Posts Tagged ‘Auricular Acupuncture’

EVEN MORE RESEARCH SHOWING THE DRAMATIC CLINICAL EFFECTS OF AURICULOTHERAPY

Monday, September 12th, 2011

There are a lot of modalities available to complementary health care professionals nowadays, and many claim significant benefits and often share testimonials of miraculous results. Whenever I check out a new technique the first question I ask is “how does it work?” The answer needs to follow some kind of logical and plausible physiological principles before I even ask the second question; “is there any research?” I have to be honest that I struggle with web-sites and marketing materials that are full of claims and stories, but lacking in rationale and evidence. Auriculotherapy is one method that has continued to impress and excite me, and for this reason it is one of the primary modalities that I offer in my own practice. This is the third in a regular update of recent research.

First let’s summarise the most recent findings:

1) Satisfaction in a wellness clinic: This study involved feedback from health professionals being given access to wellness services including Auriculotherapy once a week in the workplace. Most participants agreed or strongly agreed they felt more relaxed after sessions (97.9%), less stress (94.5%), more energy (84.3%), and less pain (78.8%). Ninety-seven percent (97%) would recommend it to a co-worker. Among surveys completed after five or more visits, more than half (59%-85%) strongly agreed experiencing increased compassion with patients, better sleep, improved mood, and more ease in relations with co-workers. Perceived benefits were sustained and enhanced by number of visits.

2) Effects on autonomic function in healthy individuals: The results of this study using non-invasive assessment methods showed a significant decrease in heart rate, a significant increase in heart rate variability total, and marked (but statistically insignificant) decrease in pulse wave velocity. This translates to signs of decreased stress physiology internally.

3) Chronic low back pain: This pilot study found that Auriculotherapy was safe and demonstrated additional clinical benefits when combined with exercise for people with chronic low back pain. This supports my own observation that the best treatment for low back pain is a combination of passive and active treatment.

4) Effect on inflammatory reactions: This study using animals showed that Auriculotherapy can increase serum Tumour Necrosis Factor and Interleukin-6, and down-regulate pulmonary NF-kappa B p 65 expression suggesting a cholinergic anti-inflammatory mechanism. This suggests a neurological pathway for antiinflammatory effects of Auriculotherapy which makes sense since Auriculotherapy is a neurological intervention!

5) Treatment of migraine attacks: This study compared using a reflex point well documented to relieve migraine (group A) versus a point unlikely to have a therapeutic effect (group B). During treatment, there was a highly significant trend in the reduction of symptoms in group A, whereas no significance was observed in group B. Symptoms were significantly lower in group A than in group B at 10, 30, 60 and 120 min after treatment. This study suggests that the therapeutic specificity of auricular points exists and is linked to the somatotopic representation of our body on the ear.

6) Analgesia and sedative effects during abdominal gynecological operation and effects on postoperative recovery of body function: This showed sedative, analgesic and function-regulating effects from Auriculotherapy. Anxiety was less, lower-doses of anaesthesia were required, breathing response was improved after the operation, and higher levels of serum beta-endorphin were found when Auriculotherapy was added. Anything that potentially improves surgical outcomes sounds like a really good thing to me!

7) Improving postural stability: Balance performance was measured on a force platform before and after Auriculotherapy. Main balance parameters pointed to an average short-term improvement of about 15% 1 hour after treatment and 5-10% after an interval of 3 days. However, a few participants showed a better than 30% improvement with the same parameters. The explanation tentatively put forward to account for the results was that Auriculotherapy reduces nociceptive interference and thus improves postural control.

8) Treating headache, trigeminal neuralgia and retro-auricular pain in facial palsy: In this study Auriculotherapy treatment showed pain alleviation in headache, trigeminal neuralgia, and retro-auricular pain levels. The researchers noted that treatment number should be no less than 10 sessions.

9) Preoperative anxiety treatment: Preoperative anxiety has become more frequent in preoperative patients and can bring negative impact on operation outcomes. The study concluded that Auriculotherapy was significantly effective in decreasing anxiety in preoperative patients.

Sounds like some good reasons to check out Auriculotherapy training to me… Go to http://www.torquerelease.com.au/Auriculotherapy-Discount.htm to find out more…

Now for the abstracts:

1) Employee use and perceived benefit of a complementary and alternative medicine wellness clinic at a major military hospital: evaluation of a pilot program.

J Altern Complement Med. 2011 Sep;17(9):809-15. 2011 Aug 11. Duncan AD, Liechty JM, Miller C, Chinoy G, Ricciardi R.

Abstract Objectives: The objectives of this study were to examine the feasibility of a weekly on-site complementary and alternative medicine (CAM) wellness clinic for staff at a military hospital, and to describe employees’ perceptions of program effectiveness. Setting: The study setting was the Restore & Renew Wellness Clinic at a United States Department of Defense hospital. Subjects: The subjects were hospital nurses, physicians, clinicians, support staff, and administrators. Interventions: The walk-in wellness clinic was open 8:00am – 2:00pm 1 day a week. Participants selected one or more modalities each visit: ear acupuncture, clinical acupressure, and Zero Balancing. Outcome measures: A self-report survey was done after each clinic visit to evaluate clinic features and perceived impact on stress-related symptoms, compassion for patients, sleep, and workplace or personal relationships. Results: Surveys completed after first-time and repeat visits (n=2,756 surveys) indicated that most participants agreed or strongly agreed they felt more relaxed after sessions (97.9%), less stress (94.5%), more energy (84.3%), and less pain (78.8%). Ninety-seven percent (97%) would recommend it to a co-worker. Among surveys completed after five or more visits, more than half (59%-85%) strongly agreed experiencing increased compassion with patients, better sleep, improved mood, and more ease in relations with co-workers. Perceived benefits were sustained and enhanced by number of visits. The most frequently reported health habit changes were related to exercise, stress reduction, diet/nutrition, and weight loss. Conclusions: This evaluation suggests that a hospital-based wellness clinic based on CAM principles and modalities is feasible, well-utilized, and perceived by most participants to have positive health benefits related to stress reduction at work, improved mood and sleep, and lifestyle.

