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Tardelli JDC, Gubitoso B, Botelho AL, Valente MLDC, Reis ACD. Efficacy of acupuncture on craniomandibular myofascial pain in temporomandibular disorder patients: A systematic review. Heliyon 2024; 10:e32075. [PMID: 39091957 PMCID: PMC11292537 DOI: 10.1016/j.heliyon.2024.e32075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/11/2024] [Accepted: 05/28/2024] [Indexed: 08/04/2024] Open
Abstract
Background This systematic review aimed to answer the question, "What is the efficacy of acupuncture treatment in patients with temporomandibular disorder (TMD) with myofascial pain?". Data sources and study selection This study followed PRISMA guidelines and was registered in PROSPERO. The electronic search strategy was applied to the Scopus, PubMed, Embase, and Science Direct databases. As inclusion criteria, were selected randomized clinical articles that evaluated patients with myofascial pain symptoms treated by acupuncture without the restriction of time and language. Results The search in the databases resulted in 286 articles, after removing the duplicates 251 were analyzed by title and abstract. Twenty were selected for full reading and 10 were included in the systematic review. The studies evaluated acupuncture treatments by puncture and laser, auriculotherapy by puncture and laser, and an occlusal device for treating myofascial TMD. Conclusions Comparing acupuncture with placebo acupuncture, it was observed that it is effective for subjective pain relief and palpation of orofacial structures with immediate results; it should be noted that there is still no specific protocol and that the duration of treatment must be personalized. When comparing it with the occlusal device, the associated treatment has enhanced the results. Future studies are suggested by the current literature gap that prevents the determination of clinical guidelines for effective acupuncture treatment in TMD patients with myofascial pain. Practical implications Laser and needle puncture acupuncture treatment and laser and needle puncture auriculotherapy have shown favorable results in short-term myofascial pain relief. The need for long-term studies to assess benefits and reduce possible biases is highlighted. Clinical trial registry name PROSPERO (CRD42021271505).
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Affiliation(s)
- Juliana Dias Corpa Tardelli
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Bruna Gubitoso
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - André Luís Botelho
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Mariana Lima da Costa Valente
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Andréa Cândido dos Reis
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
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Usichenko TI, Cummings M. Appropriate times to measure the credibility of blinding in placebo-controlled acupuncture trials. Acupunct Med 2024; 42:52-53. [PMID: 38014697 DOI: 10.1177/09645284231210579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Affiliation(s)
- Taras I Usichenko
- Department of Anaesthesiology, University Medicine of Greifswald, Greifswald, Germany
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
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Cheng SI, Swamidoss CP, Soffin EM. Perioperative Acupuncture: A Novel and Necessary Addition to ERAS Pathways for Total Joint Arthroplasty. HSS J 2024; 20:122-125. [PMID: 38356751 PMCID: PMC10863582 DOI: 10.1177/15563316231204308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 02/16/2024]
Affiliation(s)
- Stephanie I Cheng
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA
- Department of Anesthesiology, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
| | - Cephas P Swamidoss
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA
- Department of Anesthesiology, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
| | - Ellen M Soffin
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA
- Department of Anesthesiology, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
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Hua K, Cummings M, Bernatik M, Brinkhaus B, Usichenko T, Dietzel J. Cardiovascular effects of auricular stimulation -a systematic review and meta-analysis of randomized controlled clinical trials. Front Neurosci 2023; 17:1227858. [PMID: 37727325 PMCID: PMC10505819 DOI: 10.3389/fnins.2023.1227858] [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: 05/23/2023] [Accepted: 08/17/2023] [Indexed: 09/21/2023] Open
Abstract
Background The number of randomized controlled trials using auricular stimulation (AS) such as transauricular vagus nerve stimulation, or other auricular electrostimulation or auricular acupuncture or acupressure, in experimental and clinical settings, has increased markedly over the last three decades. This systematic review focusses on cardiovascular effects of auricular stimulation. Methods and analysis The following databases were searched: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ISI Web of Science, and Scopus Database. RCTs were reviewed that had been published in English and European languages. Data collection and analysis was conducted by two reviewers independently. Quality and risk assessment of included studies was performed and the meta-analysis of the effect of the most frequently assessed biomarkers. Results Altogether, 78 trials were included. 38 studies assessed heart rate (HR), 19 studies analyzed heart rate variability (HRV), 31 studies analyzed blood pressure (BP) and 7 studies were identified that measured oxygen saturation (O2), 2 studies on baroreflex sensitivity and 2 studies on skin conductance were evaluated in this review. 26 studies contained continuous data and were eligible for meta-analysis, 50 trials reported non continuous data and were evaluated descriptively. The overall quality of the studies was moderate to low. AS leads to a significant reduction of HR, the changes though were not considered an adverse reaction. Furthermore, when looking at HRV, AS was able to reduce the LF/HF ratio significantly compared to control procedures. No other cardiovascular parameters (blood pressure, oxygen saturation, baroreflex sensitivity) were changed significantly. AS produced only minor side effects in all trials. Conclusion AS can lead to clinically safe reduction of HR and changes in the LF/HF ratio of the HRV, which is presumably via an increase in vagal activity. More research is needed to clarify whether AS can be used to modulate tachycardia or indications with autonomic imbalance. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=231885 PROSPERO, ID CRD42021231885.
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Affiliation(s)
- Kevin Hua
- Institute for Social Medicine, Epidemiology and Health Economics, Berlin Institute of Health, Charité - University Medicine, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Mike Cummings
- British Medical Acupuncture Society, London, United Kingdom
| | | | - Benno Brinkhaus
- Institute for Social Medicine, Epidemiology and Health Economics, Berlin Institute of Health, Charité - University Medicine, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Taras Usichenko
- Department for Anesthesiology, University Hospital Greifswald, Greifswald, Germany
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
| | - Joanna Dietzel
- Institute for Social Medicine, Epidemiology and Health Economics, Berlin Institute of Health, Charité - University Medicine, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
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Adaptive Auricular Point Acupressure for Sleep Disturbance in Women with Breast Cancer: A Randomized Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:8637386. [PMID: 36353150 PMCID: PMC9640241 DOI: 10.1155/2022/8637386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 10/10/2022] [Indexed: 11/07/2022]
Abstract
Objectives The study aimed to evaluate the preliminary effect and efficacy of auricular point acupressure (APA) on the quality of sleep in women with breast cancer who were undergoing chemotherapy. Sample & Setting. We conducted a randomized controlled trial on 68 patients with breast cancer who reported poor sleep quality based on the Pittsburgh Sleep Quality Index (PSQI) scores (>7). Methods & Variables. Participants were randomly assigned to an APA treatment group or a control group. Patients in the APA group had magnetic pellets attached to selected auricular points and were instructed to apply pressure to these points 4×/day for three consecutive weeks. We objectively measured sleep quality using the Actiwatch Spectrum and the PSQI at the baseline and postintervention. Statistical analyses of changes in sleep data were performed using the t-test, a rank-sum test, and analyses of covariance. Results In patients treated with APA, the PSQI total score and sleep onset latency had significantly decreased, while the total sleep time and sleep efficiency had significantly increased. Although the total PSQI score differed between groups at the baseline, ANCOVA results showed that the APA group had a significantly lower total PSQI score. Conclusion APA could be an inexpensive and effective approach to improving sleep quality and reducing sleep disturbance in patients with breast cancer. Further research needs a larger sample size to verify our findings.
