1
|
Wang Y, Su Y, Wang J, Zhang K, Zhang W, Cui J, Liu Y, Wang X, Bai W. Networks of Nerve Fibers, and Blood and Lymphatic Vessels in the Mouse Auricle: The Structural Basis of Ear Acupuncture. Med Acupunct 2024; 36:79-86. [PMID: 38659726 PMCID: PMC11036157 DOI: 10.1089/acu.2023.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
Objective Ear acupuncture, as a system for treating and preventing diseases through stimulation of points on the auricle, has been systematically introduced during the last 60 years. Although the auricular cartography was described somatotopically as an inverted fetus by Paul Nogier, MD, the underlying mechanism of auricular stimulation remains unclear. The aim of this research was to gain an understanding of the structural basis of auricular stimulation, as well as showing the distribution of the nerve fibers, and the blood and lymphatic vessels. Materials and Methods The distribution of nerve fibers, and blood and lymphatic vessels was examined in whole-mount auricular skins of mice by combining the biomarkers protein gene product 9.5, cluster of differentiation 31, and lymphatic-vessel endothelial hyaluronan receptor-1 following tissue-clearing treatment with multiple immunofluorescent staining. Results The labeled nerve fibers, and the blood and lymphatic vessels were distributed extensively in the inner and outer parts of the auricular skin. Auricular nerves aligning with blood vessels ran from the basal region to the peripheral region and crossed over lymphatic vessels, thus forming the neural, vascular, and lymphatic networks. Conclusions As these are important tissue components of auricular skin, this result implies that the auricular nerve fibers, and blood and lymphatic vessels may coordinate with each other to respond directly to auricular stimulation.
Collapse
Affiliation(s)
- Yuqing Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuxin Su
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jia Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Kaiwen Zhang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wenjie Zhang
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jingjing Cui
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yihan Liu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaoyu Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wanzhu Bai
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
2
|
Sagui E, Claverie D, Bidaut W, Grelot L. Heart rate variability and cold-induced vascular dilation after stimulation of two different areas of the ear: a prospective, single-blinded, randomized crossover study. BMC Complement Med Ther 2024; 24:83. [PMID: 38350937 PMCID: PMC10863191 DOI: 10.1186/s12906-024-04392-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/07/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Both noninvasive transauricular vagus nerve stimulation (taVNS) and traditional medical practice (TMP), such as auriculotherapy, use the auricle as a starting point for stimulation, but with two different conceptual frameworks: taVNS depends on vagal afferences to account for its effects, whereas TMP requires stimulation of the ear with high topographical accuracy regardless of the afferent nerves. The aim of this study was to measure heart rate variability (HRV) and cold water-induced vasodilation (CIVD) after puncturing two different ear points with the same afference but that should have opposite effects according to TMP. METHODS Ten healthy subjects were investigated in this single-blinded crossover study over three sessions. In the first session, sympathetic activation was performed via cold water immersion of the right hand, with recordings taken from multiple fingers. HRV was assessed in the time domain (square root of the mean squared differences of NN intervals (RMSSD)) and frequency domain (low (LF) and high frequencies (HF)). In the second and third sessions, the same skin immersion test was performed, and mechanical stimulation was applied to the ear at two different points on the internal surface of the antitragus, one with alleged parasympathetic activity and the other with alleged sympathetic activity. The stimulation was done with semipermanent needles. RESULTS Stimulation of the point with alleged parasympathetic activity immediately resulted in a significant decrease in RMSSD in 75% of the subjects and in LF in 50% of the subjects, while stimulation of the point with alleged sympathetic activity resulted in an increase in HF and RMSSD in 50% of the subjects. Stimulation of these points did not affect the CIVD reflex. The 20 min cold water immersion induced an immediate decrease in LF and the LF/HF ratio and an increase in HF. The skin temperature of the nonimmersed medius significantly decreased when the contralateral hand was immersed, from 34.4 °C to 31.8 °C. CONCLUSIONS Stimulation of two different ear points innervated by the same afferent nerves elicited different HRV responses, suggesting somatotopy and a vagal effect beyond vagal afferences. These results are not in accordance with the claims of TMP. TRIAL REGISTRATION NCT04130893 (18/10/2019) clinicaltrials.com.
Collapse
Affiliation(s)
- Emmanuel Sagui
- European Hospital of Marseille, 13002, Marseille, France.
- French Biomedical Research Institute, 91220, Bretigny sur Orge, France.
| | - Damien Claverie
- French Biomedical Research Institute, 91220, Bretigny sur Orge, France
| | - Wahiba Bidaut
- European Hospital of Marseille, 13002, Marseille, France
| | - Laurent Grelot
- Institute of Technology, Aix-Marseille University, dept HSE, 13708, La Ciotat, France
- French Military Hospital Laveran, 13384, Marseille, France
| |
Collapse
|
3
|
Silva Vilela Terra AM, Santos PDG, Gomes M, Santos ATS, Pezarat-Correia P. Effects of auriculotherapy on muscle fatigue: A randomized crossover trial. J Bodyw Mov Ther 2024; 37:209-219. [PMID: 38432808 DOI: 10.1016/j.jbmt.2023.11.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 11/15/2023] [Accepted: 11/24/2023] [Indexed: 03/05/2024]
Abstract
OBJECTIVE This study aimed investigate the effect of auriculotherapy on exercise-induced muscle fatigue, isometric torque production, and surface electromyographic activity (EMG). METHODS Design: Randomized Crossover Trial. The sample consisted of 18 males' volunteers who exercised at least twice a week. THE SAMPLE WAS RANDOMLY ASSIGNED TO TWO GROUPS Placebo Group (n = 9) and Treated Group (n = 9), and after seven days, the groups were crossed. The data analysis included 18 participants in each group. MAIN OUTCOME MEASURE The muscle fatigue index, force production rate, and EMG of the quadriceps were used for evaluation. The evaluation moments included baseline pre-fatigue, baseline post-fatigue, 48 h post-intervention pre-fatigue, and 48 h post-intervention post-fatigue. Mixed two-way test ANOVA was used to compare times and groups. RESULTS The fatigue index for peak torque and work showed no significant effect on time, groups, or interaction (p > 0.05). However, for isometric torque, force production rate, and EMG median frequency and average, the results indicate a positive change in values over time (p < 0.05) (with little practical relevance), with no differences observed between the groups or interaction (p > 0.05). CONCLUSIONS In conclusion, auriculotherapy had no effect on exercise-induced muscle fatigue, isometric torque production, and surface electromyographic activity.
Collapse
Affiliation(s)
- Andréia Maria Silva Vilela Terra
- Neuromuscular Research Lab, Faculty of Human Kinetics, Lisbon University, 1499-002, Cruz Quebrada-Dafundo, Portugal; Human Performance Research Laboratory, Alfenas Federal University, 37133-840, Santa Clara, Alfenas, MG, Brazil.
