Accepted: Received: [email protected] E-mail: 71345-1359, Shiraz,Iran Sciences, P.O. Box: ofMedical University Midwifery, Shiraz of Nursingand Faculty Department of Midwifery, Marzieh Akbarzade, * CorrespondingAuthor: Amir Azizi 5- Faculty ofPharmacy, Shiraz Univers 2- Departments of Midwifery, Faculty ofNursing and Midwif Medical Sciences, Shiraz,Iran 1- Maternal-Fetal Medicine Research Ce Marzieh Akbarzade Comparison oftheEffect reported Perineal traumahas been (NVD)(1). ery comfort up to after 10 days natural vaginal deliv- 4- Departmentof TraditionalPharmacy, Faculty of Pharmacy 3- Department of Biostatistics McGill PainQuestionnaire Point onIntensity ofPostpartum Peri

of the female population experience this dis- femaleexperience this of the population fifth Overall, one the delivery. after few days majorfirst erineal painisa inthe morbidity Mar. 3, 2015 Oct. 26, 2014 Oct. 26, 5

1 Introduction 

, Mehrnoush Ghaemmaghami

Conclusion: significant. statistically ter theintervention,sovariationbe fromth sure groupreached 35.6±8.1before significant (p<0.01).Meandifferenceofth between the differences ed that ly, 24 ly, from 37.5±6.8 beforetheinterventionto11.1±6.1, 6.9±4.7, and3.8±3.6 immediate- Results: significant. ered statistically thedata to using repeatedm analyze pleted bothbeforeandaftertheinterventi based on clockwise model. The short-form of McGill pain questionnaire wascom- up to 3 times a week (once a day) and acupressure was performedand acupressurewas for15-20 times(once aday) up to3 aweek ofallowingdelivery. reducing painintensity mayduced perineal pain.Therefore,they cases. Afteratleast4-8 Methods: McGill painquestionnaire(SMPQ). ofpostpartumBL23 point ontheintensity perineal painbasedontheshort-form of at and acupressure of dry the effect aimedto investigate This study Background: Abstract McGill Pain Questionnaire. J Repr McGill Pain Questionnaire. pressure at BL23 Point on Intensity of Postpartum Perineal Pain Based on the Short Form of Acu- and Therapy Cupping Dry Effect of the of A. Comparison A, Azizi Mohagheghzadeh cite this article:To Keywords:

, Infertility Research Center, Shiraz Uni hr

ity ofMedicalScie In the cupping therapy group,mean reduced In thecuppingtherapy oftheperinealpainintensity , and 2 weeks after the intervention, respectively. The results of study show- The resultsofstudy weeks aftertheintervention,respectively. , and2

nter, Departmentof Midwifery, School of Nu The present clinical trial was conduc trial was present clinical The Acupressure,BL23 point, Dry cupping, Perineal pain, Postpartum. of Dry CuppingTherapy a The study findings showed that findings study The J Reprod Infertil. 2016;17(1):39-46 Infertil. 2016;17(1):39-46 Reprod J Perineal pain is a major morbidity in the first few days after delivery. delivery. after majorfirst fewdays Perinealpainisa inthe morbidity Akbarzade M, Ghaemmaghami M, Yazdanpanahi Z, Zare N, 2 nces, Shiraz, Iran , ZahraYazdanpanahi hr ery, Shiraz UniversityofMe of delivery, cupping therapy wasperformed cuppingtherapy for15-20 ofdelivery, , Shiraz Universityof Me neal Pain Based ontheShort Formof the intervention and control groups werestatistically od Infertil. 2016;17(1):39-46. Infertil. od versity ofMedicalSc perineal trauma in (2). In astudy afterdelivery numberTherefore, alarge ofwomenexperience episiotomies. accompanied taneous ruptures by ruptur 46% ofspontaneous in 63% of vaginal deliveries, 15% ofepisiotomies, easures ANOVA. Besides, p<0.05wasconsid- tween intervention and control groups was tween interventionandcontrolgroups on. The SPSS statistical software was used on. TheSPSSstatisticalsoftwarewas be consideredaseffectivetreatments for e intervention to 10.4±5.5 two weeks af- 10.4±5.5 twoweeks e interventionto e perineal pain intensity in the acupres- inthe e perinealpainintensity 1 , Najaf Zare Najaf , rsing and Midwifery, Shiraz