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Liu Y, Huang L, Xu G, Tian H, Zhou Z, Huang F, Liang F. The Application of Acupuncture Therapy for Postoperative Pain Over the Past 20 Years: A Bibliometric Analysis. J Pain Res 2022; 15:2085-2104. [PMID: 35923845 PMCID: PMC9343020 DOI: 10.2147/jpr.s371399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/16/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose The purpose of this study is to analyze and visualize the research trends on acupuncture therapy for postoperative pain over the past 20 years to identify hotspots and frontiers, and provide new research ideas. Methods A search of the Web of Science database, with a time frame of 2001–01-01 to 2022–02-28, was conducted to collect literatures related to acupuncture therapy for postoperative pain. A bibliometric analysis and visualization of results was performed using CiteSpace software for the volume of annual publications, journals, countries, institutions, authors, keywords, and references. Results A total of 840 literatures were eventually included in the analysis. The number of publications has fluctuated upwards each year over the past 20 years and reached a peak in the latest three years. Evidence-Based Complementary and Alternative Medicine was the journal with the most relevant publications and Pain was the most frequently cited journal. The country with the highest volume of publications was China, and the USA contributed most to the international collaboration. The most prolific and influential authors were Inhyunk Ha and Han JS respectively. The most frequent keyword was “acupuncture”. References with highest frequency or centrality were both systematic evaluations focusing on different acupuncture therapies for postoperative pain relief. Conclusion The field of acupuncture therapy for postoperative pain is currently in a period of high growth. China and the USA have made the largest contribution to the volume of publications. The most influential institutions and authors are mainly from China and South Korea. The overall collaborative network needs to be strengthened. Electroacupuncture and auricular acupuncture (therapeutic techniques), low back surgery (types of surgery), and “postoperative pain, nausea and vomiting” are research hotspots in this field. Improvement of postoperative life quality, proof of clinical efficacy and evidence-based evaluation are the current research trends and frontiers.
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Affiliation(s)
- Yilin Liu
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Liuyang Huang
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Guixing Xu
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Hao Tian
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Zhuo Zhou
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Fengyuan Huang
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Fanrong Liang
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of China
- Correspondence: Fanrong Liang, Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of China, Tel +86 136 0805 8216, Fax +86-028-87683962, Email
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He K, Zhan M, Li X, Wu L, Liang K, Ma R. A Bibliometric of Trends on Acupuncture Research About Migraine: Quantitative and Qualitative Analyses. J Pain Res 2022; 15:1257-1269. [PMID: 35509621 PMCID: PMC9059996 DOI: 10.2147/jpr.s361652] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/11/2022] [Indexed: 12/18/2022] Open
Affiliation(s)
- Kelin He
- Department of Acupuncture and Moxibustion, the Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, Zhejiang, People’s Republic of China
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, the Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Mingjie Zhan
- Department of Acupuncture and Moxibustion, the Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, Zhejiang, People’s Republic of China
| | - Xinyun Li
- Department of Acupuncture and Moxibustion, the Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, Zhejiang, People’s Republic of China
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, the Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Lei Wu
- Department of Acupuncture and Moxibustion, the Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, Zhejiang, People’s Republic of China
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, the Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Kang Liang
- Department of Acupuncture and Moxibustion, the Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, Zhejiang, People’s Republic of China
| | - Ruijie Ma
- Department of Acupuncture and Moxibustion, the Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), Hangzhou, Zhejiang, People’s Republic of China
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, the Third School of Clinical Medicine (School of Rehabilitation Medicine), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
- Correspondence: Ruijie Ma, Department of Acupuncture and Moxibustion, the Third Affiliated Hospital of Zhejiang Chinese Medical University (Zhongshan Hospital of Zhejiang Province), No. 219 Moganshan Road, Xihu District, Hangzhou, Zhejiang, People’s Republic of China, Email
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Auricular acupuncture in TMD — A sham-controlled, randomized, clinical trial. Complement Ther Clin Pract 2022; 48:101569. [DOI: 10.1016/j.ctcp.2022.101569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/22/2021] [Accepted: 02/24/2022] [Indexed: 11/21/2022]
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Perioperative nonopioid analgesia reduces postoperative opioid consumption in knee arthroscopy: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 2021; 29:1887-1903. [PMID: 32889557 DOI: 10.1007/s00167-020-06256-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 08/21/2020] [Indexed: 01/14/2023]
Abstract
PURPOSE The opioid epidemic has prompted an emphasis on investigating opioid-sparing alternatives for pain management following knee arthroscopy. This review evaluated the effects of perioperative nonopioid adjunct analgesia on postoperative opioid consumption and pain control in patients undergoing knee arthroscopy. METHODS A systematic review and meta-analysis was performed using the following databases: PubMed, Embase, Web of Science, MEDLINE, and SCOPUS. Prospective comparative studies assessing the efficacy of various perioperative nonopioid analgesic strategies in patients undergoing knee arthroscopy were included. Twenty-five studies (n = 2408) were included. RESULTS Pre-emptive nonopioid pain medications demonstrated a reduction in cumulative postoperative oral morphine equivalent (OME) consumption by 11.8 mg (95% CI - 18.3, - 5.4, p ≤ 0.0001) and VAS pain scores by 1.5 (95% CI - 2.3, - 0.7, p < 0.001) at 24 h compared to placebo. Postoperative nonopioid pain medications significantly reduced cumulative postoperative OME consumption by 9.7 mg (95% CI - 14.4, - 5.1, p < 0.001) and VAS pain scores by 1.0 (95% CI - 1.354, - 0.633, p < 0.001) at 24 h compared to placebo. Saphenous nerve blocks significantly reduced cumulative postoperative OME consumption by 6.5 mg (95% CI - 10.3, - 2.6, p = 0.01) and VAS pain scores by 0.8 (- 1.4, - 0.3, p = 0.03) at 24 h compared to placebo. Both preoperative patient education and postoperative cryotherapy reduced postoperative opioid consumption. CONCLUSION Perioperative nonopioid pharmacotherapy, saphenous nerve blocks, and cryotherapy for patients undergoing knee arthroscopy significantly reduce opioid consumption and pain scores when compared to placebo at 24 h postoperatively. These interventions should be considered in efforts to reduce opioid consumption in patients undergoing knee arthroscopy. More research is needed to determine which interventions can reduce pain outside of the immediate postoperative period and the potential synergistic effects of combining interventions. LEVEL OF EVIDENCE II.
