Archive for April, 2017

Never-ending Auriculotherapy Research

Tuesday, April 25th, 2017

Auriculotherapy to reduce anxiety and pain in nursing professionals: A randomized clinical trial.

Rev Lat Am Enfermagem. 2017 Apr 6;25 - Kurebayashi, Turrini, Souza, Marques, Rodrigues, Charlesworth.

Objectives: To evaluate the effectiveness of the auricular protocol (APPA) in reducing pain and anxiety and improving the quality of life of the nursing staff of a hospital.

Method: Randomized clinical trial with an initial sample of 180 professionals divided into 4 groups Control (G1), Seed (G2), Needle (G3) and Tape (G4). The evaluation instruments were the State-Trait Anxiety Inventory, Pain Visual Analog Scale and Quality of Life instrument, applied at the start and after five and 10 sessions (five weeks).

Results: There was a statistical difference (p < 0.05) for anxiety according to the repeated measures ANOVA, with better results for the G3 in the final assessment. There was a reduction of pain of 36% in G3 and 24% in G2 and a 13% increase in the mental aspect of quality of life for the G3, although without statistical significance.

Conclusion: The APPA protocol reduced the anxiety levels of nursing staff after 10 sessions…

Auricular Acupuncture Analgesia in Thoracic Trauma: A Case Report.

J Acupunct Meridian Stud. 2017 Jan;10(1):49-52. Papadopoulos, Tzimas, Liarmakopoulou, Petrou.

We report a case of thoracic trauma (rib fractures with pneumothorax and pulmonary contusions) with severe chest pain leading to ineffective ventilation and oxygenation. The patient presented to our emergency department. The patient had chronic obstructive pulmonary disease and was completely unable to take deep breaths and clear secretions from his bronchial tree. After obtaining informed consent, we applied auricular acupuncture to ameliorate pain and hopefully improve his functional ability to cough and breathe deeply. Within a few minutes, his pain scores diminished considerably, and his ventilation and oxygenation indices improved to safe limits. Auricular acupuncture analgesia lasted for several hours. Parallel to pain reduction, hemodynamic disturbances and anxiety significantly resolved. A second treatment nearly a day later resulted in almost complete resolution of pain that lasted at least 5 days and permitted adequate ventilation, restored oxygenation, and some degree of mobilization (although restricted due to a compression fracture of a lumbar vertebra). Nonopioid and opioid analgesics were sparsely used in low doses during the entire hospitalization period. Hemodynamic alterations and anxiety also decreased, and the patient was soon ready to be discharged.

Effects of Auricular Acupressure Therapy on Stress and Sleep Disturbance of Middle-Aged Women in South Korea.

Holist Nurs Pract. 2017 Mar/Apr;31(2):102-109. Cha NH, Park YK, Sok SR.

This study sought to examine the effect of auricular acupressure therapy on the stress and sleep status of middle-aged women in South Korea. A quasi-experimental pre-test/post-test control group design was employed. The study sample consisted of 67 middle-aged women (experimental: 35 samples; control: 32 samples) in Seoul, South Korea. Auricular acupressure therapy including the auricular acupressure needle on the skin paper tape was applied on an ear for 2 weeks, 2 times per week. The acupoints were Gyogam, Sinmun, Bushin, Naebunbi, and Pijilha. For the placebo control group, only the skin paper tape without the auricular acupressure needle was applied on the same acupoints. Measures were a stress scale, cortisol level in blood, and a sleep status scale. The findings showed that there were significant differences on stress, cortisol level in blood, and sleep status. Health care providers should consider providing auricular acupressure therapy as an alternative method for reducing physical and psychological stress, cortisol level in blood, and sleep disturbance…

Effects of auriculotherapy on labour pain: A randomized clinical trial.

Rev Esc Enferm USP. 2016 Sep-Oct;50(5):726-732. Mafetoni RR, Shimo AK.