cupping therapy and acupressurere- cupping therapy dical Sciences, Shiraz,Iran ted on 150 subjects in 3 groups of50 nd AcupressureatBL23 dical Sciences,Shiraz,Iran iences, Shiraz, Iran 3 , Abdolali Mohagheghzadeh Mohagheghzadeh , Abdolali

es, and 2% of the spon- of the es, and2% Universityof Original Article min min 4

,

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40 skin), while in the so-called wet or bloody skin skin), whileintheso-called wetorbloody or firecuppingisusedfornormalDry skin(intact area. glass createsasuctioncup onthepainful of different techniques of the East culture.Each Middle ical techniquefromAsia, andthe Europe, diseases is (10). Cupping an ancientmed-therapy different treatmentpain in in the of has beenused which and clinicalsetting who trainedincupping and reduces pain (9). Cupping was performed by muscles, stimulates theperipheralnervoussystem, and the skin blood flowtoward joints, directsthe fluids, loosens andmoves up theconnectivetissue removesextra the dromesCupping therapy (8). treatment painfulsyn- ofdiseases,particularly importantin highly which is therapy physical of isatype packs (7). Inaddition,cuppingtherapy ice nerve stimulation,,using local and logical methods, suchassubcutaneouselectrical and anti-inflammatory drugs(aspirinandnaproxen logical options,suchasparacetamol, non-steroidal for them. Theseinterventionsincludepharmaco- puerperium,used painreliefinterventionscanbe the of the firstdays ence theperinealpainin incidence of rupture,most ofthewomen experi- methods (6).Duetothefactthat,regardlessof lead to thehigher number ofusingtreatment pain relief. Themoreintense the advised forpain methods as well as havebeen reason fortreatmentcomplementary andvarious (1.7% the massagegroup groupcomparedto thecontrol However, IIIrupture the rateof was lowerin type perineum, IandIIruptures,episiotomy. types groups were similar regarding the rate ofhealthy two the labor outcomes.that study, labor onthe In effect of perinealmassage in the secondstageof the clinical trialinAustraliaordertoinvestigate randomizedGeorgina etal.(2001)conducteda (4). to moremonths than18 afterthedelivery long termup effects,suchaspainfulintercourse, puerperiumhave during the can long-lasting pain and perineal pain fatigue. Moreover, pression and selves ortheirbabies,andleadstomaternalde- interferes withthewomen’s takingcareofthem- feeding, effects onbreast defecation, hasnegative duce mobility, causediscomfort inurinationand the firstweek,respectivel decrease wasobservedinthesemeasuresduring perineum.71%,38%healthy 60%, However, and I and II ruptures, and 75% of the women with womentypes of thosewith withepisiotomy, 95% Canada, perinealpainwasreportedin97% ofthe

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etc Dry Cupping andAcupressure onPostpartum Perineal Pain vs .), and opioids as well as non-pharmaco-as well .), andopioids . 3.6%)(5).Painisthemostimportant J Reprod Infertil, Vol 17, No 1, Jan-Mar 2016 2016 Jan-Mar 1, No 17, Vol Infertil, Reprod J y (3). The pain can re- (3).Thepaincan y control. and acupressure, therapy, of cupping three groups ing purposeful random sampling and dividedinto 150women Finally, wereselectedus- spectively. plications and demographic characteristics,re- cluded from com- dueto the the pregnancy study 13 womenex- consents. However,19and were informed after signingwritten rolled inthestudy womenen- 182 qualified were At first, the study. size (50casesineachgroup)wasdeterminedfor and statistical consultation, a 150-subject sample es in 2012.Accordingto the sample sizeformula Scienc- of Medical Shiraz University affiliated of ducted in thepostpartum unitofHafezhospital

