Acupressure-Moxibustion at GB-21 on Stress Levels and Blood Pressure in Primigravida Women with Gestational Age More Than 37 Weeks
Corresponding Author(s) : Ni Made Julia Wulan Dini
madewulan10@gmail.com
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 10 No. 2 (2022): 2022 Volume - 10 Issue - 2
Abstract
As many as 75% of third trimester primigravida pregnant women experience stress in Indonesia. Acumoxa GB-21 or a combination of acupressure and moxibustion can trigger relaxation and reduce serum corticosterone levels as well as improve psychological problems and its physiological parameters which are safe for pregnant women with gestational age >37 weeks. This study aims to determine the effect of acumoxa GB-21 therapy on stress levels and blood pressure of primigravida mothers with gestational age >37 weeks. This type of research is a quasi-experimental design pre and post-test control group with simple random sampling technique and randomization involving 32 primigravida women with gestational age >37 weeks who were divided into an intervention group (acumoxa point therapy GB21 for 10 minutes per day), and a control group (psychological education). Both groups were observed 3 times in 1 week using a Perceived Stress Scale questionnaire and an aneroid sphygmomanometer to measure blood pressure. Data analysis used independent t-test, Wilcoxon, Mann-Whitney. The stress level of the intervention group decreased by 8.44, while the control group was only 3.94, the comparison between groups (p<0.01). Analysis of blood pressure comparison data showed that the intervention group experienced a decrease in systolic of 6.25mmHg and diastolic of 8.13mmHg, while the control group did not experience a change so that there was a significant difference between the two groups (p<0.01). Acumoxa GB-21 can reduce the level of stress detected by the Perceived Stress Scale score and measured based on the value of systolic and diastolic blood pressure.
Keywords
Acupressure, Moxibustion, Stress, Blood Pressure
1.
Ni Made Julia Wulan Dini, Runjati, Ramlan D, Nurlaila Dilla T. Acupressure-Moxibustion at GB-21 on Stress Levels and Blood Pressure in Primigravida Women with Gestational Age More Than 37 Weeks. Int. J. of Allied Med. Sci. and Clin. Res. [Internet]. 2022 Apr. 22 [cited 2026 Jan. 20];10(2):152-9. Available from: https://ijamscr.com/ijamscr/article/view/1159
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References
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Runjati, Susanto H, Sawitri DR, Thaufik S. The effect of antenatal class plus coping skill training on the level of stress and childbirth self-efficacy. Adv Sci Lett. 2017;23:3329–33.
Mindasari Y, Yulifah R, W RCA. Hubungan Stress Ibu Pre-Operasi Seksio Sesarea Terhadap Penyembuhan Luka Operasi Sesarea di Ruang Nifas Rumah Sakit Ben Mari Malang. Nurs News (Meriden). 2017;2(2):150–62.
Khurade ST, Gowali S, C. CM, Shivaprakasha KS. Stress Detection Indicators: A Review. J Electron Commun Syst. 2019;4(1):12–7.
Handayani S. Pengukuran Tingkat Stres Dengan Perceived Stress Scale – 10?: Studi Cross Sectional Pada Remaja Putri Di Baturetno. J Keperawatan GSH. 2020;9(1).
World Health Organization. Maternal and child mental health [Internet]. 2019. Available from: https://www.who.int/teams/mental-health-and-substance-use/maternal-mental-health
Tang X, Lu Z, Hu D, Zhong X. Influencing factors for prenatal Stress, anxiety and depression in early pregnancy among women in Chongqing, China. J Affect Disord. 2019;253(January):292–302.
Wahyuni S, Anies, Soejoenoes A, Putra ST. Perceived stress dan sindrom depresi pada ibu primigravida. J Ilm Bidan. 2018;3(2):21–8.
Kasenda P, Wungouw H, Lolong J. Hubungan Stres Dengan Kejadian Insomnia Pada Ibu Hamil Di Puskesmas Bahu Kota Manado. J Keperawatan UNSRAT. 2017;5:1–7.