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Taylor G, Addie YO, Burchett J, Durkin C, Crawford P, Ledford CJW. "Miracle" or "Medicine": A Turning-Point Analysis of Patients' and Physicians' Shifting Views on Acupuncture. Med Acupunct 2020; 32:263-271. [PMID: 33101570 DOI: 10.1089/acu.2020.1428] [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: 11/13/2022] Open
Abstract
Objective: Acupuncture is one of the most widely used treatments of complementary and alternative medicine (CAM) within the military's health system. The success of CAM integration is partially dependent on both providers' and patients' perceptions that acupuncture is health-promoting. The aim of this research was to identify turning points, or changes, across treatments that enhanced or inhibited physicians' and patients' perception of acupuncture as health-promoting. Materials and Methods: Using a retrospective-interview approach, interviews were conducted with 15 family medicine physicians practicing medical acupuncture in a family medicine setting and with 17 patients (N = 32). Turning points were separated into 2 groups (health-promoting or health-inhibiting). Similarities and differences between perspectives were noted. Results: Patients and physicians identified two changes that enhanced their perspective of acupuncture as health-promoting: (1) observed health changes and (2) pain-medicine/narcotic reduction/elimination. Patients identified their ability to fulfill personal or professional roles, whereas physicians identified (1) training experiences and (2) enhanced relationships with patients. Health-inhibiting changes in perspective were identified as logistical constraints/barriers by both parties, although their perspectives differed to some degree. Turning points that were viewed as health-inhibiting treatment were identified as clinical challenges by physicians and as a lack of consistency in care by patients. Conclusions: The insight from these findings can help identify areas where medical acupuncture can be improved to promote successful integration in conventional medicine settings, as well as how providers can tailor communication with patients about acupuncture.
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Affiliation(s)
- Greenberry Taylor
- Department of Journalism, University of Florida, Gainesville, FL, USA
| | - Yewande O Addie
- Department of Journalism, University of Florida, Gainesville, FL, USA
| | - Jason Burchett
- Nellis Family Medicine Residency Program, Mike O'Callaghan Military Medical Center, Nellis Air Force Base, NV, USA
| | - Christopher Durkin
- Nellis Family Medicine Residency Program, Mike O'Callaghan Military Medical Center, Nellis Air Force Base, NV, USA
| | - Paul Crawford
- Nellis Family Medicine Residency Program, Mike O'Callaghan Military Medical Center, Nellis Air Force Base, NV, USA.,Department of Family Medicine, F. Edward Hebert School of Medicine, Military Primary Care Research Network, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Christy J W Ledford
- Department of Family Medicine, F. Edward Hebert School of Medicine, Military Primary Care Research Network, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Maryam A, Fariba A, Azita M, Babak B, Tabandeh S. The Effects of Auriculotherapy on Shoulder Pain After a Cesarean Section. J Acupunct Meridian Stud 2020; 13:157-162. [PMID: 32980559 DOI: 10.1016/j.jams.2020.09.002] [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: 05/26/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Postcesarean section shoulder pain caused by constrained upper extremity movement limits the maternal activities of breastfeeding and neonatal care. OBJECTIVES This study aims at investigating the effects of auriculotherapy on shoulder pain after a cesarean section. METHODS In this randomized controlled trial, 90 candidates for a cesarean section were selected according to the inclusion and exclusion criteria and randomly allocated into control and intervention groups by the minimization method. In the intervention group, ear seeds were placed on shoulder and muscle relaxation points from two hours prior to surgery until 24 hours after it. In the control group, ear seeds were placed on placebo points. Shoulder pain was assessed on a numerical pain scale in 1, 6, and 24 hours after surgery. RESULTS There was no significant difference between the two groups 1 and 6 hours after surgery. However, there was a significant difference between the two groups 24 hours after surgery and the mean pain score was lower in the intervention group (independent t-test, p < 0.001). CONCLUSION The use of auriculotherapy is recommended for the prevention and alleviation of shoulder pain after a cesarean section.
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Affiliation(s)
- Abedini Maryam
- Critical Care Nursing Student, School of Nursing and Midwifery; Student Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Aminzadeh Fariba
- Department of Obstetrics and Gynecology, School of Medicine, Nicknafs Educational and Treatment Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Manshoori Azita
- Department of Obstetrics and Gynecology, School of Medicine, Nicknafs Educational and Treatment Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Bakhtar Babak
- Department of Management of Treatment, Iran Social Security Organization, Rafsanjan, Iran
| | - Sadeghi Tabandeh
- Department of Pediatric Nursing, School of Nursing and Midwifery, Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Tan JY, Liu J, Suen LKP, Molassiotis A, Wang T. Development and validation of an evidence-based auricular acupressure intervention for managing chemotherapy-induced nausea and vomiting in breast cancer patients. Complement Ther Med 2020; 52:102502. [PMID: 32951751 DOI: 10.1016/j.ctim.2020.102502] [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: 05/07/2020] [Revised: 06/25/2020] [Accepted: 07/02/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Auricular therapy (AT) has been utilized as a promising complementary health approach to alleviating chemotherapy-induced nausea and vomiting (CINV) in breast cancer patients. However, current evidence on AT for CINV management has been inconclusive, and relevant AT treatment protocols have varied considerably in the intervention dosage and acupoint formula without an evidence-informed intervention protocol tailored to CINV symptoms. This study aimed to develop an evidence-based AT intervention protocol for CINV management in breast cancer patients receiving chemotherapy. METHODS This study adopted the Medical Research Council Framework for Developing and Evaluating Complex Interventions (the MRC framework) to guide the AT intervention development process. The process consists of four steps: identification of the evidence base, identification of theories and practice standards, identification of cancer symptom characteristics, and modelling and validation. The preliminary AT intervention was then evaluated through a content validity study to identify its theoretical and practical appropriateness. The content validity index (CVI) was used to determine the consensus level of the panel. RESULTS A preliminary AT intervention protocol, including a true AT intervention and a sham AT intervention, was developed based on research evidence identified from five systematic reviews, the homuncular reflex theory, the zang-fu organs and meridian theory, relevant AT practice standards, and the natural symptom progress of CINV. The true AT was designed as a daily manual acupressure for five consecutive days. While the sham AT was designed with the same intervention duration and acupoint formula as the true AT without manual acupressure. The content validity study demonstrated excellent consensus among the expert panel to support the AT intervention as a theoretically and practically feasible program with the item-level CVI ranging from 0.83 to 1.0 and the scale-level CVI reaching 1.0. CONCLUSION This study followed the MRC framework to develop an evidence-based AT intervention for CINV management which is well supported by systematic review research evidence, AT theories and practice standards, CINV symptom characteristics, and expert panel consensus. The AT intervention would be further evaluated in a pilot randomised controlled trial to confirm its utility, feasibility and acceptability in clinical settings.