2) Brain-modulated effects of auricular acupressure on the regulation of autonomic function in healthy volunteers.

Evid Based Complement Alternat Med. 2011 Aug 29. Gao XY, Wang L, Gaischek I, Michenthaler Y, Zhu B, Litscher G.

Auricular acupuncture has been described in ancient China as well as Egypt, Greece, and Rome. At the end of the 1950s, ear acupuncture was further developed by the French physician Dr. Paul Nogier. The goal of this study was to develop a new system for ear acupressure (vibration stimulation) and to perform pilot investigations on the possible acute effects of vibration and manual ear acupressure on heart rate (HR), heart rate variability (HRV), pulse wave velocity (PWV), and the augmentation index (AIx) using new noninvasive recording methods. Investigations were performed in 14 healthy volunteers (mean age ± SD: 26.3 ± 4.3 years; 9 females, 5 males) before, during, and after acupressure vibration and manual acupressure stimulation at the “heart” auricular acupuncture point. The results showed a significant decrease in HR (P ≤ 0.001) and a significant increase in HRV total (P = 0.008) after manual ear acupressure. The PWV decreased markedly (yet insignificantly) whereas the AIx increased immediately after both methods of stimulation. The increase in the low-frequency band of HRV was mainly based on the intensification of the related mechanism of blood pressure regulation (10-s-rhythm). Further studies in Beijing using animal models and investigations in Graz using human subjects are already in progress.

3) Exercise and Auricular Acupuncture for Chronic Low-back Pain: A Feasibility Randomized-controlled Trial.

Clin J Pain. 2011 Jul 12. Hunter RF, McDonough SM, Bradbury I, Liddle SD, Walsh DM, Dhamija S, Glasgow P, Gormley G, McCann SM, Park J, Hurley DA, Delitto A, Baxter GD.

OBJECTIVES: To evaluate the feasibility of a randomized-controlled trial (RCT) investigating the effects of adding auricular acupuncture (AA) to exercise for participants with chronic low-back pain (CLBP).

METHODS: Participants with CLBP were recruited from primary care and a university population and were randomly allocated (n=51) to 1 of 2 groups: (1) “Exercise Alone (E)”-12-week program consisting of 6 weeks of supervised exercise followed by 6 weeks unsupervised exercise (n=27); or (2) “Exercise and AA (EAA)”-12-week exercise program and AA (n=24). Outcome measures were recorded at baseline, week 8, week 13, and 6 months. The primary outcome measure was the Oswestry Disability Questionnaire.

RESULTS: Participants in the EAA group demonstrated a greater mean improvement of 10.7% points (95% confidence interval, -15.3,-5.7) (effect size=1.20) in the Oswestry Disability Questionnaire at 6 months compared with 6.7% points (95% confidence interval, -11.4,-1.9) in the E group (effect size=0.58). There was also a trend towards a greater mean improvement in quality of life, LBP intensity and bothersomeness, and fear-avoidance beliefs in the EAA group. The dropout rate for this trial was lower than anticipated (15% at 6 mo), adherence with exercise was similar (72% E; 65% EAA). Adverse effects for AA ranged from 1% to 14% of participants.

DISCUSSION: Findings of this study showed that a main RCT is feasible and that 56 participants per group would need to be recruited, using multiple recruitment approaches. AA was safe and demonstrated additional benefits when combined with exercise for people with CLBP, which requires confirmation in a fully powered RCT.

4) Effect of electroacupuncture of auricular concha on inflammatory reaction in endotoxaemia rats.

Zhen Ci Yan Jiu. 2011 Jun;36(3):187-92. Zhao YX, He W, Gao XY, Rong PJ, Zhu B.

OBJECTIVE: To evaluate the effect of electroacupuncture (EA) of the auricular concha (EA-AC) on serum cytokines contents and pulmonary transcription factor nuclear factor-kappaB (NF-kappaB) expression in lipopolysaccharide (LPS) induced endotoxaemia rats so as to study its mechanism underlying cholinergic anti-inflammatory efficacy.

METHODS: Male SD rats were randomized into normal control, model (LPS), simple EA-AC, EA-AC + LPS, vagal nerve stimulation (VNS) + LPS, and EA-Zusanli (ST 36) + LPS groups (n = 12/group). Endotoxaemia model was duplicated by intravenous (tail vein) injection of LPS (0.5 mL/kg). Two intradermal needles were inserted into the central sites of the cavity of concha and cymba of auricular concha respectively on each side and stimulated electrically by using an electrical stimulator (i.e, EA-AC). VNS was applied to the left cervical vagal nerve, and EA (1 mA, 10 Hz, pulse-width 1 ms) was also applied to bilateral “Zusanli” (ST 36). Serum cytokines (TNF-alpha IL-6) contents 2 h after modeling were determined by using enzyme linked immunosorbent assay (ELISA), and pulmonary NF-kappaB p 65 expression 2 h after modeling was detected by using western blotting.

RESULTS: Compared with the normal control group, serum TNF-alpha and IL-6 contents, and pulmonary NF-kappaB p65 expression level in the model group were increased significantly (P < 0.01). In comparison with the model group, serum TNF-alpha contents in the simple EA-AC, EA-AC + LPS, VNS+ LPS and ST 36 + LPS groups, and serum IL-6 contents and pulmonary NF-kappaB p 65 expression levels in the simple EA-AC, EA-AC + LPS and VNS + LPS groups were down-regulated considerably (P < 0.05, P < 0.01). Compared with the VNS + LPS group, serum TNF-alpha -28) and IL-6 contents, and pulmonary NF-kappaB p 65 expression level in the ST 36 + LPS group were increased significantly (P < 0.05, P < 0.01). In comparison with the EA-AC + LPS group, pulmonary NF-kappaB p 65 expression level in the ST 36 + creased remarkably (P < 0.05).

CONCLUSION: Both EA of auricular concha and vagus nerve stimulation can increase serum TNF-alpha and IL-6 contents, and down-regulate pulmonary NF-kappaB p 65 expression level in endotoxaemia similar cholinergic anti-inflammatory mechanism between them.