Fidora I, Hapsari ED, Rahmat I. Pengaruh Pendidikan Kesehatan Individu terhadap Perubahan Maternal Depressive Symptoms pada Ibu Post Partum. J Menara Med. 2018;1(1):66–74.
Sari H. Penerapan Terapi Kelompok Suportif Pada Ibu Hamil Dengan Ansietas Melalui Pendekatan Teori Mercer Di Kelurahan Balumbang Jaya, Bogor Barat. Idea Noursing J. 2013;2(2).
Taati F, Bahramnezhad F, Seyedfatemi N, Sharifi F, Navab E. The Effect of Participation in Support Groups on Depression, Anxiety and Stress in Family Caregivers of People with Alzheimer’s: Randomized clinical trail. Int J Med Res Heal Sci. 2016;5(75):256–62.
Murray A, Wilson K. Yoga and hypertension: a systematic review. J Yoga Phys Ther. 2018;8(2).
Hewett ZL, Pumpa KL, Smith CA, Fahey PP, Cheema BS. Effect of a 16-week Bikram yoga program on perceived stress, self-efficacy and health-related quality of life in stressed and sedentary adults: A randomised controlled trial. J Sci Med Sport. 2018;21:352–7.
Kim HJ, Kim JW, Park HS, Moon DG, Lee JG, Oh MM. The use of a heating pad to reduce anxiety, pain, and distress during cystoscopy in female patients. Int Urogynecol J. 2019;30(10):1705–10.
Wang L, Wang L, Shi G, Zeng L, Yang Y, Zhang T, et al. Efficacy and safety of ginger-salt-indirect moxibustion for urge urinary incontinence after stroke: Protocol for a pilot multicentre randomised controlled trial. BMJ Open. 2014;4(10):1–8.
KURNIAWATI MD. The Use of Oxytocin Electrostimulator Corsets as A Preventive Measures of Postpartum Bleeding Potential. In: 2Proceedings of the 5th International Seminar of Public Health and Education. Semarang: Universitas Negeri Semarang; 2020.
Deng H, Shen X. The mechanism of moxibustion: Ancient theory and modern research. Evidence-based Complement Altern Med. 2013;
Kesumawati KAM, Latifah L. The Effect of Acumoxa Therapy on Blood Pressure in Gestational Hypertension. Int J Nurs Heal Serv. 2020;3:569–75.
Kondo T, Kawamoto M. Acupuncture and moxibustion for stress-related disorders. 2014;2–11.
Carr DJ. The safety of obstetric acupuncture: forbidden points revisited. Acupunct Med. 2015;33(5):413–419.
Moradi Z, Akbarzadeh M, Moradi P, Toosi M, Hadianfard MJ. The Effect of Acupressure at GB-21 and SP-6 Acupoints on Anxiety Level and Maternal-Fetal Attachment in Primiparous Women: a Randomized Controlled Clinical Trial. Nurs Midwifery Stud. 2014;3(3):e19948.
Lee Y-T. Principle Study of Head Meridian Acupoint Massage to Stress Release via Grey Data Model Analysis. Evidence-based Complement Altern Med. 2016;19.
Matsubara T, Arai Y-CP, Shiro Y, Shimo K, Nishihara M, Sato J, et al. Comparative Effects of Acupressure at Local and Distal Acupuncture Points on Pain Conditions and Autonomic Function in Females with Chronic Neck Pain. Evidence-Based Complement Altern Med. 2011;6.
Dehghanmehr S, Mansouri A, Faghihi H, Piri F. The effect of acupressure on the anxiety of patients undergoing hemodialysis -a review. J Pharm Sci Res. 2017;9(12):2580–4.
Niko PF. Pengaruh Terapi Dzikir Untuk Menurunkan Kecemasan Pada Ibu Hamil. J Islam. 2018;1:24–33.