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Affiliation(s)
- Jing-Yu Tan
- The Hong Kong Polytechnic University, School of Nursing, Hung Hom, Kowloon, Hong Kong Special Administrative Region; Charles Darwin University, College of Nursing and Midwifery Brisbane Centre, Level 11, 410 Ann Street, Brisbane, QLD, 4000, Australia.
| | - Jian Liu
- Fujian Provincial Cancer Hospital, Department of Breast Oncology, Fuma Road, Jinan District, Fuzhou, Fujian, 340014, China
| | - Lorna K P Suen
- The Hong Kong Polytechnic University, School of Nursing, Hung Hom, Kowloon, Hong Kong Special Administrative Region
| | - Alex Molassiotis
- The Hong Kong Polytechnic University, School of Nursing, Hung Hom, Kowloon, Hong Kong Special Administrative Region
| | - Tao Wang
- The Hong Kong Polytechnic University, School of Nursing, Hung Hom, Kowloon, Hong Kong Special Administrative Region; Charles Darwin University, College of Nursing and Midwifery Brisbane Centre, Level 11, 410 Ann Street, Brisbane, QLD, 4000, Australia
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Collinsworth KM, Goss DL. Battlefield Acupuncture and Physical Therapy Versus Physical Therapy Alone After Shoulder Surgery. Med Acupunct 2019; 31:228-238. [PMID: 31456869 DOI: 10.1089/acu.2019.1372] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Objective: Opioid pain medications are commonly prescribed postsurgically for pain. Few studies have investigated the effects of Battlefield Acupuncture (BFA) on postsurgical pain and pain-medication use. To date, no studies have investigated BFA's effectiveness for reducing postoperative shoulder pain and pain-medication use post surgery. The objective of this study was to determine if adding BFA to a rehabilitation protocol was effective for reducing pain and use of prescribed pain medications, compared to that protocol alone after shoulder surgery. Materials and Methods: Forty Department of Defense beneficiaries (ages 17-55) were randomized to either a standard-of-care group or a standard-of-care + BFA group prior to shoulder surgery. The standard BFA protocol was administered with semipermanent acupuncture needles emplaced on the subjects' ears for 3-5 days within 24 hours after shoulder surgery in an outpatient physical therapy setting. BFA was reapplied, as needed, up to 6 weeks postsurgically for pain management in the intervention group. The primary outcomes were visual analogue scale (VAS) pain rating and daily pain medication use by each subject. Secondary outcome measures were the Global Rating of Change and Patient Specific Functional scale. Outcome measures were obtained at 24 hours, 72 hours, 1 week, 2 weeks, and 6 weeks post surgery. Results: Significant differences in average and worst VAS pain change scores were noted between baseline and 7 days (P < 0.05). The main effect for time was significant (average and worst VAS pain) at all timepoints (P < 0.05), without time-group interactions seen. No significant differences between the groups in pain-medication use were observed (P > 0.05) Conclusions: BFA reduced postsurgical shoulder pain significantly between the groups' average and worst pain change scores between baseline and 7 days despite similar opioid and nonsteroidal anti-inflammatory drug use between the groups.
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Affiliation(s)
- Keith M Collinsworth
- Keller Army Community Hospital, West Point, NY.,Baylor-KACH Division 1 Sport Physical Therapy, Waco, TX
| | - Donald L Goss
- Keller Army Community Hospital, West Point, NY.,Baylor-KACH Division 1 Sport Physical Therapy, Waco, TX
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Crawford P, Moss DA, Crawford AJ, Sharon DJ. Modified Battlefield Acupuncture Does Not Reduce Pain or Improve Quality of Life in Patients with Lower Extremity Surgery. Mil Med 2019; 184:545-549. [DOI: 10.1093/milmed/usy277] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 09/20/2018] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
This study seeks to determine if modified Battlefield Acupuncture is more effective at relieving acute extremity pain, reducing medication use, and improving quality of life than placebo acupuncture or standard care after lower extremity surgery.
Methods
We conducted a multi-site 3-arm randomized, double-blind controlled trial of standard care alone versus standard care + placebo auricular acupuncture with semi-permanent needles versus standard care + modified battlefield acupuncture with semi-permanent needles for lower extremity surgery at two Air Force hospitals. Subjects reported pain level immediately after acupuncture, 24, 48, 168, and 720 hours later to a blinded research associate. Additionally, subjects completed a PIQ-6 30 days post-operatively, and opioid use was tracked for 30 days post-operatively.
Results
Two hundred thiry-three subjects >18 years old (92 females and 141 males) with a mean age of 44.5 years were randomized with 81 randomized to modified BFA, 74 randomized to placebo acupuncture, and 78 randomized to standard care. Overall pain levels were unchanged at each time point between groups. Outcomes showed unchanged pain, opioid and quality of life between groups.
Conclusion
The use of modified battlefield acupuncture protocol does not change pain opioid use or quality of life in those with lower extremity surgery.
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Affiliation(s)
- Paul Crawford
- Nellis Family Medicine Residency, Mike O’Callaghan Military Medical Center, 4700 Las Vegas Blvd N, Nellis AFB, NV
| | - David A Moss
- Nellis Family Medicine Residency, Mike O’Callaghan Military Medical Center, 4700 Las Vegas Blvd N, Nellis AFB, NV
| | - Amanda J Crawford
- Nellis Clinical Investigations Program, Mike O’Callaghan Military Medical Center, 4700 Las Vegas Blvd N, Nellis AFB, NV
- Clinical Research Management, San Antonio, TX
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Jang M, Lim YM, Park H. Effects of Auricular Acupressure on Joint Pain, Range of Motion, and Sleep in the Elderly with Knee Osteoarthritis. ACTA ACUST UNITED AC 2019. [DOI: 10.12799/jkachn.2019.30.1.79] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Minjin Jang
- Doctoral Student, Graduate School, College of Nursing, Ewha Womans University, Seoul, Korea
| | - Yun-Mi Lim
- Doctoral Student, Graduate School, College of Nursing, Ewha Womans University, Seoul, Korea
| | - Hyojung Park
- Professor, College of Nursing, Ewha Womans University, Seoul, Korea
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16
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Garner BK, Hopkinson SG, Ketz AK, Landis CA, Trego LL. Auricular Acupuncture for Chronic Pain and Insomnia: A Randomized Clinical Trial. Med Acupunct 2018; 30:262-272. [PMID: 30377462 DOI: 10.1089/acu.2018.1294] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Objective: In the United States, ∼1.6 million adults use complementary and alternative or integrative medicine for treating pain and insomnia. However, very few studies have tested the use of auricular acupuncture using a standard protocol for chronic pain and insomnia. The aims of this research were to assess the feasibility and credibility of auricular acupuncture, and to evaluate the effects of auricular acupuncture on pain severity and interference scores, and on insomnia severity over an 8-day study period. Materials and Methods: Forty-five participants were randomized to either an auricular acupuncture group (AAG) or a usual care group (CG) on study day 4. A standard auricular acupuncture protocol was administered, with penetrating semipermanent acupuncture needles in place for up to 4 days. The main outcome measures were feasibility of conducting the study, credibility of auricular acupuncture as a treatment modality, Brief Pain Inventory pain severity and interference scores, and Insomnia Severity Index (ISI) scores. Results: There was high interest in the study and the retention was 96%. Credibility of auricular acupuncture as a treatment was high in both groups. The use of the standard auricular acupuncture protocol in the AAG led to significant within- and between-group reduced pain severity and interference scores, compared to the CG. Both groups showed within-group decreased ISI scores. However, the AAG showed significant between-group reduced ISI severity scores compared to the CG. Conclusions: With the heightened focus on the opioid crisis in the United States, this easy-to-administer protocol may be an option for treating military beneficiaries who have chronic pain and insomnia.