OBJECTIVE: Assessing the effects of auriculotherapy in pain control and its outcomes on the duration of labour.

METHOD: This is a randomized, controlled, double-blind trial with preliminary data. Thirty pregnant women with gestational age ≥ 37 weeks, cervical dilatation ≥ 4 cm and two or more contractions in 10 minutes were selected and randomly divided into three groups: auriculotherapy, placebo and control. Auriculotherapy was applied using crystal beads on four strategic points.

RESULTS: No statistical significance was found between the groups with regard to pain; however, the women from the auriculotherapy group had lower intensity and less perception of pain at 30, 60 and 120 minutes of treatment. The average duration of labour was shorter in the auriculotherapy group (248.7 versus placebo 414.8 versus control 296.3 minutes); caesarean section rates were higher in the placebo group (50%) and the same in the other groups (10%).

CONCLUSION: Mothers who received auriculotherapy presented a tendency for greater pain control and shorter labour duration; however, caesarean section rates in this group were similar to the control group. This trial precedes a larger study in progress.

Combined Acupuncture and Auriculotherapy in Burning Mouth Syndrome Treatment: A Preliminary Single-Arm Clinical Trial.

J Altern Complement Med. 2017 Feb;23(2):126-134. Franco FR, Castro LA, Borsatto MC, Silveira EA, Ribeiro-Rotta RF.

BACKGROUND: Burning mouth syndrome (BMS) is a chronic pain disorder that is difficult to diagnose and refractory to treatment; it is more prevalent in pre- and postmenopausal women. Acupuncture and auriculotherapy have been suggested as options for the treatment of pain because they promote analgesia and allow for the reduction of symptoms with lower doses of drugs; this leads to greater patient compliance with treatment and has a positive effect on quality of life. Clinical trials investigating the effectiveness of acupuncture in the treatment of BMS are scarce in the literature.

OBJECTIVE: To investigate the effect of combined acupuncture and auriculotherapy on pain management and quality of life in patients with BMS.

METHODS: Sixty patients with BMS were subjected to a thorough differential diagnosis. Of these, 12 met the inclusion criteria and agreed to participate. Eight patients completed treatment with acupuncture and auriculotherapy using a previously established protocol. The outcome variables were analyzed before and after treatment: pain/burning (visual analog scale; VAS), salivary flow (unstimulated sialometry), and quality of life (Short-Form Oral Health Impact Profile [OHIP-14]). Two-year follow-up was carried out by assessing VAS and OHIP-14.

RESULTS: The intensity of pain/burning decreased significantly after the first treatment sessions, as shown by low values on the VAS (0-2) and a subjective indicator of quality of life. There was no relationship between salivary flow and the intensity of pain/burning. At 2-year follow-up, no statistically significant difference was observed for VAS, but improvement on OHIP-14 was seen.

CONCLUSIONS: Combined acupuncture/auriculotherapy was effective in reducing the intensity of burning and improving quality of life. There was no relationship between salivary flow and the intensity of burning mouth. Patients’ status improved after acupuncture and auriculotherapy at 2-year follow-up.

Auricular Acupuncture Versus Progressive Muscle Relaxation in Patients with Anxiety Disorders or Major Depressive Disorder: A Prospective Parallel Group Clinical Trial.

J Acupunct Meridian Stud. 2016 Aug;9(4):191-9. de Lorent L, Agorastos A, Yassouridis A, Kellner M, Muhtz C.