the lactic acidandcarbonmonoxide accumulatedin ters, activation ofopioids system, andremoval of Ying Yang symbols, secretion ofneurotransmit- between flow,balance circulation andenergy improvementmore,leads to acupressure blood in vaginal discharges, and insomnia (14).Further- irregularmenstruation,such asinfertility, chronic disorders knee pain,genitalgynecological treatment of pain syndromes suchas low back and in applied.Thispointhasalsobeenused ately appropri- and acupressurecanbe on aflatspace placed can becorrectly point, thecups tion ofthis loca- to the Due employed. lumbar vertebrawas lower border ofthespinousprocesssecond the lateral to located 1.5cuns (Shenshu) whichis bilities (13). In BL23point the present study, and natural self-healingcapa- induce thebody’s pointsontheskininordertostimulatethe key ture. In thismethod, fingersareusedforpressing relieve painfulmuscletension (11,12). to circulation and and lymph increase localblood to is applied (hijama),is cut.Cupping theskin cine experts. cles aswelltheinstructionsoftraditionalmedi- tional medicinearti- usingthereliablescientific tradi- to the this science aimedto link sent study pre- the therapy, on cupping clinical trials ber of tries around theworld and dueto the limited num- coun- and other in Iran suffering fromthis pain pain (15). the tains thebody's naturalfunctionandreduces the age between 18 and 40 years, having at least havingat the agebetween18and40 years, Admissions criteria: con- randomizedtrial was The present clinical Acupressure is also another branch of acupunc- branch of also another Acupressure is Considering the high frequency Considering of thewomenthe highfrequency

body

during

muscle Methods Theinclusioncriteriawere

contraction.

Thus,

it

main-

Downloaded from http://www.jri.ir liable pain assessment tools allowingthepatients the mostre- is oneof vention. Thisquestionnaire immediately, 24 and groupsbefore completed inthethreestudy (17, 18). hospital mothersto the calling torefer dinated by after discharge. Thethirdinterventionwascoor- 20 took about sure continuedfor20 min In thesecond5 thumb, in counter-clockwisedirectionfor5 his searcher pressed"pressurepoints-BL23"with received nointervention. 15-20 andrelievingpainfulmuscle tension(16). lysis autohemo-and lymphatic circulationandcausing increasingblood the nerveandmuscle, thereby stretches negative pressureinthecupsusedwhich the localtissuestructures thatspecificchangesin It washypothesized days. was performedalternate dark pink.Cupping on ping marks,to whichrangefrom rose slightly pending onthecolorofcircularso-calledcup- up theskinwithineachcup(12). drawing cooled, vacuumswere created, cups was the inside of As theair painful area. suction overa create cup wasutilizedto BL23 point.Aglass over were heldinverted obese andleansubjects adviser, professional of a the supervision 3 weeksunder researchers, butfor Itwasconductedby other day. was performed for15-20 partum careunitofthehospital.Cuppingtherapy cupping interventionwasperformedpost- inthe glasses withdiametersfrom 75 tion and cupping was performed as follows:3-4 posi- in prone patients werelaid cupping.The dry wet was conductedthrough cupping. Ourstudy is Cupping done in therapy two forms and of dry theresearchers. wasapprovedby cupping therapy written informed consents. ing andsigning willing totakepart in thestudy, and deep venousthrombosis, livinginShiraz,be- inflammation,tebral fractures,diskhernia,acute and serious mentalphysical disorders such asver- middlenot sufferingfromany schooleducation, The short-form of McGill pain questionnaire was pain questionnaire The short-formof McGill In acupressurebasedonclockwisemodel,re- the for acupressure wasapplied On theothergroup, to 20 were removedafter 10 The glasses Data collection: Data ontheoppositedirection.Similarly thepres- min

necessary . However,thecontrolgroupsubjects min After at least4-8 min hr , twiceinthehospitalandonce

, and 2 weeks after the inter- , and2weeksafterthe training , pressure was applied for 5 pressure wasappliedfor , min occur as a result of local occur asaresultof min . In fact, this process . Infact,this

was upto3times every mm

performed to 120 hr of delivery, ofdelivery, min mm J Reprod Infertil, Vol 17, No 1, Jan-Mar 2016 2016 Jan-Mar 1, No 17, Vol Infertil, Reprod J

min de- for and .