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Affiliation(s)
| | | | - Ann K Ketz
- Landstuhl Regional Medical Center, Landstuhl, Germany
| | - Carol A Landis
- Professor Emerita, University of Washington, Seattle, WA
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17
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Effect of Auriculotherapy on the Plasma Concentration of Biomarkers in Individuals with Knee Osteoarthritis. J Acupunct Meridian Stud 2018; 11:145-152. [PMID: 29783048 DOI: 10.1016/j.jams.2018.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 03/30/2018] [Accepted: 05/09/2018] [Indexed: 11/20/2022] Open
Abstract
Knee osteoarthritis (KOA) is one of the most frequent noncommunicable diseases with pain associated symptoms and affects the musculoskeletal system. Various forms of treatment can be indicated, and nonpharmacological treatment is also an available option for the management of KOA individuals. For instance, auriculotherapy (AT) is one possible procedure associated with the Traditional Chinese Medicine for dealing with KOA. It is believed that the concentration of certain biomarkers could be altered in individuals with KOA after AT. The aim of this study was to evaluate the effect of AT on plasma concentration of biomarkers in KOA individuals. This intervention is a controlled trial. Twenty-one subjects were grouped in two groups and submitted to AT with the stimulation of the Shen Men, kidney, and knee points in the treatment group or different points in the control group, once a week for 5 weeks. Blood was collected before the beginning of protocols and a week after the last session. Kolmogorov-Smirnov and Wilcoxon tests were performed, and a p ≤ 0.05 was considered statistically significant. Hematological parameters did not show any significant variation between the control group and treated group. Concerning the biochemical parameters, a significant reduction of direct bilirubin (from 43.31 ± 22.10 to 21.21 ± 5.30 μmol/L, p = 0.003), aspartate aminotransferase (from 0.48 ± 0.16 to 0.38 ± 0.09 μKat/L, p = 0.010), and triglycerides (from 7.04 ± 2.90 to 5.45 ± 2.57 mmol/L, p = 0.008) in the treated group was obtained. In conclusion, the analysis of results suggests that AT might be a useful intervention for the management of KOA individuals.
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18
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Fisher CL, Ledford CJW, Moss DA, Crawford P. Physician Communication to Enhance Patient Acupuncture Engagement in Family Medicine. JOURNAL OF HEALTH COMMUNICATION 2018; 23:422-429. [PMID: 29630471 DOI: 10.1080/10810730.2018.1458924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Integrating complementary therapies (acupuncture) into conventional medicine has garnered recent support. Given the health benefits, low cost, and minimal risks, the military has advocated for acupuncture and begun training family medicine physicians. Little is known about the role of physician communication in patients' acupuncture engagement (uptake and adherence) in conventional medicine settings. We interviewed physicians (N = 15) and patients (N = 17) to capture physician communication they perceived affected treatment engagement. Data for each group were thematically analyzed. Physicians and patients prioritized different communication approaches and associated strategies. Physicians identified four approaches that enhance treatment engagement: (1) using shared decision-making (e.g., treatment options); (2) not being pushy (e.g., in tone); (3) carefully choosing language (e.g., Eastern versus Western terms); and (4) explaining treatment outcomes (e.g., efficacy). Patients also prioritized explaining treatment outcomes but differently (e.g., timing clarity), with two additional approaches: (5) talking with the same physician (e.g., continuity) and (6) being responsive to patient (e.g., flexibility). Findings highlight how physicians and patients prioritize patient-centered communication differently and how it is embedded within a unique, complex therapy. Data showcase authentic narratives that could be translated into physician communication skills training to promote treatment engagement in integrative care.
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Affiliation(s)
- Carla L Fisher
- a College of Journalism & Communications, STEM Translational Communication Center, UF Health Cancer Center; UF Health Center for Arts in Medicine , University of Florida , Gainesville , FL , USA
| | - Christy J W Ledford
- b Department of Family Medicine, F. Edward Hebert School of Medicine, Military Primary Care Research Network , Uniformed Services University of the Health Sciences , Bethesda , MD , USA
| | - David A Moss
- c Nellis Family Medicine Residency Program , Mike O'Callaghan Military Medical Center , Nellis Air Force Base , NV , USA
| | - Paul Crawford
- b Department of Family Medicine, F. Edward Hebert School of Medicine, Military Primary Care Research Network , Uniformed Services University of the Health Sciences , Bethesda , MD , USA
- c Nellis Family Medicine Residency Program , Mike O'Callaghan Military Medical Center , Nellis Air Force Base , NV , USA
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19
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Rosen DA, Unger K, Gustafson RA, Trieu C, Zeltzer LK, Lin YC. Electroacupuncture Addition to the Anesthesia Care of Pediatric Patients for Congenital Heart Surgery. J Cardiothorac Vasc Anesth 2017; 31:1497-1504. [PMID: 28526209 DOI: 10.1053/j.jvca.2017.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Indexed: 11/11/2022]
Affiliation(s)
- David A Rosen
- Department of Anesthesia and Pediatrics, West Virginia University, Morgantown, WV.