Although acupuncture treatment is increasingly in demand among psychiatric patients, to date no studies have investigated the effectiveness of auricular acupuncture (AA) in treating anxiety disorders or major depressive disorder. Thus, this study aimed to compare the effectiveness of AA versus progressive muscle relaxation (PMR), a standardized and accepted relaxation method. We examined 162 patients with a primary diagnosis of anxiety disorder or major depressive disorder, and each patient chose between treatment with AA, executed according to the National Acupuncture Detoxification Association protocol, and treatment with PMR. Each group had treatments twice a week for 4 weeks. Before and after treatment, each participant rated four items on a visual analog scale: anxiety, tension, anger/aggression, and mood. Statistical analyses were performed with the original visual analog scale scores and the Change-Intensity Index, an appropriate indicator of the difference between two values of a variable. Our results show that treatment with AA significantly decreased tension, anxiety, and anger/aggression throughout the 4 weeks, but did not elevate mood. Between AA and PMR, no statistically significant differences were found at any time. Thus, we suggest that both AA and PMR may be useful, equally-effective additional interventions in the treatment of the above-mentioned disorders.

A case series of auricular acupuncture in a veteran’s population using a revised auricular mapping-diagnostic paradigm (RAMP-uP).

Complement Ther Med. 2016 Aug;27:130-6. Huang W, Halpin SN, Perkins MM.

OBJECTIVES: To evaluate clinical effects of auricular acupuncture treatments for pain based on a revised auricular mapping and diagnostic paradigm (RAMP-uP).

MAIN OUTCOME MEASURES: Pain and efficacy rating scores based on visual analogue scales during each clinical visit. Duration of acupuncture treatment effects based on clinic notes documentation.

RESULTS: Patients’ average pain score decreased by almost 60% (p<0.0001). The treatment effects lasted 1-3 months (47%). The overall efficacy reported by most patients was helpful (83.6%).

CONCLUSION: The observed clinical effects of auricular acupuncture based on RAMP-uP are promising. Further research is needed to assess its feasibility to generalize and generate clinical effects in randomized controlled clinical trials.

The effect of auricular acupressure on nausea and vomiting caused by chemotherapy among breast cancer patients.

Complement Ther Clin Pract. 2016 Aug;24:189-94. Eghbali M, Yekaninejad MS, Varaei S, Jalalinia SF, Samimi MA, Sa’atchi K.

OBJECTIVE: The aim of this study was to determine the effect of auricular acupressure in relieving nausea and vomiting among the women who received chemotherapy.

METHODS: 48 women suffering from Breast Cancer and receiving chemotherapy were recruited for the study. The patients were randomly assigned into two groups of experiment and control. In the initial phase of chemotherapy, the experimental group received standard medications to control nausea and vomiting and auricular acupressure for five days. Meanwhile, the control group received only the standard medications.

RESULTS: The use of auricular acupressure led to the decrease in the number and intensity of nausea and vomiting in both the acute and delayed phases in experimental group which were significantly lower than the control group (P = 0/001).

CONCLUSIONS: It is suggested that nurses use this pressure technique as a complementary treatment, non - pharmacological, inexpensive, non-invasive approach for the relief of chemotherapy-induced nausea and vomiting.

Active Somatic and Psychic Ear Acupuncture Points in Newborn Infants with Neonatal Abstinence Syndrome.

J Altern Complement Med. 2016 Oct;22(10):788-793. Kurath-Koller S, Pansy J, Mileder LP, Schmölzer GM, Urlesberger B, Raith W.

BACKGROUND: Neonatal abstinence syndrome (NAS) occurs within the first days after birth in newborns of mothers with a history of drug abuse. It may also occur in newborns whose mothers are undergoing substitution therapy.

OBJECTIVE: To determine the presence of active ear acupuncture points in newborn infants with NAS.

METHODS: Among newborn infants with NAS admitted to the Division of Neonatology at the University Hospital Graz between March 2009 and November 2014, an acupuncture-point detector (PS3 Silberbauer, Vienna, Austria) was used to identify active ear acupuncture points. An integrated optical and acoustical signal detects the ear points, which were then assigned to the ear map. A total of 31 newborn infants were assessed; 1 infant was excluded, however, because the mother had already weaned herself off opiates before admission.