5) Ear acupuncture in the treatment of migraine attacks: a randomized trial on the efficacy of appropriate versus inappropriate acupoints.

Neurol Sci. 2011 May;32 Suppl 1:S173-5. Allais G, Romoli M, Rolando S, Airola G, Castagnoli Gabellari I, Allais R, Benedetto C.

Ear acupuncture can be a useful mean for controlling migraine pain. It has been shown that a technique called the Needle Contact Test (NCT) can identify the most efficacious ear acupoints for reducing current migraine pain through just a few seconds of needle contact. The majority of the points were located on the antero-internal part of the antitragus (area M) on the same side of pain. The aim of this study was to verify the therapeutic value of area M and to compare it with an area of the ear (representation of the sciatic nerve, area S) which probably does not have a therapeutic effect on migraine attacks. We studied 94 females suffering from migraine without aura, diagnosed according to the ICHD-II criteria, during the attack. They were randomly subdivided into two groups: in group A, tender points located in area M, positive to NCT were inserted; in group B, the unsuitable area (S) was treated. Changes in pain intensity were measured using a VAS scale at various times of the study. During treatment, there was a highly significant trend in the reduction of the VAS value in group A (Anova for repeated measures: p < 0.001), whereas no significance was observed in group B. VAS values were significantly lower in group A than in group B at 10, 30, 60 and 120 min after needle insertion. This study suggests that the therapeutic specificity of auricular points exists and is linked to the somatotopic representation of our body on the ear.

6) Effects of magnetic auricular point-sticking on adjuvant anesthesia and postoperative recovery of body function.

Zhongguo Zhen Jiu. 2011 Apr;31(4):349-52. Li WS, Cui SS, Li WY, Zhao WX, Wanlai SQ.

OBJECTIVE: To prove analgesia and sedative effect of adjuvant anesthesia with magnetic auricular point-sticking on abdominal gynecological operation and its effect on postoperative recovery of body function.

METHODS: Ninety-two patients with abdominal gynecological operation were randomly divided into 3 groups. The auricular point-sticking group (APS group, n=31) was pasted and pressed by plasters with magnetic beads at bilateral Shenmen, Pizhixia (subcortex), Zigong (uterus) and Penqiang (pelvic cavity), etc. the night before operation. The placebo group (n=31) was pasted by plasters without magnetic beads. The blank group (n=30) was given no intervention. The mental and gastrointestinal functional changes before and 3 days after the operation were observed.

RESULTS: As compared with those in the control group and the blank group, the postoperative score of Self rating Anxiety Scale (SAS) was less (25.5 +/- 0.81 vs. 28.9 +/- 3.19, 28.3 +/- 2.36, both P < 0.01), with lower-dose of Innovar [(2.5 + 1.1) mL vs. (3.4 + 1.8) mL, (3.2 + 1.6) mL, both P < 0.05], earlier exsufflation after the operation [(34.2 + 12.1) h vs. (46.3 + 10.9) h, (43.2 + 14.8) h, both P < 0.01] and higher level serum of beta-endorphin before and after the operation in the APS group (all P < 0.05).

CONCLUSION: The magnetic auricular point-sticking has sedative, analgesic and function-regulating effects on the abdominal gynecological operation.

7) Laser acupuncture and auriculotherapy in postural instability – a preliminary report.

J Acupunct Meridian Stud. 2011 Mar;4(1):69-74. Bergamaschi M, Ferrari G, Gallamini M, Scoppa F.

The risk of falling is rather high among elderly people. Indexes obtained through the Romberg stabilometric test on a force platform have been suggested to be correlated with the risk of falling. This work aimed to test the effectiveness of auriculopuncture and ultralow-power laserpuncture versus placebo (sham stimulation) in improving postural control in an elderly population. Balance performance was measured on a force platform before and after both forms of stimulation. Main balance parameters pointed to an average short-term improvement of about 15% 1 hour after treatment and 5-10% after an interval of 3 days. However, a few participants showed a better than 30% improvement with the same parameters. Although the sample size does not allow reliable statistical analysis, the modifications are remarkable and some differences are observed between the two kinds of stimulation. Further testing with larger sized groups and including one further group using both stimulations is suggested. Although postural instability has to be defined as multi-factorial, it is often associated with balance dysfunctions that cannot be related to vestibular or central impairments but rather to proprioceptive deficits. A significant role may be ascribed to (even subliminal) nociceptive interferences with proprioceptive inputs and to a reduced capacity for updating cortical motor control models in the case of progressively declining locomotor capabilities. The explanation tentatively put forward to account for the results observed in the present preliminary study is that laser acupuncture and auriculopuncture stimulations reduce nociceptive interference and thus improve postural control.

8) A clinical pilot study comparing traditional acupuncture to combined acupuncture for treating headache, trigeminal neuralgia and retro-auricular pain in facial palsy.

J Acupunct Meridian Stud. 2011 Mar;4(1):29-43. Ahn CB, Lee SJ, Lee JC, Fossion JP, Sant’Ana A.

Traditional acupuncture (TA) and ear acupuncture (EA) are used for treatment of headache, trigeminal neuralgia, and retro-auricular pain. The purpose of this study is to develop effective treatment using combined acupuncture (CA) which consists of TA and EA and to set clinical protocols for future trials. Participants were divided into TA (n = 15) control and CA (n = 34) experimental groups. Obligatory points among Korean Five Element Acupuncture and optional individual points along with symptom points were used in the TA group. The CA group was exposed to ear points of Fossion and TA. Acupuncture treatment consisted of six mandatory sessions per patient over 3 weeks and extended to 12 sessions. Pain was assessed using the visual analogue scale. We compared TA to CA and researched their relevant publications. No significant difference was observed between the two groups (p = 0.968) which showed pain-alleviating tendency. Pain alleviation was significantly different after the fifth and sixth sessions (p = 0.021, p = 0.025), with headache being the most significantly relieved (F = 4.399, p = 0.018) among the diseases. When assessing pain intensity, both the Headache Impact Test and the Migraine Disability Assessment Scale should be adopted for headache and the fractal electroencephalography method be used in pain diseases. In the future, studies should consist of TA, EA, and CA groups; each group having 20 patients. Treatment number should to be no less than 10 sessions. Korean Five Element Acupuncture should be a compulsory inclusion along with individual points being optional inclusion in TA. EA could be selected from Nogier, Fossion and so forth. In conclusion, acupuncture treatment, whether TA or CA, showed pain alleviation in headache, trigeminal neuralgia, and retro-auricular pain, but no significant difference was seen between groups. Prospective, well-controlled, and relevant protocols using multimodal strategies to define the role of TA, EA, and CA are needed.