Akbarzade M, etal. study (19). study Bagheri et al.was also thebasis for thepresent of and of the questionnairein validity the study questionnaire wasreportedas98%.Thereliability sein hospital, Shahrood, ofthis Iran, the reliability of lowerextremity surgery fractures atImam Hos- (2007) on78patientsw Bagherietal. conducted vere. by In thestudy through 4optionsofnone,mild,se- average,and quality theirpain and thepatientshavetoidentify mension and 4items intheemotional dimension di- itemsthe sensory of 11 in tionnaire consists ate words.Theshort-form ofMcGillpainques- to expresstheirperceptionofpainusingappropri- been performed inthelast30years. has women obstetrics anddiseasesof nostudy pact has beendoneonchronic pain. Butsofar,in but fewstudiesinthisfieldareavailable. upressure to relieve back pain and perinealpain, ac- and Shu) through 23 point(Shen BL employed study first, the clude thefollowing; SPSS

cy oftheobtainedresults. cy to beconductedinorderdetermine theaccura- ther placebo-controlled clinicaltrialsareneeded transparent nature ofits performance. Thus,fur- the dueto not employed inthecurrentstudy be used inorderto avoid .However, itwas IRCT: 2013072611944N2. trial has beenregisteredwithregistrationnumber ipants. ofclinical The researchin Iranian Registry formed consentswereobtainedfrompartic- allthe in- Sciences andwritten ofMedical University thelocalEthicsCommitteeapproved by ofShiraz coefficient=0.05. were performed consideringCI=95% andalpha groups.Allthestatisticaltests the threestudy order tocompare thedemographic features among time. In addition,Chi-squaretestwasutilizedin intervention regardless oftheeffectgroupand the and after pain before the meanscore of es in ures ANOVA wasused for comparing thechang- three groupsweresimilar regarding thedemo- Second, a study of cupping therapy and its im-and its cupping therapy of study Second, a Data analysis: Limitations considerations: Ethical Strengths of thestudy: The results of the present study showed that the showedthat present study The resultsofthe

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42 the gynecological diseasesinIranandaroundthe the gynecological tionnaire arepresentedintable1. changes intheemotional dimension oftheques- The the intervention(p<0.001). and 2weeksafter mension of theperineal pain immediately, 24 di- were quite effectiveinreducingthesensory andacupressure intervention, cupping therapy the groups before found amongthe three ence was differ- morethe factthatno effective.Inspiteof being cupping therapy pain, with the perineal animportantacupressure played roleinreducing and both cuppingtherapy vention (p<0.01).Thus, 24 in pain intensity (p<0.001). Also, significantchangeswereshown significant and thecontrolgroupwasstatistically that and repeated tively measures ANOVAshowed acupressure,andcontrolgroups,respec- therapy, 11.1±6.1, 22.6±6.6, and26.4±7.0 inthecupping were pain intensity tion, themeansof perineal groups in thisregard(p=0.1).Aftertheinterven- difference amongthree showed nosignificant the The resultsof tively. repeated measures ANOVA acupressure,andcontrolgroups,respec- therapy, 37.5±6.8, 35.6±8.1, and34.7±8.8 inthecupping beforetheinterventionwere neal painintensity of McGill painquestionnaire, the means ofperi- short-formto the (p=0.064). Moreover,according graphic characteristics,su

JRI The present study wasthefirstclinicaltrialon The present study

the Dry Cupping andAcupressure onPostpartum Perineal Pain

difference

SMPQ emotional SMPQ sensory SMPQ Data

Table 1. 24 post-interventionImmediately Baseline 10.1±2.5 24 post-interventionImmediately Baseline 27.6±5.5 9. post-interventionImmediately Baseline 37.5±10.8 25. 35. ek otitreto 1. 2 weekspost-intervention 2. 2 weekspost-intervention 3.8 2 weekspost-intervention 24 hr hr hr ps-nevnin 1.5±1. post-intervention 5.4±3. post-intervention ps-nevnin 6.9±4. post-intervention

between The results ofshort-form ofMcGillpainques Discussion hr J Reprod Infertil, Vol 17, No 1, Jan-Mar 2016 2016 Jan-Mar 1, No 17, Vol Infertil, Reprod J and2 weeks aftertheinter- ch as the mothers’ age ch asthemothers’

