Effect of Chinese herbal medicine suppositories for hyperemesis gravidarum by using an index for nausea and vomiting of pregnancy.
"Chinese herbal medicines, which are considered effective and safe for
morning sickness and hyperemesis gravidarum in East Asia, present some
disadvantages when ingested orally, e.g., induction of nausea because of their
characteristic odour. Because of the above reason, we formulated and used
suppositories of Chinese herbal medicine extracts. The chief symptoms of
hyperemesis gravidarum are subjective, making it difficult to compare the
symptoms and evaluate efficacy of treatment. In the present clinical trial,
therefore, we categorised symptoms by severity and evaluated therapeutic
efficacy according to a questionnaire-based survey using the Index for Nausea
and Vomiting of Pregnancy.
It is difficult to evaluate hyperemesis gravidarum objectively, because of the fact that it mainly consists of subjective symptoms. Furthermore, the number of classes of the complaints considered to be symptoms of hyperemesis gravidarum is as numerous as 20. Based on the above background, the Emesis Index (EI) has been created, modified and used. The EI originally created chiefly consisted of three symptoms of high incidence and intense severity, i.e., nausea, vomiting, and appetite. The INVP, modified to include the symptoms of salivation and dryness of mouth and acetone in the urine, was used in the present clinical trial. The INVP is thought to be more useful than the EI for evaluating hyperemesis gravidarum.
Fluid therapy was combined in treating many cases. Suppositories alone were used in the majority of outpatients and in the inpatients who detested the odour of the fluid. These patients showed no particular problems, and the improving process of symptoms did not differ from the patients in whom fluid therapy was combined. In the patients in whom fluid therapy was used alone and in combination with suppositories, symptoms improved earlier at the time of combined therapy than at the time of fluid therapy alone.
Herbal remedies are recommended commonly for nausea and vomiting of pregnancy. Chinese herbal medicine suppositories appear to be a reasonable therapeutic alternative for hyperemesis gravidarum. A randomised trial is needed to confirm the efficacy of Chinese herbal medicine suppositories for hyperemesis gravidarum."