| | - Paulo Duarte Guia Santos
- Neuromuscular Research Lab, Faculty of Human Kinetics, Lisbon University, 1499-002, Cruz Quebrada-Dafundo, Portugal
| | - Miguel Gomes
- Neuromuscular Research Lab, Faculty of Human Kinetics, Lisbon University, 1499-002, Cruz Quebrada-Dafundo, Portugal
| | - Adriana Teresa Silva Santos
- Human Performance Research Laboratory, Alfenas Federal University, 37133-840, Santa Clara, Alfenas, MG, Brazil
| | - Pedro Pezarat-Correia
- Neuromuscular Research Lab, Faculty of Human Kinetics, Lisbon University, 1499-002, Cruz Quebrada-Dafundo, Portugal; CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada, Dafundo, Portugal
| |
Collapse
|
4
|
Bonemazzi I, Nosadini M, Pelizza MF, Paolin C, Cavaliere E, Sartori S, Toldo I. Treatment of Frequent or Chronic Primary Headaches in Children and Adolescents: Focus on Acupuncture. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1626. [PMID: 37892289 PMCID: PMC10605007 DOI: 10.3390/children10101626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Acupuncture is a spreading and promising intervention, which has proven to be very useful in the treatment and prevention of chronic pain, in particular chronic headaches, in adults; the literature about the treatment of pediatric chronic headaches is scarce. In addition, few guidelines advise its use in children. The aim of this review is to collect all relevant studies with available data about the use, effect, and tolerability of acupuncture as a treatment for pediatric primary headaches. METHODS This is a narrative review based on eight studies selected from 135 papers including pediatric cases treated with acupuncture for headache. RESULTS Despite the differences in tools, procedures, and application sites, acupuncture demonstrated a positive effect on both the frequency and intensity of headaches and was well tolerated. There are no studies considering the long-term efficacy of acupuncture. CONCLUSION Further additional studies are needed on acupuncture in children and adolescents, with larger series and standardized procedures, in order to better assess efficacy, tolerability, and long-term prognosis and to define guidelines for the use of this promising and safe treatment. It is particularly relevant to identify safe and well-tolerated treatment options in pediatric patients affected by recurrent and debilitating headaches.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Irene Toldo
- Juvenile Headache Center, Department of Woman’s and Child’s Health, University Hospital of Padua, 35128 Padua, Italy; (I.B.); (M.N.); (M.F.P.); (C.P.); (E.C.); (S.S.)
| |
Collapse
|
5
|
Michel-Cherqui M, Ma S, d’Ussel M, Ebbo D, Spassova A, Chaix-Couturier C, Szekely B, Fischler M, Lemaire N, Le Guen M. Auriculotherapy in prevention of migraine attacks: an open randomized trial. Front Neurol 2023; 14:1193752. [PMID: 37284181 PMCID: PMC10241207 DOI: 10.3389/fneur.2023.1193752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 05/02/2023] [Indexed: 06/08/2023] Open
Abstract
Use of auriculotherapy to prevent episodic migraine pain has seldom been reported. The aim of this open study was to show that three sessions of auriculotherapy, 1 month apart, using semi-permanent needles decrease frequency and intensity of an attack in patients presenting episodic migraine. A total of 90 patients were randomized to the treatment group (AUR group, n = 58) or the control group (C group, n = 32). Four patients dropped out during the study (three in the AUR group and one in the C group). The number of days with migraine and non-migraine headache was similar when the analysis focused on the 3 months of the study or on the difference in each group of this number between the 3 months preceding the inclusion and the 3 months of the study (p = 0.123). AUR group patients had fewer days with non-migraine headache (p = 0.011) and took less Triptans (p = 0.045) than group C. Number of days with migraine, sum of the pain intensities of all migraines and non-migraine headaches, and total number of analgesics taken, other than triptan, were similar between groups. MIDAS score decreased with time in the AUR group while it increased in the C group whether in absolute values (p = 0.035) or as categories (p = 0.037). These contrasted results should lead to further study of the effectiveness of auriculotherapy for the prevention of migraine. Clinical trail registration: Protocol registered on the Clinicaltrials.gov, website (January 30, 2017, NCT03036761).
Collapse
Affiliation(s)
- Mireille Michel-Cherqui
- Department of Anesthesiology, Hospital Foch, Suresnes, France
- Department of Medicine, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Sabrina Ma
- Department of Anesthesiology, Hospital Foch, Suresnes, France
- Department of Medicine, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | | | - David Ebbo
- Department of Pain Medicine, Hospital Saint Joseph, Paris, France
| | | | | | - Barbara Szekely
- Department of Anesthesiology, Hospital Foch, Suresnes, France
- Department of Medicine, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Marc Fischler
- Department of Anesthesiology, Hospital Foch, Suresnes, France
- Department of Medicine, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | | | - Morgan Le Guen
- Department of Anesthesiology, Hospital Foch, Suresnes, France
- Department of Medicine, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| |
Collapse
|
6
|
Lovato A, Postiglione M, Gagliardi G, Parmagnani M, Biral M, Ceccherelli F. Needle contact test in auricular acupuncture for shoulder pain and where effective auricular acupoints identified are positioned on the map: A controlled study. Eur J Transl Myol 2023; 33. [PMID: 36920326 PMCID: PMC10141739 DOI: 10.4081/ejtm.2023.11113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/26/2023] [Indexed: 03/16/2023] Open
Abstract
Active Points Test on auricle was renamed Needle Contact Test (or NCT), considered an extremely effective method to select most efficient auricle acupoint for Auricular Acupuncture (or AA) therapy. Our aims were to evaluate NCT efficiency as viable diagnostic option to identify the most appropriate AA acupoints to be selected for SupraSpinatus Tendinopathy (SST) associated shoulder pain treatment and to evaluate which auricle area has greater concentration of NCT positive acupoints in subjects with SST shoulder pain, comparing results with available AA ear maps. 45 subjects with SST diagnosis were enrolled. On 30 subjects in treatment group, NCT was performed on acupoints of the auricle shoulder representation areas (i.e., Scaphoid Fossa), while in 15 subjects of control group, NCT was performed on auricle areas not shoulder associated. Statistically significant lower Numeric Pain Rating Scale scores were seen for study group over time and compared to control. A small sample showed statistically significant increase of SST shoulder maximum abduction range of Movements. NCT identified best SST shoulder pain AA acupoints in Scaphoid Fossa (or SF1 and SF2). In conclusion NCT is a viable tool to efficiently identify the best AA acupoints in SST shoulder pain treatment.
Collapse
Affiliation(s)
- Antonello Lovato
- Pain Therapy Clinic, Lonigo (VI), Italy; Italian Association for the Research and the Scientific Update (A.I.R.A.S.), Padua.
| | - Marco Postiglione
- Italian Association for the Research and the Scientific Update (A.I.R.A.S.), Padua.
| | - Giuseppe Gagliardi
- Italian Association for the Research and the Scientific Update (A.I.R.A.S.), Padua, Italy; Department of Anesthesiology and Intensive Care Unit, Hospital Rovigo.
| | - Moreno Parmagnani
- Italian Association for the Research and the Scientific Update (A.I.R.A.S.), Padua, Italy; General practitioner, Minerbe (Verona).
| | - Mario Biral
- Italian Association for the Research and the Scientific Update (A.I.R.A.S.), Padua.
| | | |
Collapse
|
7
|
The Effect of Auriculotherapy on Situational Anxiety Trigged by Examinations: A Randomized Pilot Trial. Healthcare (Basel) 2022; 10:healthcare10101816. [DOI: 10.3390/healthcare10101816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/02/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Auriculotherapy may activate the parasympathetic nerve system and reduce anxiety levels. Short-term auriculotherapy’s effects and safety on university students’ anxiety levels was assessed prior to exams. Methods: A randomized, controlled pilot trial was conducted. The day before the exam, university students were randomly allocated to the auriculotherapy group (AA, n = 13) or the waiting-list group (WG, n = 13). Baseline measures were taken 4 weeks before the exam at Time point (TP 0); at 7.30 a.m. on the day before the exam (TP I); at 11 a.m. before auriculotherapy (TP II); 30 min after AA (TP III); and at 7.30 a.m. before the exam (TP IV). The outcomes were the State-Trait-Anxiety Inventory (STAI); quality of night-sleep, Visual Analogue scale (VAS) for anxiety, and salivary cortisol. Adverse events were also recorded. Results: A total of 26 students participated in this study and became more anxious as assessed by STAI in TPII (p = 0.002) and TPIV (p = 0.000) than TP0. AA reduced the STAI in TPIII (p = 0.045) and PIV (p = 0.001) and the VAS (p = 0.012) in TPIV. Cortisol was reduced in TPIII (p = 0.004), and the AA slept better (p = 0.014) at TPIV. Discomfort at the auricular site was reported in only one AA participant. Conclusions: Auriculotherapy appeared safe and effective in reducing anxiety levels before university exams.