9) Comparing the treatment effectiveness of body acupuncture and auricular acupuncture in preoperative anxiety treatment.

J Res Med Sci. 2011 Jan;16(1):39-42. Wu S, Liang J, Zhu X, Liu X, Miao D.

BACKGROUND: Preoperative anxiety has become more frequent in preoperative patients and can bring negative impact on operation outcomes. Many studies have reported the effect of body acupuncture in reducing anxiety syndromes. The aim of this study is to compare the treatment effect of body acupuncture and auricular acupuncture in preoperative patients with preoperative anxiety.

METHODS: Thirty five elective ambulatory surgery patients were selected in the randomized and blinded trial. Subjects were randomly categorized in two intervention groups, the body acupuncture group who received acupuncture in the special points of body, and the auricular acupuncture group who received ear acupuncture. Zung Self-Rating Anxiety Scale (SAS) was used before and after the study.

RESULTS: For the auricular acupuncture group, the mean score of SAS was 57.57 ± 8.22 before the intervention and 46.32 ± 6.37 afterward. For the body acupuncture group, the SAS score was 55.39 ± 5.41 and 44.82 ± 6.76 before and after the intervention, respectively. For both groups, the difference between pre- and post-treatment scores reached the significant level (p = 0.00).

CONCLUSIONS: Both auricular and body acupuncture treatment methods were effective in decreasing anxiety in preoperative patients.

Sounds like some good reasons to check out Auriculotherapy training to me… Go to http://www.torquerelease.com.au/Auriculotherapy-Discount.htm to find out more…

MORE RECENT RESEARCH SHOWING THE DRAMATIC CLINICAL EFFECTS OF AURICULOTHERAPY

Saturday, March 12th, 2011

I see myself as first and foremost a Chiropractor, and I love to keep abreast of any recent research evidence supporting the chiropractic wellness scope of practice. But at the same time I like to keep an open mind towards other natural approaches and the modality that keeps impressing me and to a degree creates some envy in me in regards to the amount and quality of research being published, is Auriculotherapy (often referred to as auricular acupuncture in the literature). And this is the primary reason that Gill and I teach and endorse this therapeutic gem. The secondary reason is that we have both used this technique in practice for a number of years and the feedback we receive and observations that we make bolster our faith, confidence and belief that this is a “must have” service in clinical practice.

The last year seems to have been a particularly productive year as you will see from the following synopsis:

1) Reduced need for analgesia during hip replacement: Imagine if all medication doses could be reduced by 15% – Imagine a 15% reduction in adverse side effects – considering that this is now one of the leading causes of morbidity and mortality in our society that would be of enormous benefit!

2) Raynaud Disease: This study showed significant reduction in both frequency and severity of attacks, and the interesting follow-up was that the improvements were sustained months after cessation of treatment.

3) Antiinflammatory effects: Auriculotherapy is a great ally during crisis management and this study sheds some light on why. Based on an animal study it was shown that there is an antiinflammatory and analgesic effect, and the biochemical pathways involved were more specifically differentiated.

4) Use of complementary and alternative medicine at Norwegian and Danish hospitals: No rocket science here, just some evidence that acupuncture, including ear acupuncture is being offered in some hospitals, more-so in Norway than Denmark. Perhaps of some interest is that the primary reason for including acupuncture was perception of scientific evidence.

5) Neonatal abstinence syndrome: This study examined the presence of active ear reflex points on newborns born with abstinence syndrome. Active organic and psychic ear points were detectable in both ears. In the future, it could be possible to use active ear points for diagnostic and therapeutic purposes.

6) Insomnia: Auricular Acupuncture played an effective role in improving the quantity and quality of sleep, including sleep quality, time on falling asleep, sleeping time, efficiency and disorder of sleep, and daytime functional disorder.

7) Ear acupoint detection before and after hysteroscopy: This study concluded that when auricular acupuncture is applied to reduce discomfort during hysteroscopy, particular attention must be paid when choosing the points/areas to be stimulated. This confirms that you need to have an Auriculotherapy instrument with a good diagnostic mode so that you can determine which active reflex points need to be treated on any given visit – and that you may need to think outside the box in terms of point selection .

8) 94% success rate in weight gain: This is one we don’t see too often – a study testing the efficacy of a weight gain program! There are actually people on this planet who do need to gain weight for clinical reasons. An interesting aside in this study is that there was only a modest but insignificant benefit in adding body acupuncture to the mix.

9) Immediate analgesia for migraine: This study compared different forms of acupuncture and found needling therapy, auricular electroacupuncture therapy then bloodletting to be the most effective for immediate relief.

10) Correcting erectile dysfunction: This study found that when auricular acupuncture was added to the multimodal treatment mix outcomes improved by 15%.

11) Surface electromyography for studying auricular acupuncture: It was concluded in this study that a surface electromyography can be used as a tool to investigate possible alterations of electrical activity in muscles after auricular acupuncture.

12) Unilateral migraine pain: This study successfully identified the most important auricular zones for pain control and showed that the insertion of a semi-permanent needle in these zones allowed stable control of the migraine pain, which occurred within 30 minutes and persisted at the same levels 24 hours later.

13) Systematic review of acupuncture treatment for cancer pain: The only high-quality trial that was identified showed that auricular acupuncture therapy was significantly superior to placebo in pain alleviation

14) Identifying excess or deficiency syndrome of stroke: This study compared active ear points between stroke patients and healthy subjects, and then between two variants of stroke victims, and found significant differences in each scenario. The conclusion is that the points can be used to assist in differential diagnosis. An important aspect of Auriculotherapy as we teach it is the diagnostic component and this study supports the idea that Auriculotherapy can make you a better clinician.

