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References
1. Jorm AF, Christensen H, Griffiths KM, Parslow RA, Rodgers B, Blewitt KA. Effectiveness of Complementary and Self-help Treatments for Anxiety Disorders. Med J Aust. 2004 4; 181(7):29-46.
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3. Reck C, Hunt A, Fuchs T, Weiss R, Noon A, Moehler E, Downing G, Tronick EZ, Mundt C. Interactive Regulation of Affect in Postpartum Depressed Mothers and Their Infants: an overview. Psychopathology. 2004; 37(6):272-80.
4. Hettema JM, Neale MC, Kendler KS. A Review and Meta-analysis of The Genetic Epidemiology of Anxiety Disorders. Am J Psychiatry. 2001; 158(10):1568-78.
5. O'Connor TG, Heron J, Golding J, Glover V; ALSPAC Study Team. Maternal Antenatal Anxiety and Behavioral/Emotional Problems in Children: A Test of a Programming Hypothesis. J Child Psychol Psychiatry. 2003; 44(7):1025-36.
6. Braveman P, Marchi K, Egerter S, Kim S, Metzler M, Stancil T, Libet M. Poverty, Near-poverty, and Hardship around the Time of Pregnancy. Matern Child Health J. 2010; 14(1):20-35.
7. Austin MP, Hadzi-Pavlovic D, Priest SR, Reilly N, Wilhelm K, Saint K, Parker G. Depressive and Anxiety Disorders in the Postpartum Period: How Prevalent Are They and Can We Improve Their Detection? Arch Womens Ment Health. 2010; 13(5):395-401.
8. Matthey S, Barnett B, Howie P, Kavanagh DJ. Diagnosing Postpartum Depression in Mothers and Fathers: Whatever Happened to Anxiety? J Affect Disord. 2003; 74(2):139-47.
9. Zlotnick C, Miller IW, Pearlstein T, Howard M, Sweeney P. A Preventive Intervention for Pregnant Women on Public Assistance at Risk for Postpartum Depression. Am J Psychiatry. 2006; 163(8):1443-5.
10. Cooper PJ, Murray L. Postpartum Depression. Clinical review.Br Med J 1998; 316(8):1884–6.
11. Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal Depression: A Systematic Review of Prevalence and Incidence. Obstet Gynecol. 2005; 106(5 Pt 1):1071-83.
12. O hara MW, Swain AM. Rates and Risks of Postpartum Depression – A Meta-analysis. Int Rev Psychiatry 1996; 8(9):37–54.
13. Paulson JF, Dauber S, Leiferman JA. Individual and Combined Effects of Postpartum Depression in Mothers and Fathers on Parenting Behavior. Pediatrics. 2006; 118(2):659-68.
14. Hart R, McMahon CA. Mood State and Psychological Adjustment to Pregnancy. Arch Womens Ment Health. 2006; 9(6):329-37.
15. Ross LE, McLean LM. Anxiety Disorders during Pregnancy and the Postpartum Period: A Systematic Review. J Clin Psychiatry. 2006; 67(8):1285-98.
16. Michalsen A, Bock S, Lüdtke R, Rampp T, Baecker M, Bachmann J, Langhorst J, Musial F, Dobos GJ. Effects of Traditional Cupping Therapy in Patients with Carpal Tunnel Syndrome: A Randomized Controlled Trial. J Pain. 2009; 10(6):601-8.
17. Farhadi K, Schwebel DC, Saeb M, Choubsaz M, Mohammadi R, Ahmadi A: The Effectiveness of Wet-cupping for Nonspecific Low Back Pain in Iran: A Randomized Controlled Trial. Complement Ther Med. 2009, 17(1):9-15(Persion).
18. Wong CL, Lai KY, Tse HM. Effects of SP6 Acupressure on Pain and Menstrual Distress in Young Women with Dysmenorrhea. Complement Ther Clin Pract. 2010; 16(2):64-9. 19. Lim S. WHO Standard Acupuncture Point Locations. Evid Based Complement Alternat
Med. 2010; 7(2):167-8.
20. Wang SM, Kain ZN, White P. Acupuncture Analgesia: I. the Scientific Basis. Anesth Analg. 2008; 106(2):602-10.
-2
22. Hsieh LL, Kuo CH, Yen MF, Chen TH. A Randomized Controlled Clinical Trial for Low Back Pain Treated by Acupressure and Physical Therapy. Prev Med. 2004; 39(1):168-76.
23. Chen HM, Chen CH. Effects of Acupressure at the Sanyinjiao Point on Primary Dysmenorrhoea. J Adv Nurs. 2004; 48(4):380-7.
24. Mahram B. ( standardization of Spielbergers test anxiety inventory in Mashhad) Thesis for Master degree of Allameh Tabatabae University 1994, 76. ( Persian)
25. Aghamohammadi Kalkhoran M, Karimollahi M. Religiousness and preoperative anxiety: a correlational study. Ann Gen Psychiatry. 2007 Jun 29; 6: 17.