RESULTS: The excluded infant did not develop signs of NAS, had a low Finnegan score (3 points), and did not present any detectable active psychic ear acupuncture points. In all included newborn infants with NAS, active ear acupuncture points were identified: The psychovegetative rim was the most common active somatic area in each infant, followed by a few somatic and psychic ear acupuncture points. In all infants with symptoms of NAS, active psychic ear points were identified, of which the most frequently found points were the Frustration point and the R point.

CONCLUSION: The activity of psychic ear acupuncture points may be specific for neonates with NAS.

Effects of Auricular Acupressure on Obesity in Women with Abdominal Obesity.

J Korean Acad Nurs. 2016 Apr;46(2):249-59. Cha HS, Park H.

PURPOSE: The purpose of this study was to examine the effects of auricular acupressure on reducing obesity in adult women with abdominal obesity.

METHODS: The study design was a non-equivalent control group pretest-posttest design. Participants were 58 women, aged 20 years or older, assigned to the experimental group (n=30) or control group (n=28). Auricular acupressure using vaccaria seeds was administered to the experimental group. The sessions continued for 8 weeks. Outcome measures included body weight, abdominal circumference, and body mass index, body fat mass, body fat percentage, triglyceride, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and serum glucose.

RESULTS: Women in the experimental group showed significant decreases in body, abdominal circumference, and body mass index after 8 weeks compared with those in the control group.

CONCLUSION: Results show that auricular acupressure using vaccaria seeds was effective in decreasing body weight, abdominal circumference, body mass index, and triglyceride levels in adult women with abdominal obesity.

Efficacy of modified auriculotherapy for post-operative pain control in patients subjected to laparoscopic cholecystectomy.

Cir Cir. 2016 Apr 27. Toca-Villegas J, Esmer-Sánchez D, García-Narváez J, Sánchez-Aguilar M, Hernández-Sierra JF.

BACKGROUND: The high frequency of post-operative pain in the patients after laparoscopic cholecystectomy has led to the need to use multiple analgesic therapies. These include auriculotherapy, although not very good results have been obtained with the traditional techniques.

OBJECTIVE: To evaluate the effectiveness of modified auriculotherapy for post-operative pain control in laparoscopic cholecystectomy patients.

MATERIAL AND METHODS: Double-blind controlled clinical trial. Experimental group: Different points ear puncture with xylocaine without needles vs. placebo group. Post-operative visual analogue scale (VAS) at 6, 12, 18, 24, 36, and 48h and rescue doses of analgesics, were measured in both groups.

RESULTS: At 6h post-operative, 87% of the auriculotherapy group had a VAS of <4 vs. 48% of placebo group, and 96 vs. 74%) at 18hours. At 24, 36 and 48h after surgery there were no differences, and as all of the patients in both groups had a VAS<4, they were discharged to the hospital.

CONCLUSIONS: Modified auriculotherapy was better to the conventional analgesics for post-operative pain control in patients subjected to laparoscopic cholecystectomy.

Efficiency of auricular acupuncture in climacteric symptoms after cancer treatments.

Climacteric. 2016 Jun;19(3):274-8. Viel E, Vanoli A, Melis A, Rocher F, Schipman B, Truong D.

OBJECTIVES: This paper aims to highlight the efficiency of auriculotherapy in the treatment of hot flushes, especially in cancer-related menopausal transition.

METHODS: We used systematically collected data from patients in 2014 in a medical oncology practice. The treatment was made according to the guidelines of The Inter-University Diploma and the cartography of the World Health Organization; data on satisfaction were collected orally.

RESULTS: In 2014, 49 patients, among whom 41 had cancer, were treated for hot flushes. Although it is not recommended to treat several symptoms during the same session, we dealt with 1.7 symptoms per session on average. Sixty-nine percent of the patients were satisfied. We lacked data for nine patients, who did not come to the minimal recommended number of treatments (three). Only one patient among those who did not observe any improvement received three treatments.