Erisna M, Runjati R, Kartini A, Azam M, Mulyantoro DK. The Impact of Maryam Exercise Towards the Stress Level and Cortisol Serum Level among Primiparous Pregnant Women. Int J Nurs Heal Serv. 2020;3(5):598–607.
Yi T, Qi L, Li J, Le JJ, Shao L, Du X, et al. Moxibustion upregulates hippocampal progranulin expression. Neural Regen Res. 2016;11(4):610–6.
Suzuki S, Tobe C. Effect of Acupressure, Acupuncture and Moxibustion in Women With Pregnancy-Related Anxiety and Previous Depression: A Preliminary Study. J Clin Med Res. 2017;9(6):525–7.
Cho Y, Joo J-M, Sok, Kim S, Sohyune. Effects of Meridian Acupressure on Stress, Fatigue, Anxiety, and Self-Efficacy of Shiftwork Nurses in South Korea. Int J Environ Res Public Health. 2021;18(8):4199.
Siddiqui MJ, Kamarudin MF Bin, Al-Shami AKM, So’ad SZM, Jamshed SQ, Siddiqui MJ, et al. Moxibustion (Artemisia plant at acupuncture point) as alternative therapy in Hypertension: A promising approach. J Pharm BioAllied Sci. 2017;9(4):279–81.
Sarli D, Putri AD. Acupressure Point Gall Bladder 21 (Gb21) Terhadap Tekanan Darah Dan Jumlah Perdarahan Pada Ibu Postpartum. J Ilmu Kesehat. 2020;4(2):89–94.
References
Runjati, Susanto H, Sawitri DR, Thaufik S. The effect of antenatal class plus coping skill training on the level of stress and childbirth self-efficacy. Adv Sci Lett. 2017;23:3329–33.
Mindasari Y, Yulifah R, W RCA. Hubungan Stress Ibu Pre-Operasi Seksio Sesarea Terhadap Penyembuhan Luka Operasi Sesarea di Ruang Nifas Rumah Sakit Ben Mari Malang. Nurs News (Meriden). 2017;2(2):150–62.
Khurade ST, Gowali S, C. CM, Shivaprakasha KS. Stress Detection Indicators: A Review. J Electron Commun Syst. 2019;4(1):12–7.
Handayani S. Pengukuran Tingkat Stres Dengan Perceived Stress Scale – 10?: Studi Cross Sectional Pada Remaja Putri Di Baturetno. J Keperawatan GSH. 2020;9(1).
World Health Organization. Maternal and child mental health [Internet]. 2019. Available from: https://www.who.int/teams/mental-health-and-substance-use/maternal-mental-health
Tang X, Lu Z, Hu D, Zhong X. Influencing factors for prenatal Stress, anxiety and depression in early pregnancy among women in Chongqing, China. J Affect Disord. 2019;253(January):292–302.
Wahyuni S, Anies, Soejoenoes A, Putra ST. Perceived stress dan sindrom depresi pada ibu primigravida. J Ilm Bidan. 2018;3(2):21–8.
Kasenda P, Wungouw H, Lolong J. Hubungan Stres Dengan Kejadian Insomnia Pada Ibu Hamil Di Puskesmas Bahu Kota Manado. J Keperawatan UNSRAT. 2017;5:1–7.
Fidora I, Hapsari ED, Rahmat I. Pengaruh Pendidikan Kesehatan Individu terhadap Perubahan Maternal Depressive Symptoms pada Ibu Post Partum. J Menara Med. 2018;1(1):66–74.
Sari H. Penerapan Terapi Kelompok Suportif Pada Ibu Hamil Dengan Ansietas Melalui Pendekatan Teori Mercer Di Kelurahan Balumbang Jaya, Bogor Barat. Idea Noursing J. 2013;2(2).
