊號,有效降低嘔吐的頻率和嚴重程度。
II. Tonifying Spleen-Stomach and Direct Gastric Regulation
II. 健脾和胃與直接胃部調控
  • **Zusanli (ST36):** Supports the body’s baseline energy (Qi) and strengthens Spleen function, ensuring adequate post-vomiting recovery and absorption. Its local stimulation helps harmonize gastric acid secretion.
    **足三里(ST36):** 補益身體基礎正氣,強化脾胃功能,確保嘔吐後的恢復和吸收。局部刺激有助於協調胃酸分泌。
  • **Shangwan (CV13):** Located directly on the epigastrium. It is the intersection point of the Ren, Stomach, and Small Intestine Meridians, directly regulating the stomach’s descending function and eliminating food stagnation (if present).
    **上脘(CV13):** 位於上腹部正中。為任脈、胃經、小腸經交會穴,直接調節胃腑的降逆功能,並消除(若有)飲食積滯。
III. Autonomic Balance and Hormonal Adaptability
III. 自主神經平衡與荷爾蒙適應性
  • Acupuncture, especially the combination of abdominal and limb points, is demonstrated to stabilize the autonomic nervous system, reducing sympathetic hyperactivity often associated with severe HG symptoms.
    針刺,特別是腹部與肢體穴位的組合,被證實可以穩定自主神經系統,減少與嚴重 HG 症狀相關的交感神經過度興奮。
  • By regulating Qi flow across the body, this prescription assists the pregnant body in adapting to high levels of pregnancy hormones (hCG and Estrogen) which are implicated in the etiology of HG.
    透過調和全身氣機,此配穴有助於孕體適應高水平的妊娠荷爾蒙(hCG 和雌激素),這些荷爾蒙被認為與 HG 的病因相關。
Clinical Conclusion

The strategy of coupling PC6 (Acute relief/Neuro-modulation) with ST36 (Constitutional Tonification) and CV13 (Direct Gastric Regulation) provides a safe, effective, and multi-layered approach to managing the debilitating symptoms of Hyperemesis Gravidarum.

將**內關**(急性緩解/神經調節)與**足三里**(體質補益)和**上脘**(直接胃腑調控)結合的策略,為治療妊娠惡阻的衰弱症狀提供了一個安全、有效且多層次的方法。

🔽 References|參考文獻(折疊) Click to expand|點擊展開
  1. Lee A, Fan L. **Stimulation of the P6 acupoint for preventing postoperative nausea and vomiting**. *Cochrane Database Syst Rev*. 2009. (Meta-analysis on PC6 effectiveness)
    Lee A, Fan L. **刺激 P6 穴位預防術後噁心和嘔吐**. *Cochrane Database Syst Rev*. 2009. (內關穴有效性之統合分析)
  2. Smith C, et al. **Acupuncture to control nausea and vomiting in early pregnancy: a randomized controlled trial**. *Birth*. 2002;29(1):1-9. (Clinical trial on early pregnancy NVP)
    Smith C, et al. **針灸控制早孕期噁心和嘔吐:一項隨機對照試驗**. *Birth*. 2002;29(1):1-9. (早孕噁心嘔吐之臨床試驗)
  3. Zhong Y, et al. **Acupuncture for hyperemesis gravidarum: A systematic review and meta-analysis of randomized controlled trials**. *Complement Ther Med*. 2021;60:102758. (Systematic review on HG and acupuncture)
    Zhong Y, et al. **針灸治療妊娠劇吐:隨機對照試驗的系統評價和薈萃分析**. *Complement Ther Med*. 2021;60:102758. (針灸治療妊娠劇吐的系統評價)

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