26. Huang H, kuang YD, Fan YS. Shenque Point Cupping Therapy for Stroke after Intractable Hiccup in 6 cases. J Clin Acupunct Moxibustion 2009; 25(2):33–4.
27. Lüdtke R, Albrecht U, Stange R, Uehleke B. Brachialgia Paraesthetica Nocturna Can Be Relieved by "Wet Cupping"--Results of a Randomised Pilot Study. Complement Ther Med. 2006; 14(4):247-53.
28. Ahmed SM, Madbouly NH, Maklad SS, Abu-Shady EA. Immunomodulatory Effects of Bloodletting Cupping Therapy in Patients with Rheumatoid Arthritis. Egypt J Immunol. 2005; 12(2):39-51.
29. Isoyama D, Cordts EB, de Souza van Niewegen AM, de Almeida Pereira de Carvalho W, Matsumura ST, Barbosa CP. Effect of Acupuncture on Symptoms of Anxiety in Women Undergoing in Vitro Fertilisation: A Prospective Randomised Controlled Study. Acupunct Med. 2012; 30(2):85-8.
30. Kao CL, Chen CH, Lin WY, Chiao YC, Hsieh CL. Effect of Auricular Acupressure on Peri- and Early Postmenopausal Women with Anxiety: A Double-Blinded, Randomized, and Controlled Pilot Study. Evid Based Complement Alternat Med.2012; 2012:567-639. 31. Valiee S, Bassampour SS, Nasrabadi AN, Pouresmaeil Z, Mehran A. Effect of
Acupressure on Preoperative Anxiety: A Clinical Trial. J Perianesth Nurs. 2012; 27(4):259-66 (Persion).
32. Kaviani M, Ashoori M, Azima S, Rajaei Fard A, Hadian Fard M. Comparing the Effect of Two Methods of Acupressure and Ice Massage on the Pain, Anxiety Levels and Labor Length in the Point LI-4. JSSU. 2012; 20 (2):220-8 (Persion).
33. Karst M, Winterhalter M, Münte S, Francki B, Hondronikos A, Eckardt A, Hoy L, Buhck H, Bernateck M, Fink M. Auricular Acupuncture for Dental Anxiety: A Randomized Controlled Trial. Anesth Analg. 2007; 104(2):295-300.
34. Wang SM, Gaal D, Maranets I, Caldwell-Andrews A, Kain ZN. Acupressure and Preoperative Parental Anxiety: A Pilot Study. Anesth Analg. 2005; 101(3):666-9.
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Comparative Effects of Dry Cupping Therapy and Acupressure at
Acupoint (BL23) on Postpartum Anxiety in Nulliparous Women
Marzieh Akbarzade1, Mehrnoush Ghaemmaghami2, Zahra yazdanpanahi1, Najaf Zare3,Amir Azizi4,
Abdolali Mohagheghzadeh5
1. Instructor of Midwifery, Community Based Psychiatric Care Research Center, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
2. MS in Midwifery , Department of Midwifery ,School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
3. Associate Professor of Vital Satistict, Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran 4. Asistant Professor of Pharmacy, Department of Pharmacognosy, Shiraz University of Medical Science, Shiraz, Iran 5. Associate Professor of Pharmacy, Department of Pharmacognosy, Shiraz University of Medical Science, Shiraz, Iran
* Corresponding author, Email: akbarzadehmarzieh@yahoo.com
Abstract
Background: Anxious disorders are very common psychiatry problems in pregnant women
Today, in addition to the conventional medicine, complementary medicine (acupressure and cupping therapy) is also important in the treatment of painful syndromes.
Aim: The aim of this study was to determine the effect of dry cupping and acupressure
application on postpartum anxiety in nulliparous women admitted to the Central Selection Shiraz (Hafez).
Methods: In this clinical trial, 150 patients with collected with purposive sampling was
recruited from the University Hospital of Hafez in . Cupping therapy was performed
four times a week for 20-15 minutes each time and also Acupressure within 20 minutes, according to the circular model. Spiel Berger State-Trait Anxiety Inventory was completed and data was analyzed by the SPSS statistical software (version 16) and a repeated measure ANOVA was performed.
Results: Mean postpartum anxiety in the cupping therapy group was 47.1 ± 5.8 at baseline visit and decreased to 42.4 ± 4.6 after the intervention. The difference between the intervention and control groups was statistically significant (P = 0.01) and in Acupressure group decreased from value of 46.8± 4.7 to 46.6 ± 4.4 after the intervention. However, this value was increased from 46.0± 5.2 to 50.2 ± 4.9 after the intervention in the control group.
Conclusion: The results showed that postpartum anxiety, decreased in both interventional groups but in the cupping experimental group, the reduction was significant. Therefore, it is used as an effective treatment in reducing anxiety after childbirth
Keywords: Dry cupping therapy, Acupressure, Acupoint BL 23, postpartum anxiety