15) Correspondence of the auricular acupoint (AA) with the upper trapezius using EMG: The AA peripheral stimulus can act as a modulator mechanism of muscle activity and was possible to verify correspondence of the auricular acupoint with the trapezius muscle.

16) Vagal activity: Electroacupuncture but not manual acupuncture was found to have a positive effect on Vagal tone. The results underline the potential role of auricular electrical stimulation to induce an increase in vagal activity, and it therefore might be used as preventive or adjuvant therapeutic intervention promoting health.

17) Seasonal allergic rhinitis: 75% reported marked improvement of health conditions. It manifested itself as the disappearance of clinical symptoms of the disease and a substantial decrease in the number and severity of pathological changes in nasal mucosa revealed by rhinoscopy.

To take advantage of an online discount to register for the next Auriculotherapy training session go to this link: www.torquerelease.com.au/Auriculotherapy-Discount.htm

ABSTRACTS:

1) The effect of auricular acupuncture on fentanyl requirement during hip arthroplasty: A randomized controlled trial.

Clin J Pain. 2011 Mar-Apr;27(3):262-7. Wetzel B, Pavlovic D, Kuse R, Gibb A, Merk H, Lehmann C, Wendt M, Usichenko TI.

Although auricular acupuncture (AA) is suggested to be effective in treatment of pain, it has not yet been used for intraoperative analgesia. Therefore, we studied whether the AA reduces intraoperative analgesic requirement during total hip arthroplasty (THA)… One hundred and twenty patients scheduled for THA were enrolled in this patient-anesthesiologist-blinded study. The patients were randomly assigned to receive needling of specific AA points or a sham procedure (needling of 3 non-acupoints on the ear helix) ipsilateral to the surgery site. Fixed indwelling AA needles were placed in the evening before THA and withdrawn on the day after surgery. The patients received general anesthesia with desflurane, which end-tidal concentration was kept within 3.5 volume % to 5.5 volume % to maintain the Bispectral Index within 40% to 55%. The anesthesiologists were asked to titrate fentanyl to keep the heart rate and blood pressure within 20% of baseline values. The primary outcome was fentanyl amount given during surgery… The data of fentanyl requirement of 116 patients were available for the final analysis. Patients from AA group required 15% less fentanyl during surgery than the controls (4.6±1.1 μg/kg vs. 5.2±1.3 μg/kg; mean±SD; P=0.008). Demographic data and secondary outcome measures were comparable in both groups…

2) Auricular electroacupuncture reduces frequency and severity of Raynaud attacks.

Wien Klin Wochenschr. 2011 Feb 17. Schlager O, E Gschwandtner M, Mlekusch I, Herberg K, Frohner T, Schillinger M, Koppensteiner R, Mlekusch W.

Acupuncture has been shown to influence skin perfusion and the subjective cold perception threshold. Therefore, we hypothesized that auricular electroacupuncture (EA) might reduce symptoms in primary Raynaud’s phenomenon (PRP)… Twenty-six patients with PRP received 6 cycles of auricular EA. After 3, 6 and 24 weeks attack frequency and severity were re-evaluated using standardized questionnaires and a visual analogue scale (VAS). Skin temperature was assessed by infrared thermography and laser Doppler perfusion imaging was used to determine skin perfusion… Compared to baseline we found a significant reduction of attack frequency after 3 (p = 0.001) and 6 weeks (p < 0.001) of auricular EA. This improvement sustained following cessation of EA, after 24 weeks (p < 0.001). Furthermore, attack associated pain was reduced after 3 (p = 0.003), 6 (p = 0.003) and 24 weeks (p = 0.001) of treatment, while skin temperature and skin perfusion did not change significantly throughout the study period… Auricular EA reduces symptoms by means of frequency and severity of attacks in PRP but has no influence on skin perfusion and skin temperature.

3) Peripheral muscarinic receptors mediate the anti-inflammatory effects of auricular acupuncture.

Chin Med. 2011 Jan 21;6(1):3. Chung WY, Zhang HQ, Zhang SP.

The cholinergic and opioid systems play important roles in modulating inflammation. This study tests whether auricular acupuncture (AA) produces anti-inflammatory effects via opioid and peripheral cholinergic receptors in a rat model… Rats were anesthetized with chloral hydrate and inflammation was induced by intraplantar injection of carrageenan. Electroacupuncture was performed at auricular points bilaterally. The severity of inflammation was assessed using changes in paw volume and thermal and mechanical pain thresholds of the rats during recovery from anesthesia… Electroacupuncture at selected auricular acupoints significantly reduced paw edema and mechanical hyperalgesia, with no significant effect on thermal hyperalgesia. The anti-edematous and analgesic effects of AA were abolished by blockade of peripheral cholinergic muscarinic receptors with methyl atropine. Blockade of local muscarinic receptors at the inflamed site with a small dose of atropine also antagonized the anti-edematous effect of AA. By contrast, systemic opioid receptor blockade with naloxone did not antagonize the anti-inflammatory effects of AA… CONCLUSION: This study discovers a role of peripheral muscarinic receptors in mediating the anti-inflammatory effects of AA. The cholinergic muscarinic mechanism appears to be more important than the opioid mechanism in the anti-inflammatory action of AA.

4) Use of complementary and alternative medicine at Norwegian and Danish hospitals.

BMC Complement Altern Med. 2011 Jan 18;11:4. Salomonsen LJ, Skovgaard L, la Cour S, Nyborg L, Launsø L, Fønnebø V.