Collapse
|
8
|
Vieira A, Moreira A, Machado JP, Robinson N, Hu XY. Is auriculotherapy effective and safe for the treatment of anxiety disorders? – A systematic review and meta-analysis. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
9
|
Favre-Félix J, Laurent V, Branche P, Huissoud C, Raffin M, Pradat P, Aubrun F, Dziadzko M. Auricular Acupuncture for Preoperative Anxiety in Parturient Women with Scheduled Cesarean Section: A Randomized Placebo-Controlled Blind Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:569-578. [PMID: 35394895 DOI: 10.1089/jicm.2021.0346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Introduction: Preoperative anxiety before cesarean section is a major issue. Nonpharmacologic anxiety control is believed to be more suitable in pregnant women. Auricular acupuncture (AA) is an inexpensive, easy-to-use, and validated intervention to reduce anxiety in different surgical settings. We evaluated the effect of AA on preoperative cesarean section anxiety. Methods: In a prospective, blind, controlled trial, pregnant women with a scheduled cesarean section under spinal anesthesia were randomized to receive AA with needle, AA without needle (sham), or usual care (no intervention). Anxiety level was assessed by using a visual analogue scale for anxiety (VAS-A; 0-minimal anxiety, 100-maximal anxiety) at three time points: inclusion (pre-induction room-T0), when entering the operating room (T1), and before incision (T2). The primary outcome was the VAS-A variation (percentage changes) between T0 and T1 in the AAe group compared with that in the sham AA group. The secondary outcomes were the VAS-A variation between T0 and T1 in the AA group compared with that in the control group, and the variation between T0 and T2 compared between the three groups, the effect of AA on parasympathetic tone, and the incidence of adverse effects. Results: In women immediately before anesthesia for cesarean section, the AA produced a 19% decrease of anxiety, compared with a 21% anxiety increase in sham AA, which is significantly different. The effect of AA was more present in women with low initial anxiety. The proportion of patients reaching clinically significant anxiety reduction (>33% from the initial level) was 2.5 times higher in the AA group (p = 0.02) compared with the sham group. No differences in anxiety variations were found compared with the no-intervention group. No effect of AA was noted on parasympathetic tone. Conclusion: Compared with sham, AA decreased maternal anxiety level when arriving in the operation room and just before the beginning of the cesarean section, with a trend toward improvement compared with usual care.
Collapse
Affiliation(s)
- Jeremy Favre-Félix
- Service d'Anesthésie, Réanimation, Douleur, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Virginie Laurent
- Service d'Anesthésie, Réanimation, Douleur, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Patricia Branche
- Service d'Anesthésie, Réanimation, Douleur, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Cyril Huissoud
- Service de Gynécologie-Obstétrique, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Stem Cell and Brain Research Institute, U846-INSERM, Bron, France
| | - Mahé Raffin
- Centre de Recherche Clinique, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Pierre Pradat
- Centre de Recherche Clinique, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Frederic Aubrun
- Service d'Anesthésie, Réanimation, Douleur, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Research on Healthcare Performance (RESHAPE), U1290-INSERM et Université Claude Bernard Lyon 1, Lyon, France
| | - Mikhail Dziadzko
- Service d'Anesthésie, Réanimation, Douleur, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Research on Healthcare Performance (RESHAPE), U1290-INSERM et Université Claude Bernard Lyon 1, Lyon, France
| |
Collapse
|
10
|
Korelo RIG, Moreira NB, Miguel BADC, Cruz CDGD, Souza NSPD, Macedo RMBD, Gallo RBS. Effects of Auriculotherapy on treatment of women with premenstrual syndrome symptoms: A randomized, placebo-controlled clinical trial. Complement Ther Med 2022; 66:102816. [DOI: 10.1016/j.ctim.2022.102816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/18/2022] [Accepted: 02/11/2022] [Indexed: 11/03/2022] Open
|
11
|
Sant'Anna MB, Sant'Anna LB, Chao LW, Sant'Anna FM. Auriculotherapy for Chronic Cervical Pain. Med Acupunct 2021; 33:403-409. [PMID: 34976273 DOI: 10.1089/acu.2021.0039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Chronic cervical pain is a common and recurrent complaint. Auriculotherapy (AT) or ear acupuncture is an effective complementary method used for pain control, but only a few studies have evaluated this treatment for chronic cervical pain. Thus, the aim of this study was to analyze the effectiveness of AT to control chronic cervical pain and improve functional capacity. Materials and Methods: This study involved patients with at least 2 years of cervical pain and a neck disability index score (NDI) >5. AT was performed at detectable points once per week over 6 weeks. Patients were evaluated with the NDI and a visual analogue scale (VAS) for pain before and at 1 and 4 months after the final treatments. An analysis of variance test for repeated measures was used for comparisons. Results: During the study, 19 patients, with a mean (± SD) age of 44.5 ± 15.2 years, were enrolled. The majority of the patients were right-handed (89%) and female (79%). The median (interquartile range) disease duration was 48 months (range: 24-66 months ). An average of 4 ear points were used per session; the most frequent points used were: Shen men, Posterior Wall, Zero, and C1. Statistically significant decreases in NDI (15.58 ± 5.93) and VAS (4.76 ± 2.37) scores were observed at 1 and 4 months (8.84 ± 5.59; P < 0.0001 and 3.21 ± 2.12; P = 0.003, respectively) after AT treatment. Conclusions: AT can be used successfully as a complementary method to treat chronic cervical pain.
Collapse
Affiliation(s)
| | | | - Liaw Wen Chao
- Acupuncture Center, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Fernando Mendes Sant'Anna
- Cardiology Department, Universidade Federal do Rio de Janeiro, Macaé, Rio de Janeiro, Brazil; and Department of Interventional Cardiology, Hospital Santa Izabel, Cabo Frio, RJ, Brazil
| |
Collapse
|
12
|
Rangon CM, Barruet R, Mazouni A, Le Cossec C, Thevenin S, Guillaume J, Léguillier T, Huysman F, Luis D. Auricular Neuromodulation for Mass Vagus Nerve Stimulation: Insights From SOS COVID-19 a Multicentric, Randomized, Controlled, Double-Blind French Pilot Study. Front Physiol 2021; 12:704599. [PMID: 34408665 PMCID: PMC8365750 DOI: 10.3389/fphys.2021.704599] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/22/2021] [Indexed: 12/23/2022] Open
Abstract
Importance: An exacerbated inflammatory response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is believed to be one of the major causes of the morbidity and mortality of the coronavirus disease 2019 (COVID-19). Neuromodulation therapy, based on vagus nerve stimulation, was recently hypothesized to control both the SARS-CoV-2 replication and the ensuing inflammation likely through the inhibition of the nuclear factor kappa-light-chain-enhancer of activated B cells pathway and could improve the clinical outcomes as an adjunct treatment. We proposed to test it by the stimulation of the auricular branch of the vagus nerve, i.e., auricular neuromodulation (AN), a non-invasive procedure through the insertion of semipermanent needles on the ears. Objective: The aim of this study was to assess the effect of AN on the clinical outcomes in patients affected by COVID-19. Design, Setting, and Participants: A multicenter, randomized, placebo-controlled, double-blind clinical trial included 31 patients with respiratory failure due to COVID-19 requiring hospitalization. Within 72 h after admission, patients received either AN (n = 14) or sham neuromodulation (SN, n = 15) in addition to the conventional treatments. Main Outcome and Measures: The primary endpoint of the study was the rate of a clinical benefit conferred by AN at Day 14 (D14) as assessed by a 7-point Clinical Progression Scale. The secondary endpoint of the study was the impact of AN on the rate of transfer to the intensive care unit (ICU) and on the survival rate at D14. Results: The AN procedure was well-tolerated without any reported side effects but with no significant improvement for the measures of both primary (p > 0.3) and secondary (p > 0.05) endpoints at the interim analysis. None of the AN-treated patients died but one in the SN group did (81 years). Two AN-treated patients (73 and 79 years, respectively) and one SN-treated patient (59 years) were transferred to ICU. Remarkably, AN-treated patients were older with more representation by males than in the SN arm (i.e., the median age of 75 vs. 65 years, 79% male vs. 47%). Conclusion: The AN procedure, which was used within 72 h after the admission of patients with COVID-19, was safe and could be successfully implemented during the first two waves of COVID-19 in France. Nevertheless, AN did not significantly improve the outcome of the patients in our small preliminary study. It is pertinent to explore further to validate AN as the non-invasive mass vagal stimulation solution for the forthcoming pandemics. Clinical Trial Registration: [https://clinicaltrials.gov/], identifier [NCT04341415].