the

intervention

Cupping group

groups 11612.±. 26.4±7.0 11.1±6.1 22.6±6.6 0.001 .±. .±. 6.2±2.7 2.2±1.9 5.2±2.2 0.001 20.7±7 8.8±4.7 17.4±5.5 0.001 ±. .±. 2.9±1.9 6±1.0 2.8±2.3 0.001 8.8±3.7 7±2.9 7.7±4.1 0.001 hr groups (M±SD) groups (M±SD) 361.±. 11.6±4.7 ±3.6 10.4±5.5 0.001

, .±. 4.2±2.1 6 3.7±1.8 0.001 13.2±4.2 5 11.5±4.9 0.001 7 15.3±5.8 16.8±6.4 7 15.3±5.8 0.001

tionnaire (SMPQ) fortheintervention and control

Acupressure group Acupressure with usual care (p=0.03) ora heating pad(p< effects of cuppingonbrachialgia paincompared drugs and analgesics in two studies.Thefavorable neuralgia (p<0.01)compared with anticancer trigeminaland pain (p<0.05) in cancer was shown cupping Thepositiveeffects of were analyzed. and insevenofthem,criteria alltheinclusion inreducingpain(21). tiveness ofcuppingtherapy effec- compatibleresults, revealingthe withour have improvedfunctiona tenderness and improving therangeofmotion muscleshowed thatpromptof painand reduction patients withlowbackpain(LBP).Theresults and tenderness,improved range ofmotionfor pain revealed reduced the study weeks and least 8 patientswhoreportedbackpainforat twenty-one wasinvestigatedon the effect ofcuppingtherapy compatible withourfindings(20). increased pressurepainthresholds.Thisresultis to led cupping therapy subjects) indicatedthat 12 patients (6neckpainand6healthy Emerichon by etal.(2014) The resultsofastudy significant(p=0.01). difference wasstatistically compared to the control group, reduced and the group, tumthe cuppingtherapy perinealpainin postpar- of the meanintensity results, study to the ofpostpartumintensity perinealpain.According application of pressureonthe pointsby of body andstimulationpeutic effectsofcuppingtherapy aimedworld. Thisstudy toinvestigatethethera- Kimdatabases etal.(2011)searchedfourteen (2014), Markowskietal. by Also, inthestudy 8±2.5 9.3±2.5 0.1 9±5.9 25.8±5.5 0.1 6±8.1 34.7±8.8 0.1

Control group P-value P-value group Control

l movement. Thisis

Downloaded from http://www.jri.ir fetal attachment (29). fetal attachment was effectiveinincreasingmaternalternal anxiety a mechanismrate ofcesarean;also, ma- toreduce pain of labor,duration der Meridian point(GB-21)(28)toreducethe sure at thesp6point(27)andJianJing-GallBlad- tered. adminis-McGill questionnairewas in ourstudy of visual painscalewasusedtomeasure pain,but of measuringstudy ference isthescale pain.The dif- The only compatible withthecurrentstudy. are (p=0.05) (26).Theresultsofthesestudies duction (p=0.0001); also, walking time improved sure, theinterventiongrouphada39% painre- acupres- the applicationof (p=0.24). Aweekafter respectively of 10, and 5.70 were 6.38 trol groups con- the interventionand vention, VASscoresfor inter- back pain.Beforethe plied onpatientswith ap- using lavenderoil et al.studiedacupressure cine was introducedtoreduce back pain(25).Yip medi-an effectivealternative tion, acupressureas interven- after the (77 patients); therapy physical used two groupsofacupressure(69patients)and in thisstudy. ofperinealpainintheacupressuregroup intensity might have causedsignificantreduction inthe itrestoresthehumanThis quently health(24). as well asbalance flow, andconse- in theenergy er, acupressure resultsinopeningofthechannels this flow resultsin incidence ofdiseases.Howev- and imbalancein flow ridians, adjustthe me- channels,called tion thatspecialhumanbody assump-on the significant. Thismethodis based intervention and controlgroupswerestatistically perineal pain reducedand the differencesamong andnosebleeding(22). nia, sciatica,hydrocele, excessive menstrual bleeding,edema,her- scrotal in treatmentincluding ployed ofvariousdisorders, em- is therapy cupping Dry to another. one place principle, with thoseofthecurrentstudy. compatible these studiesare (23). Theresultsof childbirth pain after lower back sedation toreduce was introducedas therapy an effectivemethod in cupping conductedinIran, pain (22).Inastudy effectiveness of cuppingwhich is usedtotreat more detailed studies are needed to confirm the 0.001) advised have beenreported. However, they