Several studies have found that a high proportion of the population in western countries use complementary and alternative medicine (CAM). However, little is known about whether CAM is offered in hospitals. The aim of this study was to describe to what extent CAM is offered in Norwegian and Danish hospitals and investigate possible changes in Norway since 2001… CAM is presently offered in about 50% of Norwegian hospitals and one-third of Danish hospitals. In Norway CAM was offered in 50 hospitals, 40 of which involved acupuncture. 19 hospitals gave other alternative therapies like biofeedback, hypnosis, cupping, ear-acupuncture, herbal medicine, art therapy, homeopathy, reflexology, thought field therapy, gestalt therapy, aromatherapy, tai chi, acupressure, yoga, pilates and other. 9 hospitals offered more than one therapy form. In Denmark 38 hospitals offered acupuncture and one Eye Movement Desensitization and Reprocessing Light Therapy. The most commonly reported reason for offering CAM was scientific evidence in Denmark. In Norway it was the interest of a hospital employee, except for acupuncture where the introduction is more often initiated by the leadership and is more based on scientific evidence of effect. All persons (except one) responsible for the alternative treatment had a medical or allied health professional background and their education/training in CAM treatment varied substantially… The extent of CAM being offered has increased substantially in Norway during the first decade of the 21st century. This might indicate a shift in attitude regarding CAM within the conventional health care system.

5) Active ear acupuncture points in neonates with neonatal abstinence syndrome (NAS).

Am J Chin Med. 2011;39(1):29-37. Raith W, Kutschera J, Müller W, Urlesberger B.

The aim of the study was to determine the presence of acupuncture ear points in neonates with Neonatal Abstinence Syndrome (NAS). NAS occurs in the first days of life in neonates whose mothers have a history of drug abuse, and may also occur in neonates whose mothers are currently following substitution therapy. The patients are neonates with NAS admitted over one year to the Division of Neonatology at the University Hospital Graz. The examination took place on the third day after delivery (mean value 70.3 hours) and was performed by a neuronal pen (PS 3 © Silberbauer, Vienna, Austria). An integrated sound and optical signal detected the active ear points that were then placed on an ear map. We investigated six neonates (four male, two female). All investigated neonates showed the presence of active ear acupuncture points. The psychovegetative rim was the most common organic area of the children, following by a few organic points. This corresponds with the results found in healthy neonates. In all neonates with NAS, we found the presence of psychic ear points. The identified psychic ear points are the frustration-point, R-point and the psychotropic area nasal from the incisura intertragica. In all neonates with NAS, active organic and psychic ear points were detectable in both ears. In the future, it could be possible to use active ear points for diagnostic and therapeutic purposes.

6) Auricular acupuncture for insomnia: A randomized controlled trial.

Zhonghua Liu Xing Bing Xue Za Zhi. 2010 Dec;31(12):1400-1402. Jiang B, Ma ZH, Zuo F.

To investigate the effect of auricular acupuncture therapy (AAT) and standardized acupoints on sleep parameters among people with insomnia… A single-blind, randomized pilot study where the treatment group AAT on active points and the control group received AAT on sham points during a 4-week treatment period… In all, 125 patients were included in the study, with 63 in treatment group and 62 in control group. Sleep parameters were obtained by using the Pittsburgh Sleep Quality Index (PSQI)… (1) Significant improvement in the PSQI total score and seven components score including sleep quality, time on falling asleep, sleeping time, efficiency and disorder of sleep, hypnotic and daytime functional disorder after treatment in both treatment group and control group (P < 0.01). (2) After treatment, there was a statistically significant difference seen in the PSQI total score and six components score (P < 0.01) except for hypnotic between the two groups. There were statistically significant differences in the rank differential value of total score and seven components of two groups (P < 0.01). (3) There were statistically significant differences in the mean rank of PSQI seven components using Mann-Whitney test (P < 0.01)… Evidence was found to support the hypothesis that AAT played an effective role in improving the quantity and quality of sleep in those subjects with insomnia. A standardized AAT might help the treatment of insomnia, especially when combined with other treatments as psychological and behavioral therapies.

7) Ear acupoint detection before and after hysteroscopy: Is it possible to clarify the representation of the uterus on the outer ear?

Acupunct Med. 2010 Dec;28(4):169-73. Romoli M, Allais G, Bellu D, De Ramundo B, Gabellari IC, Giommi A, Benedetto C.

In the auricular maps introduced over the past 50 years by the French and Chinese schools, most organs and systems overlap consistently. One exception is the reproductive system, which shows a markedly different somatotopic representation – for example, for the uterus and the ovary… To identify the distribution of points with increased tenderness to pressure or with reduced electrical resistance, on the outer ear of a group of women undergoing hysteroscopy… For diagnostic purposes the auricles of 78 women were examined before and after hysteroscopy using a pain-pressure test and electrical skin resistance test. The points identified were transcribed onto a graphic system called Sectogram. Spatial cluster analysis was used to identify the statistically significant clusters of sectors with a higher concentration of points appearing after hysteroscopy… The points identified after hysteroscopy tend to be concentrated in specific areas not previously recognised and which only partially overlap with the French and Chinese representation of the uterus… CONCLUSION: When auricular acupuncture is applied to reduce discomfort during hysteroscopy, particular attention must be paid when choosing the points/areas to be stimulated, which are not only those indicated in the Chinese or French maps.

8) Auricular point sticking and the combined therapy of auricular point sticking and body acupuncture for weight gain in 100 cases.

Zhongguo Zhen Jiu. 2010 Nov;30(11):943-5. Zhang FH.

To explore the efficacy difference in weight gain between auricular point sticking and the combined therapy of auricular point sticking and body acupuncture, as well as the efficacy difference among various body constitutions… One hundred cases of weight gain were randomized into two groups, auricular point sticking group (group A) and the combined therapy of auricular point sticking and body acupuncture group (group B), 50 cases in each one. In group A, semen vaccariae (Vacarria seed) was fixed with plaster on the spleen, stomach, endocrine, small intestine, buttocks, tibia, forearm, etc. in the ear. Each point was pressed 3 times daily, for 5 mm each time. The ear-points on two sides were alternated every two days. In group B, the auricular point sticking and body acupuncture were applied. The ear points and manipulation were same as the previous. Body points were Zhongwan (CV 12), (Juanyuan (CV 4), Tiansho (ST 25), Zusanli (ST 36), Sanyinjiao (SP 6), etc. Acupuncture was applied with filiform needle, once every two days. The changes in body weight and body mass index (BMI) were observed after 20 treatments… The total effective rate was 94.0% (47/50) in group A and was 98.0% (49/50) in group B, without statistical significant difference (P > 0.05). The comparison of mean body weight and mean BMI after intervention did not show statistical significance between two groups (both P > 0.05), indicating that the simple auricular point sticking could achieve the same effect as the combined therapy. CONCLUSION: The efficacy of the simple auricular point sticking on weight gain is same as the combined therapy of auricular point sticking and body acupuncture, and is much better for the cases with spleen and stomach deficiency constitution.