Collapse
Affiliation(s)
- Claire-Marie Rangon
- Pain and Neuromodulation Unit, Neurosurgery Department, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Régine Barruet
- Infectious Diseases Department, Centre Hospitalier Simone Veil, Beauvais, France
| | | | - Chloé Le Cossec
- Clinical Research Department, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Sophie Thevenin
- Clinical Research Department, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Jessica Guillaume
- Clinical Research Department, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Teddy Léguillier
- Clinical Research Department, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Fabienne Huysman
- Clinical Research Department, Centre Hospitalier Simone Veil, Beauvais, France
| | - David Luis
- Clinical Research Department, Centre Hospitalier Simone Veil, Beauvais, France.,Intensive Care Unit, Centre Hospitalier Simone Veil, Beauvais, France
| |
Collapse
|
13
|
Tsai SL, Reynoso E, Shin DW, Tsung JW. Acupuncture as a Nonpharmacologic Treatment for Pain in a Pediatric Emergency Department. Pediatr Emerg Care 2021; 37:e360-e366. [PMID: 30247457 DOI: 10.1097/pec.0000000000001619] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES With epidemic opioid deaths and abuse in the United States, government agencies recommend nonpharmacological treatments for pain. However nonopioid treatment options for moderate to severe pain in the pediatric emergency department (PED) are limited. Acupuncture has been shown to be effective for pain. The objective of this study was to evaluate the feasibility of using traditional acupuncture (TA) and battlefield acupuncture (BFA) in the treatment of pain in the PED. METHODS A pediatric cohort treated with acupuncture for pain in an urban PED was assessed. All subjects received TA or BFA as treatment, and pre/postacupuncture pain scores, feedback, and adverse events were assessed. The primary outcome was a change in pain score. RESULTS Twelve patients received BFA, and 13 received TA for these pain conditions: headaches, sciatica, paraphimosis, torticollis, joint pains (knee, shoulder, jaw), sprains (foot, wrist, thumb), dysmenorrhea, otitis externa, sickle cell, and muscle knot. The mean ± SD pain score change, 5.8 ± 2.5 (P < 0.05; 95% confidence interval, 4.9-7.0), was clinically and statistically significant. Over 90% of subjects reported significant improvement or resolution of pain; 96% were satisfied with pain relief and would receive acupuncture again. Two adverse events were noted: one patient reported dizziness, and another, a tinge of blood at 1 of 90 needled points. CONCLUSIONS This study suggests that acupuncture is a potential nonpharmacologic therapeutic option for acute pain management in the PED.
Collapse
Affiliation(s)
- Shiu-Lin Tsai
- From the Division of Pediatric Emergency Medicine, Department of Emergency Medicine
| | - Elena Reynoso
- Division of Gastroenterology, Department of Pediatrics, Columbia University College of Physicians and Surgeons
| | | | - James W Tsung
- Department of Emergency Medicine, Mount Sinai Medical Center, New York, NY
| |
Collapse
|
14
|
Viel E, Truong D, Rambach L, Guinet F, Vanoli A, Schipman B, Harami D. Efficacy of Auricular Acupuncture in Chemotherapy-Induced Peripheral Neuropathy: A Case Series of 73 Cases. Med Acupunct 2021; 33:212-218. [PMID: 35003493 DOI: 10.1089/acu.2020.1506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background: Chemotherapy-induced peripheral neuropathy (CIPN) can adversely affect completion of systemic anticancer treatment and cause long-term morbidity. To date, its physiopathology remains unclear, and treatments are rare and poorly performed. Auricular acupuncture has already offered interesting results in several symptoms. Objective: This study (AACIPN2020) assessed the efficacy of auriculotherapy in CIPN. Design: We used patients' systematically collected data of 2014-2016 in a medical oncology practice. The treatment was made according to guidelines of the interuniversity diploma and the cartography of the World Health Organization. Pain assessment according to the Common Terminology Criteria for Adverse Event scale was orally collected. Results: Seventy-three cancer patients were treated for CIPN. They had finished chemotherapy 24 weeks prior on average. They received on average 23 punctures at each appointment. Sixty-five percent of patients met satisfaction, with 31% with a real impact on their daily life. Efficacy appeared after one or two treatments for 96% of cases. Some patients continued treatment to maximize benefits. Conclusions: Auricular acupuncture is a safe and inexpensive method of CIPN treatment. It may be applied earlier in chemotherapy administration, and in a large variety of other symptoms. Clinical trial registration number: COS RGDS 2019 09 001.
Collapse
Affiliation(s)
- Erika Viel
- Medical Oncology, Ramsay Générale de Santé, Hopital Privé Sainte Marie, Chalon-sur-Saône, France.,Centre Georges-François Leclerc, Dijon, France
| | | | - Laurie Rambach
- Medical Oncology, Centre Hospitalier William Morey, Chalon-sur-Saône, France
| | - François Guinet
- Medical Oncology, Centre Hospitalier Galuzot, Montceau Les Mines, France
| | - André Vanoli
- Medical Oncology, Ramsay Générale de Santé, Hopital Privé Sainte Marie, Chalon-sur-Saône, France
| | - Benjamin Schipman
- Radiotherapy, Institut de Cancérologie de Bourgogne, Chalon-sur-Saône, France
| | | |
Collapse
|
15
|
Habibabadi MR, Ashtari F, Raeisi I. Effect of Auricular Acupuncture with Semi-Permanent Ear Needles on Controlling Migraine Symptoms: A Single-Blind Randomized Clinical Trial. J Acupunct Meridian Stud 2021; 14:58-66. [DOI: 10.51507/j.jams.2021.14.2.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 01/13/2021] [Accepted: 03/08/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Mehran Razvani Habibabadi
- Department of Anesthesiology, Anesthesiology and Critical Care Research Center, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fereshteh Ashtari
- Neurology Department, Isfahan University of Medical Sciences, Isfahan Neuroscience Research Center, Isfahan, Iran
| | - Iman Raeisi
- Resident of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
16
|
Therapeutic effects of auricular point acupressure on the recovery of patients after pterygium surgery: A pilot study. Complement Ther Clin Pract 2021; 43:101339. [PMID: 33639517 DOI: 10.1016/j.ctcp.2021.101339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 02/08/2021] [Accepted: 02/17/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND and purpose: Postoperative pain in the pterygium of the eye seriously affects patient recovery. This study was conducted to assess the efficacy of auricular point acupressure treatment on post-operative recovery in patients after pterygium surgery. MATERIALS AND METHODS This was a pilot, randomized controlled study. A total of 60 patients (60 eyes) were randomly assigned to two groups. After pterygium surgery, the auricular group was treated using ear acupressure (acupressure points with Cowherb seeds) and the control group was treated using sham auricular therapy (acupressure points without Cowherb seeds). Both groups were treated for one week. Outcome measures included pain score, corneal epithelial score, best-corrected visual acuity, and recurrence rate. RESULTS Fifty-three patients completed the study. The mean pain scores and corneal epithelial scores were significantly reduced over time in the auricular group compared with those in the control group (p < 0.05). The time-group interaction for both pain scores and corneal epithelial scores was significant between the two groups (p < 0.05). Simple main effect analysis showed the mean pain scores in the auricular group were significantly lower at each time point (the first 2-h, the first day, the third day and the first week, p < 0.05) than the control group. Mean corneal epithelial scores of the auricular group were significantly lower on the first day and third day respectively than the control group (p < 0.05). There was no significant difference in the best-corrected visual acuity or recurrence rate between the two groups (p > 0.05). CONCLUSION Auricular point acupressure accelerates corneal epithelium reconstruction and suppresses postoperative pain, making it an ideal adjunct treatment for postoperative pterygium recovery. CLINICAL TRIAL REGISTRATION NUMBER ChiCTR2000032490 on http://www.chictr.org.cn/.