Taati F, Bahramnezhad F, Seyedfatemi N, Sharifi F, Navab E. The Effect of Participation in Support Groups on Depression, Anxiety and Stress in Family Caregivers of People with Alzheimer’s: Randomized clinical trail. Int J Med Res Heal Sci. 2016;5(75):256–62.
Murray A, Wilson K. Yoga and hypertension: a systematic review. J Yoga Phys Ther. 2018;8(2).
Hewett ZL, Pumpa KL, Smith CA, Fahey PP, Cheema BS. Effect of a 16-week Bikram yoga program on perceived stress, self-efficacy and health-related quality of life in stressed and sedentary adults: A randomised controlled trial. J Sci Med Sport. 2018;21:352–7.
Kim HJ, Kim JW, Park HS, Moon DG, Lee JG, Oh MM. The use of a heating pad to reduce anxiety, pain, and distress during cystoscopy in female patients. Int Urogynecol J. 2019;30(10):1705–10.
Wang L, Wang L, Shi G, Zeng L, Yang Y, Zhang T, et al. Efficacy and safety of ginger-salt-indirect moxibustion for urge urinary incontinence after stroke: Protocol for a pilot multicentre randomised controlled trial. BMJ Open. 2014;4(10):1–8.
KURNIAWATI MD. The Use of Oxytocin Electrostimulator Corsets as A Preventive Measures of Postpartum Bleeding Potential. In: 2Proceedings of the 5th International Seminar of Public Health and Education. Semarang: Universitas Negeri Semarang; 2020.
Deng H, Shen X. The mechanism of moxibustion: Ancient theory and modern research. Evidence-based Complement Altern Med. 2013;
Kesumawati KAM, Latifah L. The Effect of Acumoxa Therapy on Blood Pressure in Gestational Hypertension. Int J Nurs Heal Serv. 2020;3:569–75.
Kondo T, Kawamoto M. Acupuncture and moxibustion for stress-related disorders. 2014;2–11.
Carr DJ. The safety of obstetric acupuncture: forbidden points revisited. Acupunct Med. 2015;33(5):413–419.
Moradi Z, Akbarzadeh M, Moradi P, Toosi M, Hadianfard MJ. The Effect of Acupressure at GB-21 and SP-6 Acupoints on Anxiety Level and Maternal-Fetal Attachment in Primiparous Women: a Randomized Controlled Clinical Trial. Nurs Midwifery Stud. 2014;3(3):e19948.
Lee Y-T. Principle Study of Head Meridian Acupoint Massage to Stress Release via Grey Data Model Analysis. Evidence-based Complement Altern Med. 2016;19.
Matsubara T, Arai Y-CP, Shiro Y, Shimo K, Nishihara M, Sato J, et al. Comparative Effects of Acupressure at Local and Distal Acupuncture Points on Pain Conditions and Autonomic Function in Females with Chronic Neck Pain. Evidence-Based Complement Altern Med. 2011;6.
Dehghanmehr S, Mansouri A, Faghihi H, Piri F. The effect of acupressure on the anxiety of patients undergoing hemodialysis -a review. J Pharm Sci Res. 2017;9(12):2580–4.
Niko PF. Pengaruh Terapi Dzikir Untuk Menurunkan Kecemasan Pada Ibu Hamil. J Islam. 2018;1:24–33.
Erisna M, Runjati R, Kartini A, Azam M, Mulyantoro DK. The Impact of Maryam Exercise Towards the Stress Level and Cortisol Serum Level among Primiparous Pregnant Women. Int J Nurs Heal Serv. 2020;3(5):598–607.
Yi T, Qi L, Li J, Le JJ, Shao L, Du X, et al. Moxibustion upregulates hippocampal progranulin expression. Neural Regen Res. 2016;11(4):610–6.
Suzuki S, Tobe C. Effect of Acupressure, Acupuncture and Moxibustion in Women With Pregnancy-Related Anxiety and Previous Depression: A Preliminary Study. J Clin Med Res. 2017;9(6):525–7.