9) Study on the best solution of immediate analgesia of acupuncture for migraine.

Zhongguo Zhen Jiu. 2010 Oct;30(10):798-801. Wang QM, Wang JJ, Hu J, Jiao Y, Wu ZC, Yang JH, Liu WZ.

To select the best solution of immediate analgesia of migraine treated with acupuncture… Taken 36 cases of migraine in attack stage as research objects, by means of orthogonal experimental design, applying the L9 (3(4)) orthogonal table, the therapeutic effect of immediate analgesia of acupuncture for migraine in attack stage was analyzed in four factors, which were effective acupoints combination, electroacupuncture therapy, auricular therapy and bloodletting therapy, and three levels of each factors. In the test procession, random approaches (stratified random and central random) and blinding experiment (the appraiser blind) were used. The time points of observation were before treatment, and 10, 20 minutes after treatment. Visual Analogue Scale (VAS) was used to evaluate therapeutic effect… Comparing with the headache before treatment, at the time points of 10 and 20 minutes after treatment, the best solution for headache relief was needling therapy (local and distal points and points selection according to the differentiation), auricular electroacupuncture therapy and bloodletting at Taiyang Zimai (Extra) or Taiyang (EX-HN 5)and Ashi points… In the attack stage of migraine, by the therapy combined with puncture on local and distal points and the points according to the differentiation, auricular electroacupuncture and bloodletting at Taiyang Zimai or Taiyang (EX-HN 5) and Ashi points, the favorable effects of immediate analgesia are received.

10) The use of acupuncture in combined balneotherapy of erectile dysfunction in patients with lumbosacral osteochondrosis.

Vopr Kurortol Fizioter Lech Fiz Kult. 2010 Sep-Oct;(5):13-7. No authors listed

The objective of the present study was to elucidate effects of therapeutic and preventive measures on restoration of compromised erectile function in patients with osteochondrosis of the lumbosacral spine segment (LSSS). The patients were treated using corporal and auricular acupuncture, Narzan mineral water baths, manual therapy, remedial gymnastics, and psychotherapeutic correction of sexual dysadaptation. This combined treatment resulted in the elimination of algic syndrome in 77.5% of the patients, restoration of sexual function in 62.5%, and normalization of hemodynamics in cavernous bodies in 65.2%. The functional activity of the hypothalamo-pituitary-testicular axis was normalized in 65% of the LSSS patients of strong and moderate sexual constitution. Introduction of acupuncture in the combined medicamentous therapy increased its efficiency by 15%. In 57.5% of the patients with strong and moderate sexual constitution, the restored sexual function persisted for at least 12 months.

11) The use of surface electromyography for the study of auricular acupuncture.

J Bodyw Mov Ther. 2010 Jul;14(3):219-26. Politti F, Amorim CF, Calili L, Andrade Ade O, Palomari ET.

The advancement of knowledge in neurophysiology has demonstrated that acupuncture is a method of peripheral neural stimulation that promotes local and systemic reflexive responses. The purpose of this study was to determine if surface electromyography can be used as a tool to study the action of auricular acupuncture on striated skeletal muscle. The electromyographic amplitudes of the anterior, middle and posterior deltoid muscle and the upper trapezium muscle with 20%, 40% and 60% of maximal voluntary contraction of 15 healthy volunteers, were analyzed after the individuals were submitted to the auricular acupuncture treatment. The non-parametric Friedman test was used to compare Root Mean Square values estimated by using a 200 ms moving window. Significant results were further analyzed using the Wilcoxon signed rank test. In this exploratory study, the level of significance of each comparison was set to p<0.05. It was concluded in this study that a surface electromyography can be used as a tool to investigate possible alterations of electrical activity in muscles after auricular acupuncture. However there is still a lack of adequate methodology for its use in this type of study, being that the method used to record the electromyographic signal can also influence the results.

12) Ear acupuncture in unilateral migraine pain.

Neurol Sci. 2010 Jun;31 Suppl 1:S185-7. Allais G, Romoli M, Rolando S, Castagnoli Gabellari I, Benedetto C.

The needle contact test (NCT) is a diagnostic technique useful to identify, through the contact of the needle on the skin of the ear, the most efficacious points for reducing pain during a migraine attack. The aim of this study was to identify the most important auricular zones for pain control by applying the NCT in a group of 15 women during a unilateral attack of migraine without aura. We also assessed how effective the insertion of a semi-permanent needle in these zones was in reducing the migraine pain during the next 24 h. The most effective tender points in pain control were located on the antero-internal part of the antitragus, the anterior part of the lobe and the upper auricular concha ipsilateral to the side of pain. The insertion of a semi-permanent needle in these zones allowed stable control of the migraine pain, which occurred within 30 min and persisted at the same levels 24 h later (ANOVA for repeated measures: p < 0.01). Pain was tested by using a visual analogue scale; the values recorded were the following: 7.6 +/- 1.6 at baseline and 4.3 +/- 1.7; 4.1 +/- 1.9; 3.9 +/- 1.8; 3.4 +/- 1.8; 2.3 +/- 1.6 after, respectively, 15, 30, 60, 120 min and 24 h.

13) Efficacy of acupuncture in treatment of cancer pain: A systematic review.

Zhong Xi Yi Jie He Xue Bao. 2010 Jun;8(6):501-9. Peng H, Peng HD, Xu L, Lao LX.