| | - Kendra Unger
- Department of Family Medicine, West Virginia University, Morgantown, WV
| | - Robert A Gustafson
- Department of Surgery and Pediatrics, West Virginia University, Morgantown, WV
| | - Christine Trieu
- Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Lonnie K Zeltzer
- Departments of Pediatrics, Anesthesiology, Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Yuan-Chi Lin
- Medical Acupuncture Service, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA
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20
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Lux EA, Wahl G, Erlenwein J, Wiese C, Wirz S. [Is supplemental ear acupuncture for surgical tooth removal with local anesthesia effective? : A pilot study]. Schmerz 2017; 31:489-498. [PMID: 28315017 DOI: 10.1007/s00482-017-0212-3] [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: 10/19/2022]
Abstract
BACKGROUND The application of ear acupuncture can contribute to a reduction of acute pain. Data on the application of ear acupuncture following oral surgery in odontology is insufficient. OBJECTIVE This study investigated the effectiveness of ear acupuncture as an auxiliary analgesic treatment in addition to local anesthesia for operative tooth removal. METHODS In this prospective open non-randomized pilot study (in accordance with the CONSORT publication) 2 cohorts of 50 patients each with the indications for an operative tooth removal either with or without the application of ear acupuncture in addition to local anesthesia with articain were observed. Patients were allocated to the groups according to their preference. Pain intensity while resting and while chewing was recorded as the primary parameter for a period of 10 days. The secondary parameters were the subjective experience of anxiety and symptoms, such as headaches, dizziness and nausea. RESULTS The two groups did not differ significantly with respect to demographic variables or the use of local anesthetics. At the various measurement intervals, pain intensity while resting or chewing differed significantly between the two groups (ANOVA, p = 0.004, p = 0.007, respectively). Furthermore, the experience of anxiety (ANOVA, p = 0.0001), the number of patients taking analgesics (χ2-test, p = 0.017) and the total postoperative consumption of analgesics (t-test, 0.001) revealed significant differences. In both groups the numerical rating scales (NRS) for postoperative headaches, dizziness and nausea were low. DISCUSSION AND CONCLUSION Despite a potential bias and methodological limitations of the study design, the results of this investigation suggest that ear acupuncture influences the experience of pain and anxiety in the postoperative period after tooth removal. As a treatment method with low adverse effects ear acupuncture can contribute to postoperative pain control, especially in patients with preoperative anxiety.
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Affiliation(s)
- E A Lux
- Klinik für Schmerz- und Palliativmedizin, Katholisches Klinikum Lünen-Werne GmbH, Fakultät für Gesundheit - Private Universität Witten-Herdecke, Lünen, Deutschland
| | - G Wahl
- Poliklinik für Chirurgische Zahn-, Mund- und Kieferheilkunde, Universitätsklinikum Bonn, Bonn, Deutschland
| | - J Erlenwein
- Klinik für Anästhesiologie, GF Schmerzmedizin, Universitätsmedizin Göttingen, Georg-August-Universität, Göttingen, Deutschland
| | - C Wiese
- Klinik für Anästhesiologie, Herzogin Elisabeth Hospital, Braunschweig, Deutschland
| | - S Wirz
- Abteilung für Anästhesiologie, Intensivmedizin, Schmerzmedizin/Palliativmedizin, Zentrum für Schmerzmedizin, GFO CURA - Katholisches Krankenhaus im Siebengebirge, Schülgenstr.15, 53604, Bad Honnef, Deutschland.
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21
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Murakami M, Fox L, Dijkers MP. Ear Acupuncture for Immediate Pain Relief-A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PAIN MEDICINE 2017; 18:551-564. [PMID: 28395101 DOI: 10.1093/pm/pnw215] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective To systematically review the literature on the effectiveness of ear acupuncture (EA) for immediate pain relief. Data sources AMED, CINAHL, Cochrane Reviews, Embase, PsycINFO, PubMed, Scopus Web of Science, from inception through March 2015. Study selection English publications, randomized controlled trials on human subjects involving EA as a treatment for pain, with outcomes recorded within 48 hours. Data extraction and design Two authors independently assessed trial eligibility, quality, results, and side effects, and extracted data; a third author checked final data. Effect size (d), mean difference (MD), and 95% confidence interval (CI) were calculated. The Physiotherapy Evidence Database (PEDro) scoring system was used to assess study quality. Meta-analysis was performed for two primary outcomes measures-pain intensity score and analgesic requirements. Results Ten studies met inclusion criteria. Quality per PEDro scores: four excellent, four good, two fair. Based on their primary outcome measures, six studies showed EA being superior to its comparator, three showed no difference to comparators (which in all cases were analgesics), and one study showed significant pain decrease at the first time point and no significant decrease at the second. Meta-analysis was completed for the three studies that evaluated pain intensity as a primary outcome measure, and EA was superior to comparator (MD = -0.96, 95% CI = -1.82- -0.11), but the MD was small. Meta-analysis was completed for the six studies that evaluated analgesic requirements, and EA was superior (MD = -1.08, 95% CI = -1.78- -0.38]), again with a small MD. Six studies reported side effects; all were minor and transient. Conclusions Ear acupuncture may be a promising modality to be used for pain reduction within 48 hours, with a low side effect profile. Rigorous research is needed to establish definitive evidence of a clinically significant difference from controls or from other pain treatments.
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Affiliation(s)
- M Murakami
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, NY, USA.,Department of Anesthesiology at University of California , San Diego, CA, USA
| | - L Fox
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, NY, USA.,Department of Toxicology, New York University, NY, USA
| | - Marcel P Dijkers
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, NY, USA
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22
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Papadopoulos GS, Tzimas P, Liarmakopoulou A, Petrou AM. Auricular Acupuncture Analgesia in Thoracic Trauma: A Case Report. J Acupunct Meridian Stud 2017; 10:49-52. [DOI: 10.1016/j.jams.2016.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 06/13/2016] [Accepted: 06/15/2016] [Indexed: 11/26/2022] Open
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Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. THE JOURNAL OF PAIN 2016; 17:131-57. [PMID: 26827847 DOI: 10.1016/j.jpain.2015.12.008] [Citation(s) in RCA: 1572] [Impact Index Per Article: 196.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 12/11/2015] [Accepted: 12/14/2015] [Indexed: 12/11/2022]
Abstract
UNLABELLED Most patients who undergo surgical procedures experience acute postoperative pain, but evidence suggests that less than half report adequate postoperative pain relief. Many preoperative, intraoperative, and postoperative interventions and management strategies are available for reducing and managing postoperative pain. The American Pain Society, with input from the American Society of Anesthesiologists, commissioned an interdisciplinary expert panel to develop a clinical practice guideline to promote evidence-based, effective, and safer postoperative pain management in children and adults. The guideline was subsequently approved by the American Society for Regional Anesthesia. As part of the guideline development process, a systematic review was commissioned on various aspects related to various interventions and management strategies for postoperative pain. After a review of the evidence, the expert panel formulated recommendations that addressed various aspects of postoperative pain management, including preoperative education, perioperative pain management planning, use of different pharmacological and nonpharmacological modalities, organizational policies, and transition to outpatient care. The recommendations are based on the underlying premise that optimal management begins in the preoperative period with an assessment of the patient and development of a plan of care tailored to the individual and the surgical procedure involved. The panel found that evidence supports the use of multimodal regimens in many situations, although the exact components of effective multimodal care will vary depending on the patient, setting, and surgical procedure. Although these guidelines are based on a systematic review of the evidence on management of postoperative pain, the panel identified numerous research gaps. Of 32 recommendations, 4 were assessed as being supported by high-quality evidence, and 11 (in the areas of patient education and perioperative planning, patient assessment, organizational structures and policies, and transitioning to outpatient care) were made on the basis of low-quality evidence. PERSPECTIVE This guideline, on the basis of a systematic review of the evidence on postoperative pain management, provides recommendations developed by a multidisciplinary expert panel. Safe and effective postoperative pain management should be on the basis of a plan of care tailored to the individual and the surgical procedure involved, and multimodal regimens are recommended in many situations.