Cho Y, Joo J-M, Sok, Kim S, Sohyune. Effects of Meridian Acupressure on Stress, Fatigue, Anxiety, and Self-Efficacy of Shiftwork Nurses in South Korea. Int J Environ Res Public Health. 2021;18(8):4199.
Siddiqui MJ, Kamarudin MF Bin, Al-Shami AKM, So’ad SZM, Jamshed SQ, Siddiqui MJ, et al. Moxibustion (Artemisia plant at acupuncture point) as alternative therapy in Hypertension: A promising approach. J Pharm BioAllied Sci. 2017;9(4):279–81.
Sarli D, Putri AD. Acupressure Point Gall Bladder 21 (Gb21) Terhadap Tekanan Darah Dan Jumlah Perdarahan Pada Ibu Postpartum. J Ilmu Kesehat. 2020;4(2):89–94.
Mindasari Y, Yulifah R, W RCA. Hubungan Stress Ibu Pre-Operasi Seksio Sesarea Terhadap Penyembuhan Luka Operasi Sesarea di Ruang Nifas Rumah Sakit Ben Mari Malang. Nurs News (Meriden). 2017;2(2):150–62.
Khurade ST, Gowali S, C. CM, Shivaprakasha KS. Stress Detection Indicators: A Review. J Electron Commun Syst. 2019;4(1):12–7.
Handayani S. Pengukuran Tingkat Stres Dengan Perceived Stress Scale – 10?: Studi Cross Sectional Pada Remaja Putri Di Baturetno. J Keperawatan GSH. 2020;9(1).
World Health Organization. Maternal and child mental health [Internet]. 2019. Available from: https://www.who.int/teams/mental-health-and-substance-use/maternal-mental-health
Tang X, Lu Z, Hu D, Zhong X. Influencing factors for prenatal Stress, anxiety and depression in early pregnancy among women in Chongqing, China. J Affect Disord. 2019;253(January):292–302.
Wahyuni S, Anies, Soejoenoes A, Putra ST. Perceived stress dan sindrom depresi pada ibu primigravida. J Ilm Bidan. 2018;3(2):21–8.
Kasenda P, Wungouw H, Lolong J. Hubungan Stres Dengan Kejadian Insomnia Pada Ibu Hamil Di Puskesmas Bahu Kota Manado. J Keperawatan UNSRAT. 2017;5:1–7.
Fidora I, Hapsari ED, Rahmat I. Pengaruh Pendidikan Kesehatan Individu terhadap Perubahan Maternal Depressive Symptoms pada Ibu Post Partum. J Menara Med. 2018;1(1):66–74.
Sari H. Penerapan Terapi Kelompok Suportif Pada Ibu Hamil Dengan Ansietas Melalui Pendekatan Teori Mercer Di Kelurahan Balumbang Jaya, Bogor Barat. Idea Noursing J. 2013;2(2).
Taati F, Bahramnezhad F, Seyedfatemi N, Sharifi F, Navab E. The Effect of Participation in Support Groups on Depression, Anxiety and Stress in Family Caregivers of People with Alzheimer’s: Randomized clinical trail. Int J Med Res Heal Sci. 2016;5(75):256–62.
Murray A, Wilson K. Yoga and hypertension: a systematic review. J Yoga Phys Ther. 2018;8(2).
Hewett ZL, Pumpa KL, Smith CA, Fahey PP, Cheema BS. Effect of a 16-week Bikram yoga program on perceived stress, self-efficacy and health-related quality of life in stressed and sedentary adults: A randomised controlled trial. J Sci Med Sport. 2018;21:352–7.
Kim HJ, Kim JW, Park HS, Moon DG, Lee JG, Oh MM. The use of a heating pad to reduce anxiety, pain, and distress during cystoscopy in female patients. Int Urogynecol J. 2019;30(10):1705–10.