Although acupuncture is a well-established treatment for cancer pain and its effects have been widely reported in recent two decades, there is still controversy over whether its efficacy is better than placebo… All randomized controlled trials (RCTs) comparing acupuncture therapy with placebo, Western drugs, Chinese herbal medicines, or comparing acupuncture therapy plus drug treatment with drug treatment… Seven published RCTs with a total of 634 patients met the inclusion criteria, and the quality of one of the included trials was high. Due to flaws in design and reporting, meta-analysis was precluded, and only qualitative analysis was done on the majority of the reports. The high-quality trial showed that auricular acupuncture therapy was significantly superior to placebo in pain alleviation. The other six low-quality trials with non-placebo showed that acupuncture therapy had some positive effects… Acupuncture is effective for pain relief. However, the poor quality of the majority of the trials reduces the reliability of the conclusion. More high-quality RCTs are needed to verify the effects.

14) Impedance characteristics of ear acupoints in identifying excess or deficiency syndrome of stroke.

Zhong Xi Yi Jie He Xue Bao. 2010 Jun;8(6):525-9. Wang P, Yang HY, Wang YQ.

To explore the impedance characteristics of ear acupoints in stroke patients with excess or deficiency syndrome, and to provide basis data for objective study of the syndromes of stroke… The data of electrical characteristics of ear acupoints in stroke patients and healthy people were collected, and excess syndrome and deficiency syndrome of stroke were identified by quantifying the syndromes of stroke using scales. The differences in impedance characteristics of ear acupoints between stroke patients and healthy people were analyzed, and the differences in impedance characteristics of ear acupoints between stroke patients with excess syndrome and stroke patients with deficiency syndrome were analyzed too. The correlation among impedance characteristics of ear acupoints, stroke and the syndromes was also analyzed… There were significant differences in impedance characteristics of ear acupoints between stroke patients and healthy people (P<0.05,P<0.01). The ear acupoints CO12 (Gan) and CO13 (Pi) had a significant role in diagnosing stroke as compared with CO18 (Neifenmi), AT3.4.AH12i (Naogan), CO10 (Shen), TG2p (Shenshangxian), AH6a (Jiaogan), AT4 (Pizhixia), and CO15 (Xin). There were significant differences in impedance characteristics of ear acupoints between stroke patients with excess syndrome and stroke patients with deficiency syndrome (P<0.05, P<0.01). The ear acupoints AH6a (Jiaogan) and CO10 (Shen) played an important role in differentiation diagnosis of excess syndrome and deficiency syndrome of stroke, followed by CO18 (Neifenmi), TF4 (Shenmen) and TG2p (Shenshangxian)… CONCLUSION: Some ear acupoints with diagnostic value for stroke may provide basis of objective research for stroke diagnosis as well as identifying excess syndrome and deficiency syndrome of stroke.

15) Correspondence of the auricular acupoint with the upper trapezius muscle: An electromyographic study.

Complement Ther Clin Pract. 2010 Feb;16(1):26-30. Politti F, Vitti M, Amorim CF, Tosello Dde O, Palomari ET.

Presently, acupuncture is a technique considered to be capable of stimulating the regulatory systems of the organism, such as the central nervous system, the endocrine system and the immunological system. The median frequency of the upper trapezium muscle with 40% and 60% of maximal voluntary contraction (MVC) of 15 healthy volunteers, was analyzed after the individuals were submitted to the AA treatment. The non-parametric Friedman test was used to compare median frequency values. In this exploratory study, the level of significance of each comparison was set to p<0.05. The intraclass analyses indicate a significant increase of the median frequency muscle at 60% of the MVC (Wicoxon test). Based on the results found, the AA peripheral stimulus can act as a modulator mechanism of muscle activity and was possible to verify correspondence of the auricular acupoint with the trapezius muscle.

16) Effects of auricular electrical stimulation on vagal activity in healthy men: Evidence from a three-armed randomized trial.

Clin Sci (Lond). 2009 Nov 9. La Marca R, Nedeljkovic M, Yuan L, Maercker A, Ehlert U.

The activity of the vagus nerve is negatively associated with risk factors such as stress and smoking, morbidity, and mortality. In contrast it is also a target of therapeutic intervention. Vagus nerve stimulation is used in depression and epilepsy. Due to its high invasivity and exclusive application to therapy-resistant patients, there is interest in less invasive methods affecting the vagus nerve. Several studies examining acupuncture report beneficial effects on vagal activity. However, findings are inconsistent and applied methods are heterogeneous resulting in difficulties in interpretation. The purpose of the present study was evaluation of the effects of acupuncture on vagal activity in a three-armed randomized trial while controlling several disturbing factors. Fourteen healthy men participated in random order in four examinations: a control condition without intervention, a condition with placebo, manual acupuncture, and electroacupuncture. Acupuncture was conducted on the concha of the ear, as there is neuroanatomical evidence for vagal afferents. Each examination took place once, with a week’s time between examinations. Respiratory sinus arrhythmia adjusted for tidal volume (RSATR) indicating vagal activity was measured continuously. The study was conducted partially blind in accordance with recommendations. After controlling for respiration, condition-specific pain sensation, individual differences in belief of acupuncture effectiveness, and time effects not attributable to the interventions, electroacupuncture but not manual acupuncture was found to have a positive effect on RSATR. The results underline the potential role of auricular electrical stimulation to induce an increase in vagal activity, and it therefore might be used as preventive or adjuvant therapeutic intervention promoting health.

17) Application of acureflexotherapy to the treatment of seasonal allergic rhinitis.

Vestn Otorinolaringol. 2009;(6):71-3. Kudaĭbergenova SF, Zhaĭsakova DE.

The objective of this study was to evaluate efficiency of acureflexotherapy for the prevention of exacerbations of seasonal allergic rhinitis. Up to seven needles were used per session depending on the acupuncture point. A set of auricular and remote (corporal) points were chosen on either side of the patient’s body. Efficiency of the treatment was evaluated from changes in the clinical picture of the disease, results of rhinoscopy and laboratory analyses during the period of plant pollination. A total of 24 patients with seasonal allergic rhinitis were given this treatment of whom 18 (75%) reported marked improvement of health conditions. It manifested itself as the disappearance of clinical symptoms of the disease and a substantial decrease in the number and severity of pathological changes in nasal mucosa revealed by rhinoscopy.

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