Collapse
|
17
|
Binesh M, Daghighi MR, Shirazi E, Oleson T, Hashem-Dabaghian F. Comparison of Auricular Therapy with Sham in Children with Attention Deficit/Hyperactivity Disorder: A Randomized Controlled Trial. J Altern Complement Med 2020; 26:515-520. [DOI: 10.1089/acm.2019.0477] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Marzieh Binesh
- Department of Research, Iran University of Medical Sciences, Tehran, Iran
| | | | - Elham Shirazi
- Spiritual Health Research Center, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Terry Oleson
- Department of Traditional Oriental Medicine, Emperor's College of Traditional Oriental Medicine, Santa Monica, CA, USA
| | - Fataneh Hashem-Dabaghian
- Research Institute for Islamic and Complementary Medicine, School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
18
|
Effects of the Whole-Body Vibration and Auriculotherapy on the Functionality of Knee Osteoarthritis Individuals. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9235194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Knee osteoarthritis (KOA) is a degenerative disease of the knee joint. This study aims to evaluate the effects of whole-body vibration (WBV), auriculotherapy (AT), and the association of these techniques with the functionality of KOA individuals. Individuals (n = 120) were allocated an AT group (GAT), a WBV group (GWBV), an association group (GWBV + AT), and their respective controls (CGAT, CGWBMV, CGWBMV + AT). The WBV intervention was performed with 5–14 Hz in 3 min of working time with 1 min rest. The control group performed the protocol with the vibrating platform (VP) turned off. The AT intervention was performed with adhesive tapes, with seeds placed in the both ears on the Shenmen point, knee joint, and kidney. The control groups had seedless tape placed on both ears. The participants were instructed to press the adhesive tapes with the fingers three times per day (for 6 days) and to remove the adhesive tapes on the seventh day, before returning to the laboratory. The International Knee Documentation Committee (IKDC), the short physical performance battery (SPPB), and the anterior trunk flexibility (ATF) tests were applied. Acute and cumulative effects were determined. In first session (acute effect of the first session), significant improvements were observed in the groups GWBV (p = 0.03) and GWBV + AT (p = 0.04), and in the cumulative effect a significant improvement was observed in the groups GWBV (p = 0.02) and GWBV + AT (p = 0.01). Concerning the overall score of the SPPB, significant improvements were observed in the individuals of the GWBV (p = 0.01) and GWBV + AT (p = 0.03) groups (cumulative effect). No changes were found in the score for the IKDC. The WBV alone or associated with AT, besides being a safe and feasible strategy, likely produces physiological responses that improve the functionality of KOA individuals, considering the findings of the ATF and the score of the SPPB.
Collapse
|
19
|
Melo RNR, Francisco SC, Moura CDC, Loudon K, Sawada NO, Chaves ÉDCL, Chianca TCM, Nogueira DA, Zhu SJ, Garcia ACM. Auriculotherapy to control chemotherapy-induced nausea and vomiting in patients with cancer: protocol of a systematic review. Syst Rev 2019; 8:206. [PMID: 31416474 PMCID: PMC6694486 DOI: 10.1186/s13643-019-1124-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/26/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Due to the worldwide rise in cancer incidence, and therefore the rise in the need for antineoplastic chemotherapy, it is important for both healthcare professionals and patients alike that the side effects of chemotherapy, such as chemotherapy-induced nausea and vomiting (CINV), are treated and prevented. Auriculotherapy is a type of acupuncture and may be a low-cost and safe antiemetic measure to control the side effects of chemotherapy. The goal of this systematic review is to synthesize the available evidence in the literature regarding the auriculotherapy effects to treat CINV in people with cancer. METHODS The review will only include randomized controlled trials (RCTs) that compare the clinical effects of the auriculotherapy intervention (used alone or as an add-on), with sham auriculotherapy, routine treatment with antiemetic drugs, or other non-pharmacological interventions in patients with cancer with CINV who are undergoing chemotherapy. The outcomes to be evaluated are nausea and vomiting: in acute, delayed, or anticipated stages, when induced by chemotherapy. A comprehensive search for studies will be carried out in these databases: MEDLINE via PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, ICTRP, LILACS, CUMED, IBECS, BVS MTCI Americas, Web of Science, Scopus, PEDro, CNKI, and CBMdisc up until December 31, 2018. Only articles in English, Portuguese, and Spanish will be selected. Two independent reviewers will evaluate full texts, extract data, and assess the risk of bias of eligible articles. The quality of evidence will be assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). A meta-analysis will be undertaken to assess the interventions and outcomes' homogeneity, assessing statistical heterogeneity using the Cochran's Q test and quantified using Higgins' inconsistency index. If there is insufficient data for a meta-analysis, a narrative synthesis will be presented. This protocol has been prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. DISCUSSION The results of this systematic review will summarize the strength of evidence for the use of auriculotherapy in the control of CINV of patients with cancer and will be used to identify evidence gaps. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018117513.