Wang L, Wang L, Shi G, Zeng L, Yang Y, Zhang T, et al. Efficacy and safety of ginger-salt-indirect moxibustion for urge urinary incontinence after stroke: Protocol for a pilot multicentre randomised controlled trial. BMJ Open. 2014;4(10):1–8.
KURNIAWATI MD. The Use of Oxytocin Electrostimulator Corsets as A Preventive Measures of Postpartum Bleeding Potential. In: 2Proceedings of the 5th International Seminar of Public Health and Education. Semarang: Universitas Negeri Semarang; 2020.
Deng H, Shen X. The mechanism of moxibustion: Ancient theory and modern research. Evidence-based Complement Altern Med. 2013;
Kesumawati KAM, Latifah L. The Effect of Acumoxa Therapy on Blood Pressure in Gestational Hypertension. Int J Nurs Heal Serv. 2020;3:569–75.
Kondo T, Kawamoto M. Acupuncture and moxibustion for stress-related disorders. 2014;2–11.
Carr DJ. The safety of obstetric acupuncture: forbidden points revisited. Acupunct Med. 2015;33(5):413–419.
Moradi Z, Akbarzadeh M, Moradi P, Toosi M, Hadianfard MJ. The Effect of Acupressure at GB-21 and SP-6 Acupoints on Anxiety Level and Maternal-Fetal Attachment in Primiparous Women: a Randomized Controlled Clinical Trial. Nurs Midwifery Stud. 2014;3(3):e19948.
Lee Y-T. Principle Study of Head Meridian Acupoint Massage to Stress Release via Grey Data Model Analysis. Evidence-based Complement Altern Med. 2016;19.
Matsubara T, Arai Y-CP, Shiro Y, Shimo K, Nishihara M, Sato J, et al. Comparative Effects of Acupressure at Local and Distal Acupuncture Points on Pain Conditions and Autonomic Function in Females with Chronic Neck Pain. Evidence-Based Complement Altern Med. 2011;6.
Dehghanmehr S, Mansouri A, Faghihi H, Piri F. The effect of acupressure on the anxiety of patients undergoing hemodialysis -a review. J Pharm Sci Res. 2017;9(12):2580–4.
Niko PF. Pengaruh Terapi Dzikir Untuk Menurunkan Kecemasan Pada Ibu Hamil. J Islam. 2018;1:24–33.
Erisna M, Runjati R, Kartini A, Azam M, Mulyantoro DK. The Impact of Maryam Exercise Towards the Stress Level and Cortisol Serum Level among Primiparous Pregnant Women. Int J Nurs Heal Serv. 2020;3(5):598–607.
Yi T, Qi L, Li J, Le JJ, Shao L, Du X, et al. Moxibustion upregulates hippocampal progranulin expression. Neural Regen Res. 2016;11(4):610–6.
Suzuki S, Tobe C. Effect of Acupressure, Acupuncture and Moxibustion in Women With Pregnancy-Related Anxiety and Previous Depression: A Preliminary Study. J Clin Med Res. 2017;9(6):525–7.
Cho Y, Joo J-M, Sok, Kim S, Sohyune. Effects of Meridian Acupressure on Stress, Fatigue, Anxiety, and Self-Efficacy of Shiftwork Nurses in South Korea. Int J Environ Res Public Health. 2021;18(8):4199.
Siddiqui MJ, Kamarudin MF Bin, Al-Shami AKM, So’ad SZM, Jamshed SQ, Siddiqui MJ, et al. Moxibustion (Artemisia plant at acupuncture point) as alternative therapy in Hypertension: A promising approach. J Pharm BioAllied Sci. 2017;9(4):279–81.
Sarli D, Putri AD. Acupressure Point Gall Bladder 21 (Gb21) Terhadap Tekanan Darah Dan Jumlah Perdarahan Pada Ibu Postpartum. J Ilmu Kesehat. 2020;4(2):89–94.