CONCLUSIONS: Auricular acupuncture is a safe and cheap method to treat hot flushes. It has been effective in numerous and various cases, among which were patients who presented cancer-related menopausal symptoms. It may be applied for a large variety of other symptoms.

Ear Acupuncture for Acute Sore Throat: A Randomized Controlled Trial.

J Am Board Fam Med. 2015 Nov-Dec;28(6):697-705. Moss DA, Crawford P.

BACKGROUND: Sore throat is a common cause of pain in outpatient encounters. Battlefield auricular acupuncture (the placing of needles in specific points in the ear) is a modality used to treat acute pain associated with a variety of ailments. The aim of our study was to determine whether auricular acupuncture reduces pain, medication usage, and missed work hours when added to standard therapy in adult patients with acute sore throat.

METHODS: We conducted an unblinded, pragmatic, randomized controlled trial among adult, non-pregnant patients presenting to an Air Force family medicine clinic with pain from acute sore throat. A total of 54 patients were followed for 48 hours after treatment.

RESULTS: Patients receiving auricular acupuncture reported lower pain scores than those who did not at 15 minutes (6.0 vs 2.6), 6 hours (4.8 vs 2.5), and 24 hours (4.1 vs 1.3). They also reported taking fewer cumulative doses of pain medication at 6 hours (1.07 vs 0.39), 24 hours (2. vs 1.37), and 48 hours (4.07 vs 2.19). There was no difference in time missed from work between the auricular acupuncture and standard therapy groups.

CONCLUSIONS: Compared with usual treatment, battlefield auricular acupuncture was associated with reduced sore throat pain for 24 hours and decreased use of pain medication for up to 48 hours. There was no apparent effect on hours missed from work.

Exploring Self-Reported Benefits of Auricular Acupuncture Among Veterans With Posttraumatic Stress Disorder.

J Holist Nurs. 2016 Sep;34(3):291-9. King CH, Moore LC, Spence CD.

PURPOSE: Auricular acupuncture treatments are becoming increasingly available within military treatment facilities, resulting in an expansion of non-pharmacologic treatment options available to veterans with posttraumatic stress disorder (PTSD). This study aimed to explore the self-reported benefits of auricular acupuncture treatments for veterans living with PTSD.

DESIGN: A qualitative research methodology, thematic content analysis, was used to analyze data.

METHOD: Seventeen active duty veterans with PTSD provided written comments to describe their experiences and perceptions after receiving a standardized auricular acupuncture regimen for a 3-week period as part of a pilot feasibility study.

FINDINGS: A variety of symptoms experienced by veterans with PTSD were improved after receiving auricular acupuncture treatments. Additionally, veterans with PTSD were extremely receptive to auricular acupuncture treatments. Four themes emerged from the data: (1) improved sleep quality, (2) increased relaxation, (3) decreased pain, and (4) veterans liked/loved the auricular acupuncture treatments.

CONCLUSIONS: Veterans with PTSD reported numerous benefits following auricular acupuncture treatments. These treatments may facilitate healing and recovery for veterans with combat-related PTSD, although further investigations are warranted into the mechanisms of action for auricular acupuncture in this population.

Role of Auriculotherapy in the Treatment of Temporomandibular Disorders with Anxiety in University Students.

Evid Based Complement Alternat Med. 2015; Iunes DH, Chaves Éde C, Moura Cde C, Côrrea B, Carvalho LC, Silva AM, de Carvalho EC.