Collapse
Affiliation(s)
- Ruan Nilton Rodrigues Melo
- School of Nursing, Federal University of Alfenas, Gabriel Monteiro da Silva street, 700-Centro, Alfenas, MG 30.130-100 Brazil
| | - Stephanie Carolina Francisco
- School of Nursing, Federal University of Alfenas, Gabriel Monteiro da Silva street, 700-Centro, Alfenas, MG 30.130-100 Brazil
| | - Caroline de Castro Moura
- School of Nursing, Federal University of Minas Gerais, Prof. Alfredo Balena avenue 190-Santa Efigênia, Belo Horizonte, MG 37.130-001 Brazil
| | | | - Namie Okino Sawada
- Ribeirão Preto College of Nursing, University of São Paulo, Bandeirantes avenue 3900–University Campus-Monte Alegre, Ribeirão Preto, SP 14.040-900 Brazil
| | - Érika de Cássia Lopes Chaves
- School of Nursing, Federal University of Alfenas, Gabriel Monteiro da Silva street, 700-Centro, Alfenas, MG 30.130-100 Brazil
| | - Tânia Couto Machado Chianca
- School of Nursing, Federal University of Minas Gerais, Prof. Alfredo Balena avenue 190-Santa Efigênia, Belo Horizonte, MG 37.130-001 Brazil
| | - Denismar Alves Nogueira
- Institute of Exact Sciences, Federal University of Alfenas, Gabriel Monteiro da Silva street 700-Centro, Alfenas, MG 37.130-001 Brazil
| | - Si Jia Zhu
- Centre of Evidence-Based Medicine, Beijing University of Chinese Medicine (BUCM)–China, East road 11 of North Third Ring road-Chaoyang district, CEP(Zip code), Beijing, 1000029 China
| | - Ana Cláudia Mesquita Garcia
- School of Nursing, Federal University of Alfenas, Gabriel Monteiro da Silva street, 700-Centro, Alfenas, MG 30.130-100 Brazil
| |
Collapse
|
20
|
Tesser CD, Moré AOO, Santos MC, da Silva EDC, Farias FTP, Botelho LJ. Auriculotherapy in primary health care: A large-scale educational experience in Brazil. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2019; 17:302-309. [PMID: 31076373 DOI: 10.1016/j.joim.2019.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 01/11/2019] [Indexed: 01/15/2023]
Abstract
Auriculotherapy consists of physical stimuli applied to the outer ear and is commonly associated with traditional Chinese medicine (TCM). The authors present and discuss the development of a course that offers a semi-on-site auriculotherapy course for Brazilian primary health care (PHC) professionals. The course was funded by the Brazilian Ministry of Health and developed at the Federal University of Santa Catarina in 2015 by a team of experts in auriculotherapy. It consisted of 75 h of distance learning (five sequential modules) and 5 h of on-site learning. The modules included the following items: (1) introduction to integrative practices; (2) ear reflexology; (3) introduction to TCM; (4) biomedical view of auriculotherapy; and (5) auriculotherapy in PHC. The teaching material included a workbook for each module, 14 video lectures and an interactive ear (online resource) to study location and application to the main auricular points. The on-site lectures follow a structured script of ear palpation techniques, auricular seed insertion practice and clinical case discussions, under the supervision of trained instructors. The course was offered in 2016 and 2017 and on-site lectures took place in 25 cities, covering all Brazilian regions, in coordination with municipal or state boards of health. A total of 4273 health professionals concluded the training and their evaluation of the course was highly positive. The Brazilian experience of large-scale training shows the potential to disseminate auriculotherapy in the context of PHC, given that its practice is fast, easy to learn, safe, effective for different health problems and well accepted by the patients.
Collapse
Affiliation(s)
- Charles Dalcanale Tesser
- Department of Public Health, Federal University of Santa Catarina, Florianópolis, Santa Catarina 88036-800, Brazil; Post-graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Santa Catarina 88036-800, Brazil
| | - Ari Ojeda Ocampo Moré
- Integrative Medicine and Acupuncture Service, University Hospital, Federal University of Santa Catarina, Florianópolis, Santa Catarina 88036-800, Brazil; Florianópolis Municipality Health Office, Florianópolis, Santa Catarina 88036-800, Brazil.
| | - Melissa Costa Santos
- Florianópolis Municipality Health Office, Florianópolis, Santa Catarina 88036-800, Brazil
| | | | | | - Lúcio José Botelho
- Department of Public Health, Federal University of Santa Catarina, Florianópolis, Santa Catarina 88036-800, Brazil; Post-graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Santa Catarina 88036-800, Brazil
| |
Collapse
|
21
|
Vieira A, Reis AM, Matos LC, Machado J, Moreira A. Does auriculotherapy have therapeutic effectiveness? An overview of systematic reviews. Complement Ther Clin Pract 2018; 33:61-70. [DOI: 10.1016/j.ctcp.2018.08.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 07/11/2018] [Accepted: 08/21/2018] [Indexed: 02/06/2023]
|
22
|
You E, Kim D, Harris R, D'Alonzo K. Effects of Auricular Acupressure on Pain Management: A Systematic Review. Pain Manag Nurs 2018; 20:17-24. [PMID: 30340870 DOI: 10.1016/j.pmn.2018.07.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 07/03/2018] [Accepted: 07/27/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Nearly half of hospitalized patients in the United States have reported experiencing pain even while undergoing treatment for pain. Analgesic use is the most common type of treatment for pain management. Many patients who experience pain seek nonpharmacologic interventions to manage their pain, including forms of complementary or alternative medicine such as auricular acupressure (AA). DESIGN This study conducted the first systematic review of the studies that have evaluated the effect of AA as an adjunct on pain management. DATA SOURCES We searched PubMed, CINAHL, Embase, Google Scholar, and Wiley for randomized controlled trials on AA. REVIEW/ANALYSIS METHODS The pain outcomes were pain severity and analgesic consumption. Methodologic quality was also evaluated. Fifteen randomized controlled trials were included in this analysis. RESULTS Twelve studies reported statistically significant improvement in the pain outcomes of AA treatment compared with the sham or standard care groups. When methodologic quality was assessed, the selected studies had medium quality, but there was a lack of high quality. This supports that the use of AA for patients may enhance self-management for their pain. However, the small number of studies and the lack of consistent rigorous methodology across the studies preclude definitive statements regarding the effectiveness of AA. CONCLUSION The nursing implications based on this review is that education about AA and complementary or alternative medicine therapies for health care providers may assist them in providing pain control for their patients. In addition, we need to continue research to build on evidence on the effect of AA on pain management.
Collapse
Affiliation(s)
| | - David Kim
- Rutgers University Medical School, New Brunswick, New Jersey
| | - Ryan Harris
- University of North Carolina, Charlotte, North Carolina
| | | |
Collapse
|
23
|
Antônio AM, Guirro ECDO, Dos Santos TP, Ferreira VTK, Silva MLD, de Araujo JE. Lower limb auriculotherapy points improves balance in young healthy subjects-assessed by computerized baropodometry. Complement Ther Clin Pract 2018; 32:46-50. [PMID: 30057056 DOI: 10.1016/j.ctcp.2018.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/26/2018] [Accepted: 05/03/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To analyze the effects of Lower Limb (LL) auricular stimulation points on the static equilibrium of healthy subjects, assessed by computerized baropodometry. METHODS AND MATERIALS Forty volunteers were assigned to one of two groups: Auriculotherapy (AT) who received unilateral needle stimulation of the coxofemoral, knee, and ankle points. Control (C) who did not receive any stimulation. We analyzed the contact area (CA) and the peak pressure (PP) for both feet at baseline, 20 and 25 min after the baseline was recorded. Three-Way ANOVA (P < 0.05) was used for data analysis. RESULTS AT showed an increase in CA (F:6.49) and a decrease in PP (F:3.11) at 20 and 25 min, when compared to C. The PP decreased was only for the right LL at 20 and 25 min (F:6.45). CONCLUSION The auriculotherapy points were able to modify the ipsilateral weight discharge on the same side of the stimulated auricular pavilion.
Collapse
Affiliation(s)
- Amanda Machado Antônio
- Laboratory of Neuropsychobiology and Motor Behavior, Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo (USP), AV. dos Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| | - Elaine Caldeira de Oliveira Guirro
- Laboratory of Neuropsychobiology and Motor Behavior, Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo (USP), AV. dos Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| | - Tamyris Padovani Dos Santos
- Laboratory of Neuropsychobiology and Motor Behavior, Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo (USP), AV. dos Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| | - Vânia Tiê Koga Ferreira
- Laboratory of Neuropsychobiology and Motor Behavior, Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo (USP), AV. dos Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| | - Marcelo Lourenço da Silva
- Laboratory of Neuropsychobiology and Motor Behavior, Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo (USP), AV. dos Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| | - João Eduardo de Araujo
- Laboratory of Neuropsychobiology and Motor Behavior, Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo (USP), AV. dos Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil.