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24
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Acar HV. Acupuncture and related techniques during perioperative period: A literature review. Complement Ther Med 2016; 29:48-55. [DOI: 10.1016/j.ctim.2016.09.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 03/22/2016] [Accepted: 09/11/2016] [Indexed: 12/18/2022] Open
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Ushinohama A, Cunha BP, Costa LOP, Barela AMF, Freitas PBD. Effect of a single session of ear acupuncture on pain intensity and postural control in individuals with chronic low back pain: a randomized controlled trial. Braz J Phys Ther 2016; 20:328-35. [PMID: 27556389 PMCID: PMC5015670 DOI: 10.1590/bjpt-rbf.2014.0158] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 12/17/2015] [Indexed: 12/19/2022] Open
Abstract
Background Ear Acupuncture (EA) is a form of acupuncture in which needles are applied to the
external ear and has been used in multiple painful conditions. Low back pain (LBP)
is highly prevalent in active individuals and causes high economic burden to
health systems worldwide. LBP affects the person’s ability to keep balance,
especially in challenging conditions. Objective The aim of the study was to examine the effects of a single session of EA on pain
intensity and body sway during postural tasks. Method Eighty adults with LBP and pain intensity equal to or greater than 4 (0-10 scale)
were randomly allocated (1:1) to EA group (EAG) or placebo group (PG). Initially,
the level of pain intensity was assessed. Next, participants stood still on a
force plate either with feet in parallel or in semi-tandem and with eyes open or
closed. Then, the EAG was treated with EA for 20 min and the PG was treated with
detuned ultrasound. After the treatment, pain intensity was assessed again and the
postural test was repeated. Pain intensity was the primary outcome and center of
pressure sway area and speed were the secondary outcomes measured. Results Results revealed that pain intensity decreased in both groups after treatment, but
decreased more in the EAG. For postural control, no effect of treatment and no
interaction between treatment and postural condition on body sway were found. Conclusion Those findings indicate that EA is better than placebo to reduce pain, but neither
treatment has any effect on postural control.
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Affiliation(s)
- Andrea Ushinohama
- Laboratório de Análise do Movimento, Programa de Pós-graduação em Ciências do Movimento Humano, Universidade Cruzeiro do Sul, São Paulo, SP, Brazil
| | - Bianca P Cunha
- Laboratório de Análise do Movimento, Programa de Pós-graduação em Ciências do Movimento Humano, Universidade Cruzeiro do Sul, São Paulo, SP, Brazil
| | - Leonardo O P Costa
- Programa de Mestrado e Doutorado em Fisioterapia, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil.,Musculoskeletal Division, The George Institute for Global Health, Sydney, Australia
| | - Ana M F Barela
- Laboratório de Análise do Movimento, Programa de Pós-graduação em Ciências do Movimento Humano, Universidade Cruzeiro do Sul, São Paulo, SP, Brazil
| | - Paulo B de Freitas
- Laboratório de Análise do Movimento, Programa de Pós-graduação em Ciências do Movimento Humano, Universidade Cruzeiro do Sul, São Paulo, SP, Brazil
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Hou PW, Hsu HC, Lin YW, Tang NY, Cheng CY, Hsieh CL. The History, Mechanism, and Clinical Application of Auricular Therapy in Traditional Chinese Medicine. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2015; 2015:495684. [PMID: 26823672 PMCID: PMC4707384 DOI: 10.1155/2015/495684] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 12/06/2015] [Indexed: 01/15/2023]
Abstract
Auricular therapy includes acupuncture, electroacupuncture, acupressure, lasering, cauterization, moxibustion, and bloodletting in the auricle. For 2500 years, people have employed auricular therapy for treating diseases, but the methods have been limited to bloodletting and cauterization. Only after 1957, the international scientific community became aware that the map of the ear resembles an inverted fetus, its introduction has led to auricular acupuncture (AA) becoming a more systemic approach, and, following the identification and standardization of more precise points, AA has been employed in clinical applications. The mechanisms of AA are considered to have a close relationship with the autonomic nervous system, the neuroendocrine system, neuroimmunological factors, neuroinflammation, and neural reflex, as well as antioxidation. Auricular therapy has been applied, for example, for pain relief, for the treatment of epilepsy, anxiety, and obesity, and for improving sleep quality. However, the mechanisms and evidence for auricular therapy warrant further study.
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Affiliation(s)
- Pu-Wei Hou
- Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan
| | - Hsin-Cheng Hsu
- Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan
| | - Yi-Wen Lin
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
| | - Nou-Ying Tang
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
| | - Chin-Yi Cheng
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
| | - Ching-Liang Hsieh
- Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
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27
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Liu XL, Tan JY, Molassiotis A, Suen LKP, Shi Y. Acupuncture-Point Stimulation for Postoperative Pain Control: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2015; 2015:657809. [PMID: 26568767 PMCID: PMC4620376 DOI: 10.1155/2015/657809] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 08/19/2015] [Accepted: 09/03/2015] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to evaluate the effectiveness of Acupuncture-point stimulation (APS) in postoperative pain control compared with sham/placebo acupuncture or standard treatments (usual care or no treatment). Only randomized controlled trials (RCTs) were included. Meta-analysis results indicated that APS interventions improved VAS scores significantly and also reduced total morphine consumption. No serious APS-related adverse effects (AEs) were reported. There is Level I evidence for the effectiveness of body points plaster therapy and Level II evidence for body points electroacupuncture (EA), body points acupressure, body points APS for abdominal surgery patients, auricular points seed embedding, manual auricular acupuncture, and auricular EA. We obtained Level III evidence for body points APS in patients who underwent cardiac surgery and cesarean section and for auricular-point stimulation in patients who underwent abdominal surgery. There is insufficient evidence to conclude that APS is an effective postoperative pain therapy in surgical patients, although the evidence does support the conclusion that APS can reduce analgesic requirements without AEs. The best level of evidence was not adequate in most subgroups. Some limitations of this study may have affected the results, possibly leading to an overestimation of APS effects.