The mean of the sensory dimensionperineal of The meanthe sensory of acupres- wasconductedinIran, using The study researchers al. (2004),the Hsiehet by In astudy In the acupressuregroup,mean of intensity isbasedonthedischarge cuppingtherapy Dry i.e . moving thewastematerials from laborandreducingthe J Reprod Infertil, Vol 17, No 1, Jan-Mar 2016 2016 Jan-Mar 1, No 17, Vol Infertil, Reprod J Akbarzade M, etal. the fact, the patients'the therapist.In relationshipwith of the disruption vention whichmightbe dueto between thetwogroups after 12 However, no significant difference wasobserved episiotomy. (p<0.001)after days 0.002) and5 two groups regarding the paincriteria 4 A significant differencewasfoundbetweenthe pain. the perineal reduction of lavender extracton Karaj, Iran in order toinvestigate the effect of on 60primiparous women inKamali hospital, status. Jahdi et al. (2012)conducted a clinical trial of greathelpinimprovingemotional thepatients’ during theinterventionandfollow-uphasbeen patients beside the the researcher uous presenceof dimension.for the sensory Moreover,thecontin- This might be due tothe same reasonmentioned after 2 weekscompared to24 dimension increased ofperinealpainintensity meanemotional group.However,the ofthe py decreased neal in thecuppingthera- pain intensity postpartum painswhilebreastfeeding. the pressure aswell thetherapist'sfinger by ference might bedue to thepatient's discomfort dif- of asignificant therapist. However,thelack the andtobeemotionally supportedby lonely valves (31). Thiscausesthe patient nottofeel of the pressure messages in the paincontrol pain throughreplacementsignals tohypothalamus of the transfer and preventing nous endorphins endoge- roleinreleasing akey Acupressure plays found compared group. tothecuppingtherapy decreased. However, no significant differencewas group intheacupressure perineal painintensity other hand, themean dimension ofthesensory of the pain (30).On reducesthepatients' eventually immune as well neurohormone and systems autonomic nervoussystem throughmediatingthe peripheral It nervous system. also stimulates the towards the skinand muscles andstimulates the flow the blood directs therapy nificant. Cupping sig- creased and thedifferenceswerestatistically groupde- inthecuppingtherapy pain intensity significant statistically were not the differences creased but de- pain intensity tional dimensionof perineal mension (32). ofpainintensity the emotionaldi- role in a critical patients play tionships between thecupping therapists andthe well rela- as the and psychological close physical result fromnature oftreatmentas thecontinuous The mean oftheemotional dimension ofperi- In the acupressure group, the meanemo-In theacupressuregroup, ofthe