| |
Collapse
|
24
|
Sampaio-Filho H, Bussadori SK, Gonçalves MLL, da Silva DDFT, Borsatto MC, Tortamano IP, Longo PL, Pavani C, Fernandes KPS, Mesquita-Ferrari RA, Horliana ACRT. Low-level laser treatment applied at auriculotherapy points to reduce postoperative pain in third molar surgery: A randomized, controlled, single-blinded study. PLoS One 2018; 13:e0197989. [PMID: 29920521 PMCID: PMC6007895 DOI: 10.1371/journal.pone.0197989] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 05/07/2018] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Evaluate the effectiveness of LLL (Low level laser therapy) in auriculotherapy points for pain reduction following lower third molar extractions. STUDY DESIGN Randomized, controlled, single-blinded study. METHODS Eighty-four bilateral, symmetrical third molar surgeries were performed in 42 healthy patients using a split-mouth design. In the immediate postoperative period, each side was randomly treated in a single-blind method with an LLL at the auriculotherapy points or simulation of its use (contralateral side) over a 21-day interval. This protocol was repeated 24 and 48 hours after surgery. All patients used the same analgesic (paracetamol) but only in case of pain. The primary variable was postoperative pain according to the visual analogue scale, and the secondary variables were mouth opening, edema, local temperature, dysphagia, and the presence of infection (systemic temperature, lymphadenopathy). These variables were evaluated at baseline and at 24 hours, 48 hours and seven days after surgery. Adverse effects were recorded and reported. RESULTS There was no difference between the groups in relation to any of the evaluated parameters (p>0.05). CONCLUSION For this experimental model, application of a low-intensity laser at auriculotherapy points did not prevent postoperative pain following lower third molar surgery. TRIAL REGISTRATION This trial is registered at ClinicalTrials.gov; the registration number is NCT02657174 and the Unique Protocol ID number is 1.100.869. (https://register.clinicaltrials.gov/prs/app/template/EditRecord.vm?epmode=View&listmode=Edit&uid=U0002BEY&ts=11&sid=S0006026&cx=6g4wff).
Collapse
Affiliation(s)
- Hélio Sampaio-Filho
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
| | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
| | - Marcela Leticia Leal Gonçalves
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
| | | | | | | | | | - Christiane Pavani
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
| | | | - Raquel Agnelli Mesquita-Ferrari
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
| | | |
Collapse
|
25
|
Clinical effect of auricular acupuncture in anxiety levels of students prior to the exams: A randomized controlled trial. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
26
|
Stadler J, Raith W. Active Ear Acupuncture Points in Neonates: Initial Results in a New Research Field. Med Acupunct 2018; 30:155-158. [PMID: 29937970 DOI: 10.1089/acu.2018.1277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Little is known about active ear acupuncture points (EAP) in neonates. Previous unblinded studies by Stähler van Amerongen et al. showed that neonates have detectable active EAP, and that sick neonates could have more EAP relative to healthy neonates. EAP was investigated in an unblinded trial involving neonates with neonatal abstinence syndrome (NAS). Furthermore, a blinded, controlled observational trial was conducted to compare active EAP present in healthy neonates with EAP of sick neonates. Materials and Methods: An electrical point search device (PS3, Silberbauer, Vienna, Austria) was used to detect EAP. Active EAP were detected with an integrated optical and acoustical signal, and readings were transferred to a standardized ear map. A Mann-Whitney-U test and Spearman's correlation were used for statistical analysis. Results: A total of 94 neonates were enrolled across both trials. EAP were detectable in all healthy and sick neonates. In the blinded trial, sick neonates had a significantly higher number of active EAP than did healthy neonates. Conclusions: A notable difference in the number of active EAP was detected between healthy and sick neonates. More trials with larger sample sizes are needed to confirm the diagnostic power of EAP in neonates.
Collapse
Affiliation(s)
- Jasmin Stadler
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.,Research Group for Paediatric Traditional Chinese Medicine, TCM Research Center Graz (Acupuncture Research), Medical University of Graz, Graz, Austria
| | - Wolfgang Raith
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.,Research Group for Paediatric Traditional Chinese Medicine, TCM Research Center Graz (Acupuncture Research), Medical University of Graz, Graz, Austria
| |
Collapse
|
27
|
Abstract
OBJECTIVES Headache remains a frequent complaint for children presenting to a pediatric emergency department (ED). Typical treatments include oral or intravenous medications, but do not always relieve pain. An alternative intervention is auricular acupuncture. It has been shown to be effective in the treatment of migraines in adults. The objective of this study was to evaluate the utility and adverse effects of auricular acupuncture in the treatment of pediatric migraines in the ED. METHODS This was a prospective, interventional, cohort study of patients 8 to 18 years of age. Efficacious ear points were located by needle contact or electrical point finder with attention to 2 migraine lines on the ear. ASP gold semipermanent ear needles were placed in the efficacious points and patients were monitored for 15 minutes. The primary outcome was the change in preintervention and postintervention pain scores using a numerical self-reported pain visual analog scale (VAS). RESULTS Nineteen patients elected to enroll in the study. The mean change in the VAS scores was both clinically and statistically significant at 7.03 (interquartile range, 6-8.5) with a P value of less than 0.001. Two patients elected to withdraw from the study secondary to incomplete resolution of migraine pain despite improvement in VAS scores. There were no known adverse events. CONCLUSIONS With all subjects showing improvement or resolution of migraine headache, this pilot study introduces an alternative intervention to pediatric migraine management. Further studies are needed to evaluate the duration of symptom resolution and comparative effectiveness; auricular acupuncture seems to be a valid alternative.
Collapse
|
28
|
Mercante B, Deriu F, Rangon CM. Auricular Neuromodulation: The Emerging Concept beyond the Stimulation of Vagus and Trigeminal Nerves. MEDICINES 2018; 5:medicines5010010. [PMID: 29361732 PMCID: PMC5874575 DOI: 10.3390/medicines5010010] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 01/12/2018] [Accepted: 01/19/2018] [Indexed: 12/16/2022]
Abstract
Neuromodulation, thanks to intrinsic and extrinsic brain feedback loops, seems to be the best way to exploit brain plasticity for therapeutic purposes. In the past years, there has been tremendous advances in the field of non-pharmacological modulation of brain activity. This review of different neurostimulation techniques will focus on sites and mechanisms of both transcutaneous vagus and trigeminal nerve stimulation. These methods are scientifically validated non-invasive bottom-up brain modulation techniques, easily implemented from the outer ear. In the light of this, auricles could transpire to be the most affordable target for non-invasive manipulation of central nervous system functions.
Collapse
Affiliation(s)
- Beniamina Mercante
- Department of Biomedical Sciences, University of Sassari, Sassari 07100, Italy.
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Sassari 07100, Italy.
| | - Claire-Marie Rangon
- Head of Scientific Auriculotherapy Diploma, Faculty of Medicine, University of Paris-Saclay, Saclay 94270, France.
| |
Collapse
|
29
|
Efficacy of Auricular Acupressure for Chronic Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:6383649. [PMID: 28804504 PMCID: PMC5539928 DOI: 10.1155/2017/6383649] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/14/2017] [Accepted: 06/08/2017] [Indexed: 12/19/2022]
Abstract
Objectives To identify the efficacy of auricular acupressure on pain and disability for chronic LBP by systematic review. Methods A search of randomized controlled trials was conducted in four English medical electronic databases and three Chinese databases. Two reviewers independently retrieved related studies, assessed the methodological quality, and extracted data with a standardized data form. Meta-analyses were performed using all time-points meta-analysis. Results A total of 7 trials met the inclusion criteria, of which 4 had the low risk of bias. The findings of this study showed that, for the immediate effect, auricular acupressure had large, significant effects in improving pain within 12 weeks. As for the follow-up effect, the pooled estimates also showed promising effect at 4-week follow-up after 4-week intervention (standardized mean difference = −1.13, 95% CI (−1.70, −0.56), P < 0.001). But, for the disability level, the therapeutic effect was not significant (mean difference = −1.99, 95% CI (−4.93, 0.95), P = 0.18). No serious adverse effects were recorded. Conclusions The encouraging evidence of this study indicates that it is recommended to provide auricular acupressure to patients with chronic low back pain. However, a more accurate estimate of the effect will require further rigorously designed large-scale RCTs on chronic LBP for improving pain and disability.