The aim of this study was to evaluate the role of auriculotherapy with mustard seeds in the treatment of temporomandibular disorders (TMDs), anxiety, and electromyographic (EMG) activity in university students. Methodology. The State Trait Anxiety Inventory (STAI), Research Diagnostic Criteria (RDC) for TMDs (RDC/TMDs), and electromyography were used in this study of 44 college students with high levels of anxiety and TMDs. The subjects were divided into two groups: an auriculotherapy (AA) group (n = 31) and an AA sham group (n = 13). The mustard seeds were applied to the shen men, rim, sympathetic, brain stem, and temporomandibular joint (TMJ) points in the AA group and to sham points in the external ear and wrist in the AA sham group. The treatment protocol was 10 sessions (two treatments per week). Results. Anxiety (p < 0.01) was significantly reduced in the AA group. This group also showed a decrease in tender points in the mandibular posterior region (p = 0.04) and in the right side of the submandibular region (p = 0.02). Complaints of bilateral pain were reduced in the temporal tendon (p ≤ 0.01) and in the left side of the ATM (p < 0.01). In addition, electromyographic (EMG) activity was reduced during temporal muscle contraction (p = 0.03).

Conclusion: Auriculotherapy was effective in the treatment of students with anxiety and TMDs.

Auricular vagal nerve stimulation ameliorates burn-induced gastric dysmotility via sympathetic-COX-2 pathways in rats.

Neurogastroenterol Motil. 2016 Jan;28(1):36-42. Li H, Yin J, Zhang Z, Winston JH, Shi XZ, Chen JD.

BACKGROUND: Severe burn injury has been demonstrated to delay gastric emptying. The aim of this study was to investigate effects and cellular mechanisms of auricular electroacupuncture (AEA) at the acupoints innervated by the auricular branch of vagus nerve on burn-induced gastric dysmotility in rats.

METHODS: Propranolol (β-adrenoceptor antagonist) was injected intraperitoneally after the rats underwent burn injury. All experiments were performed 6 h following burn/sham burn injury. AEA was performed at bilateral auricular acupoints for 45 min. Electrocardiogram was recorded for 30 min. Plasma hormones were measured; cyclooxygenase (COX)-2 expressions in gastric tissue were measured using western blotting and real-time RT-PCR.

KEY RESULTS: (i) Burn injury delayed gastric emptying (p = 0.006) and AEA increased gastric emptying by 49% (p = 0.045). (ii) Burn injury evoked a significant elevation in plasma noradrenaline, which was suppressed by AEA. (iii) Burn injury significantly increased protein and mRNA expressions of COX-2 in gastric fundus and antrum. AEA suppressed burn-induced increase in protein expressions, but not mRNA expressions of COX-2.

CONCLUSIONS & INFERENCES: Burn injury delays gastric emptying by up-regulating COX-2 attributed to sympathetic overactivity. AEA improves burn-induced delay in gastric emptying, possibly mediated via the sympathetic-COX-2 pathway.

Auricular acupuncture for pre-exam anxiety in medical students: a prospective observational pilot investigation.

Acupunct Med. 2016 Apr;34(2):90-4. Klausenitz C, Hesse T, Hacker H, Hahnenkamp K, Usichenko T.

OBJECTIVE: Auricular acupuncture (AA) is effective for the treatment of preoperative anxiety. We aimed to study the feasibility and effects of AA on exam anxiety in a prospective observational pilot study.

METHODS: Healthy medical students received bilateral AA using indwelling fixed needles at points MA-IC1, MA-TF1, MA-SC, MA-AH7, and MA-T on the day before an anatomy exam. The needles were removed after the exam. Anxiety levels were measured using the State-Trait-Anxiety Inventory (STAI) and a 100 mm visual analogue scale (VAS-100) before and after the AA intervention and once again immediately before the exam. The duration of sleep on the night before the exam was recorded and compared to that over the preceding 1 week and 6 months (all through students’ recollection). In addition, blood pressure, heart rate and the acceptability of AA to the students were recorded.

RESULTS: Ten students (all female) were included in the final analysis. All tolerated the needles well and stated they would wish to receive AA again for exam anxiety in the future. Exam anxiety measured using both STAI and VAS-100 decreased by almost 20% after AA.

CONCLUSIONS: AA was well accepted, the outcome measurement was feasible, and the results have facilitated the calculation of the sample size for a subsequent randomised controlled trial.

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