psychological

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to

the

of

cupping cupping hr aftertheinter-

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44 cant reduction of pain was found in the cupping cant reductionofpainwasfoundinthe creased in bothinterventiongroups,butasignifi- de- ofpain theintensity Inthisstudy, safety. and its efficiency regard toaffect reported inthis ment of diseases and no complications havebeen supported the useof traditional medicine intreat- above 50% in72.8% andfor30-50% in21.9% of for results, painreduced Accordingtothe ery. fromperineal painresulting traumadeliv- during for varioustimeon using localicepacks periods of to assesstheeffect research inBrazilorder ahighersuccessrate. be accompaniedby will accessible totheresearcher,intervention It seems that in case of acupressure point iseasily organs’ functi the genital kle could mobilize flow,affect the blocked energy (35). Application ofacupuncture on therightan- first session(p=0.003andp=0.001,respectively) comparedthe to therapy third sessionsoflaser ofpaininthesecond and reduction intheintensity resultsrevealedasignificant scores. Thestudy 10 pain wasassessedusingascalecontaining for ofperineal three sessions.Then, the intensity suturing after episiotomy perineal points on three performed ous women. wasdirectly Lasertherapy neal pain resultingfrom episiotomy inprimipar- on improvement low-level lasertherapy peri- of theeffectof cal trial inAustraliaordertostudy Moreover, Santos etal.(2012)carriedoutaclini- (34). the icepacks were satisfiedwithusing participants all thestudy the subjects.Inaddition, medicine. beenimportanteases has always intraditional (33). Using the plant extractsfor treating thedis- in primiparous women. methods forreductionofpostpartum perinealpain and acupressure canbe considered aseffective therapy both cupping group.Therefore, therapy in ordertoconfirm theobtainedresults. issue studies arerequiredtobe conducted onthe in primiparousanxiety women. Ofcourse,further postpartumeffective methodsreduction of for andacupressurecanbeconsideredas ping therapy cup- Therefore, both group. therapy the cupping groups, but asignificantreductionwasfoundin postpartum pain reducedinbothintervention JRI Up to now, the findings of various studies have findings ofvariousstudies Up tonow,the Furthermore, Oliveira etal.(2012)performed a The findings of the present study showed that showed present study The findingsofthe

Dry Cupping andAcupressure onPostpartum Perineal Pain Conclusion J Reprod Infertil, Vol 17, No 1, Jan-Mar 2016 2016 Jan-Mar 1, No 17, Vol Infertil, Reprod J

on, and reduce thepain.

2. 1. 9. 8. 7. 6. 5. 4. 3. for improving thelanguageofmanuscript. hospital of MedicalSciences of ShirazUniversity Nemazeecenter in clinical research Shokrpour in TheauthorswouldliketothankDr the study. tal and all the women cooperated in who kindly thors would like to thank the head of Hafezhospi- au- the Hereby, Shiraz, Iran. Medical Sciences, of search Vice-chancellorofShirazUniversity posal No.91-6341,IRCT:2013072611944N2). Ms. written Mehrnoosh Ghaemmaghamiby (pro- Authors declarenoconflictofinterests. This study was financially supported by theRe- supportedby wasfinancially This study fromthesis was extracted the The presentarticle

Pain. 2006;22(1):19-24. medical and self-management strategies. ClinJ R. Men with pelvic pain: perceivedof helpfulness Turner JA, CiolMA, Von KorffM, Berger Liu YW, Anesthesiology. 2004;101(6):1472-4. ing aparamedialthe ganglionapproach toimpar. postherpetic neuralgia andsuccessful treatmentus- G.Sacral Malkuch BW, McAllister RK, Carpentier 2009;17(1):9-15. randomized controlled trial. Complement TherMed. wet-cuppingnonspecificina back pain for Iran: low Mohammadi R, Ahmadi A.Theeffectiveness of Farhadi K, Schwebel DC, Saeb M, Choubsaz M, 8. randomized controlled trial.2009;10(6):601-J Pain. therapy in patients with carpal tunnel syndrome: a M, Bachmannal.of traditionalJ, et Effects cupping Michalsen A, BockS,Ludtke R, Rampp T,Baecker col. 2002;16(1):99-115. sphincter trauma. Best Pract Lowe Sultan AH,ThakarR. MS, LeungAY,McBethMD.Malignant Wallace 1277-80. domised controlled trial. BMJ. 2001;322(7297): in labour andpreventionof perineal trauma:ran- Stamp G,Kruzins G,Crowther C. Perineal massage inside-needle Munir MA, ZhangJ,Ahmad M. Amodified needle- 2004;191(4):1199-204. a prospective cohort study.Am JObstetGynecol. determinantsperinealafter of pain vaginal delivery: Macarthur AJ,C. Churchill LivingstonePublishers;2002.585p. pain, textbook ofregional anesthesia. Pennsylvania: Can JAnaesth. 2004;51(9):915-7.

technique Conflict ofInterest Acknowledgement Acknowledgement References References

for

the Res ClinObstetGynae- Incidence, severity,and r genital tract and anal r genitaltractand

ganglion

impar

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