Collapse
|
30
|
Sampaio-Filho H, Sotto-Ramos J, Pinto EH, Cabral MR, Longo PL, Tortamano IP, Marcos RL, Silva DFT, Pavani C, Horliana ACRT. Evaluation of low-level laser at auriculotherapy points to reduce postoperative pain in inferior third molar surgery: study protocol for a randomized controlled trial. Trials 2016; 17:432. [PMID: 27590454 PMCID: PMC5010672 DOI: 10.1186/s13063-016-1540-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 08/05/2016] [Indexed: 11/10/2022] Open
Abstract
Background A comfortable postoperative return to daily activities has increased the need to control inflammation after third molar surgery. Anti-inflammatory drugs and analgesics are not exempt from adverse effects such as allergies and chronic gastritis, and they are not without cost. The association between low-level laser and auricular acupuncture can be an alternative when conventional drugs are contraindicated. Among its advantages, we can mention the low risk of side effects, low cost and simplicity of application. The objective of this study is to evaluate the efficiency of low-level laser at auriculotherapy points in reducing postoperative pain in lower third molar surgery. Methods/design Ninety bilateral, symmetrical lower third molar surgeries will be performed in 45 healthy patients. Each patient will be their own control, through a split-mouth crossover study. One side of the mouth will be randomly chosen and, immediately after surgery, will be treated with low-level laser. After 21 days, the contralateral side will be operated on with low-level laser simulation used postoperatively. This regimen (laser application or not) will be repeated at 24 and 48 h after surgery. All patients will be requested to take analgesics (acetaminophen) if they have pain, i.e. in case of pain. Neither the surgeon nor the patients will know the assigned treatment. The primary variable will be postoperative pain assessed using a Visual Analog Scale, and the secondary variables will be trismus, edema, local temperature, dysphagia, presence of infection and painkiller ingestion. These variables will be assessed at baseline, 24 h, 48 h and 7 days after surgery. Blood samples for systemic inflammatory cytokine (TNF-α, IL-1, IL-6 and IL-8) analysis will be assessed at baseline and 24 h after surgery. Discussion Some authors believe that using a wavelength of 633 to 670 nm is a good option for laser therapy in the field of acupuncture. This wavelength can penetrate biological tissue to a depth of about 3 mm. However, for auriculotherapy points, the stimulus (mustard seeds, needles 1 to 2.5 mm) does not penetrate so deeply. For this reason, we chose a laser wavelength of 660 nm (red wavelength). Trial registration ClinicalTrials.gov Identifier: NCT02657174, registered on 11 January 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1540-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Hélio Sampaio-Filho
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil
| | - Juliane Sotto-Ramos
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil
| | - Erika Horácio Pinto
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil
| | - Marcia Regina Cabral
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil
| | - Priscila Larcher Longo
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil
| | | | - Rodrigo Labat Marcos
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil
| | - Daniela Fátima Teixeira Silva
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil
| | - Christine Pavani
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil
| | - Anna Carolina Ratto Tempestini Horliana
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil.
| |
Collapse
|
31
|
Huang W, Halpin SN, Perkins MM. A case series of auricular acupuncture in a veteran's population using a revised auricular mapping-diagnostic paradigm (RAMP-uP). Complement Ther Med 2016; 27:130-6. [PMID: 27515887 DOI: 10.1016/j.ctim.2016.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 01/19/2016] [Accepted: 06/10/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES To evaluate clinical effects of auricular acupuncture treatments for pain based on a revised auricular mapping and diagnostic paradigm (RAMP-uP). DESIGN Retrospective chart review. SETTING A major US Veterans Affairs Medical Centre located in the Southeaster United States. 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.
Collapse
Affiliation(s)
- W Huang
- Extended Care/Physical Medicine and Rehabilitation, Atlanta VA Medical Centre, 1670 Clairmont Road, Decatur, GA 30033, United States; Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States.
| | - S N Halpin
- Department of General and Geriatric Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States
| | - M M Perkins
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Centre, Atlanta VA Medical Centre, Atlanta, GA 30033, United States; Department of General and Geriatric Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States
| |
Collapse
|
32
|
Affiliation(s)
- David Alimi
- Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| |
Collapse
|
33
|
The effects of electroacupuncture on analgesia and peripheral sensory thresholds in patients with burn scar pain. Burns 2015; 41:1298-305. [PMID: 26188894 DOI: 10.1016/j.burns.2015.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 12/23/2014] [Accepted: 03/03/2015] [Indexed: 11/22/2022]
Abstract
The aim of this study is to observe if the effects of electro-acupuncture (EA) on analgesia and peripheral sensory thresholds are transposable from the model of heat pain in volunteers to the clinical setting of burn scar pain. After severe burns, pathological burn scars (PPBS) may occur with excruciating pain that respond poorly to treatment and prevent patients from wearing their pressure garments, thereby leading to unesthetic and function-limiting scars. EA might be of greater benefit in terms of analgesia and functional recovery, should it interrupt this vicious circle by counteracting the peripheral hyperalgesia characterizing PPBS. Therefore we enrolled 32 patients (22 males/10 females) aged of 46±11 years with clinical signs of PPBS and of neuropathic pain despite treatment. The study protocol consisted in 3 weekly 30-min sessions of standardized EA with extra individual needles in accordance to Traditional Chinese Medicine, in addition of previous treatments. We assessed VAS for pain and quantitative sensory testing (QST) twice: one week before and one after protocol. QST measured electrical thresholds for non-nociceptive A-beta fibers, nociceptive A-delta and C fibers in 2 dermatomes, respectively from the PPBS and from the contralateral pain-free areas. Based on heat pain studies, EA consisted in sessions at the extremity points of the main meridian flowing through PPBS (0.300s, 5Hz, sub noxious intensity, 15min) and at the bilateral paravertebral points corresponding to the same metameric level, 15min. VAS reduction of 3 points or below 3 on a 10 points scale was considered clinically relevant. Paired t-test compared thresholds (mean [SD]) and Wilcoxon test compared VAS (median [IQR]) pre and after treatment, significant p<0.05. The reduction of VAS for pain reached statistical but not clinical relevance (6.8 [3] vs. 4.5 [3.6]). This was due to a large subgroup of 14 non-responders whose VAS did not change after treatment (6.6 [2.7] vs. 7.2 [3.8]). That subgroup exhibited significant differences in sensory thresholds when compared to the 18 responders (VAS from 7 [3] to 3 [1]). First, responders' thresholds for A-delta and C fibers in the PPBS area were significantly lower than those in the pain-free area before treatment but corrected after acupuncture (from respectively 60 [30] and 63 [10]% to 91 [11] and 106 [36]%). That might account for a nociceptive hypersensitivity in the PPBS that corrected after treatment. On the contrary, in non-responders nociceptive thresholds were similar in both the PPBS and the pain-free areas before treatment and did not change after EA. However, absolute values for thresholds in the pain-free areas where significantly lower for non-responders than for responders. The fact that non-responders had significant pain scores while presenting with lowered nociceptive thresholds even in the pain-free areas might evoke the possibility of a generalized supra-spinal hyperalgesia. The fact that acupuncture did not correct the pain nor the nociceptive thresholds in this subgroup requires further investigation. We also observed a statistically and clinically relevant reduction in VAS for pruritus for all patients - even those from the subgroup of non-responders to pain - that is worth to be mentioned and requires further studies to be confirmed. This observational study is the first that confirms the effects of acupuncture on analgesia and nociceptive thresholds in the clinical setting of burn pain only for patients presenting with a burn-localized but not a generalized hyperalgesia.
Collapse
|