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Affiliation(s)
- Xian-Liang Liu
- 10th People's Hospital of Tongji University, 301 Yanchang Road, Shanghai 200072, China
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, 1100 Nudgee Road, Banyo, Brisbane, QLD 4014, Australia
- School of Nursing, Jinggangshan University, 28 Xueyuan Road, Ji'an 343009, China
| | - Jing-Yu Tan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Lorna K. P. Suen
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Yan Shi
- 10th People's Hospital of Tongji University, 301 Yanchang Road, Shanghai 200072, China
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Khorsand A, Tadayonfar MAR, Badiee S, Aghaee MA, Azizi H, Baghani S. Evaluation of the Effect of Reflexology on Pain Control and Analgesic Consumption After Appendectomy. J Altern Complement Med 2015; 21:774-80. [PMID: 26401598 DOI: 10.1089/acm.2014.0270] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Appendicitis is the most common cause of severe abdominal pain in the world, and the associated postsurgical pain, as occurs with other surgical procedures, is one of the most common problems. Today, there is a growing tendency toward nondrug methods and alternative medicine to reduce the adverse effects of drugs. Reflexology involves applying pressure on certain areas of the palms, feet, and ears in order to reduce stress and pain in certain areas of the body. The aim of this study was to determine the effect of reflexology massage on pain relief after appendectomy. METHODS This clinical trial was conducted at the surgical emergency unit of Imam Reza Hospital of Mashhad, Iran, in 2013. Pain intensity and analgesic consumption were compared between 105 patients before and immediately, 1 hour, 6 hours, and 24 hours after the intervention in three groups of intervention, control, and placebo. Patients in all three groups received analgesics, as required. The experimental group received pressure on a defined area of the right foot for about 10 minutes and the Shen Men point of the ear for 1 minute. This pressure in the placebo group was applied on the left foot and the left earlobe. Patients in the control group received routine care only. The results were evaluated at a 95% confidence level, and data were analyzed using SPSS software version 12 (SPSS, Inc., Chicago, IL). RESULTS At the beginning of the study, the mean pain intensity in different groups according to analysis of variance was not significantly different (p = 0.439); however, there was a notable difference in pain intensity between the intervention and other groups after reflexology therapy. In addition, methadone consumption was significantly lower in the reflexology group than in the other two groups (p ≤ 0.001). CONCLUSION Reflexology is effective for reducing pain after appendectomy surgery.
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Affiliation(s)
- Ali Khorsand
- 1 Department of Complementary and Chinese Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences , Mashhad, Iran
| | | | - Shapour Badiee
- 1 Department of Complementary and Chinese Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences , Mashhad, Iran
| | - Monavar Afzal Aghaee
- 3 Department of Social Medicine, Mashhad University of Medical Sciences , Mashhad, Iran
| | - Hoda Azizi
- 1 Department of Complementary and Chinese Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences , Mashhad, Iran .,4 Addiction Research Center, Mashhad University of Medical Sciences , Mashhad, Iran
| | - Sara Baghani
- 1 Department of Complementary and Chinese Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences , Mashhad, Iran
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Sonis AMD. Acupuncture in the Multimodal Biopsychosocial Pain Management. <br>Towards a New Model in Clinical Practice. Health (London) 2015. [DOI: 10.4236/health.2015.77104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Chung YC, Chien HC, Chen HH, Yeh ML. Acupoint Stimulation to Improve Analgesia Quality for Lumbar Spine Surgical Patients. Pain Manag Nurs 2014; 15:738-47. [DOI: 10.1016/j.pmn.2013.07.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 07/14/2013] [Accepted: 07/25/2013] [Indexed: 11/26/2022]
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Adverse events of auricular therapy: a systematic review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:506758. [PMID: 25435890 PMCID: PMC4241563 DOI: 10.1155/2014/506758] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 08/26/2014] [Accepted: 08/27/2014] [Indexed: 11/18/2022]
Abstract
The aim of this study was to systematically evaluate the literature on adverse events associated with auricular therapy (AT). Case reports, case series, surveys, and all types of clinical trials reporting adverse events of AT were included. Relevant articles were mainly retrieved from 13 electronic databases and seven Chinese journals on complementary medicine. AT-related adverse events were reported in 32 randomized controlled trials, five uncontrolled clinical trials, four case reports, and two controlled clinical trials. For auricular acupuncture, the most frequently reported adverse events were tenderness or pain at insertion, dizziness, local discomfort, minor bleeding and nausea, and so forth. For auricular acupressure, local skin irritation and discomfort, mild tenderness or pain, and dizziness were commonly reported. Skin irritation, local discomfort, and pain were detected in auricular electroacupuncture, and minor infection was identified in auricular bloodletting therapy. Most of these events were transient, mild, and tolerable, and no serious adverse events were identified. Our findings provide preliminary evidence that AT is a relatively safe approach. Considering the patient's safety, prospective or retrospective surveys are needed in future research to gather practitioner-reported and patient-reported adverse events on AT, and the quality of adverse events reporting in future AT trials should be improved.
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Affiliation(s)
- T I Usichenko
- Department of Anaesthesiology and Intensive Care Medicine, University Medicine of Greifswald, Greifswald, Germany
| | - K Streitberger
- University Department of Anesthesiology and Pain Therapy, Inselspital, University Hospital of Bern, Switzerland
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Vas J, Modesto M, Aguilar I, Gonçalo CDS, Rivas-Ruiz F. Efficacy and Safety of Auriculopressure for Primary Care Patients with Chronic Non-Specific Spinal Pain: A Multicentre Randomised Controlled Trial. Acupunct Med 2014; 32:227-35. [DOI: 10.1136/acupmed-2013-010507] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Chronic uncomplicated musculoskeletal pain in the spine (cervical, thoracic or lumbar) is highly prevalent and may severely limit the daily activities of those affected by it. Objective To evaluate the efficacy and safety of treatment with auriculopressure applied to patients with non-specific spinal pain. Methods A multicentre randomised controlled trial with two parallel arms (true auriculopressure (TAP) and placebo auriculopressure (PAP)) was performed. The intervention phase lasted 8 weeks and outcomes were measured 1 week after the last intervention (T1) and 6 months after baseline (T2). The primary outcome measure was change in pain intensity according to a 100 mm visual analogue scale (pain VAS) at T1. Secondary outcome measures were the Lattinen index, the McGill Pain Questionnaire and the SF-12 health-related quality of life scale (Spanish version in every case). Results There were 265 participants (TAP group, n=130; PAP group, n=135). Pain was most frequently located in the upper back (55.1%, n=146), followed by the lower back (25.3%, n=67) and the dorsal area (12.5%, n=33). Nineteen patients (7.2%) reported pain affecting the entire spine. There were statistically significant differences between TAP and PAP in the change in the pain VAS at T1 of 10 mm (95% CI 2.8 to 17.3, p=0.007) and in the change in the pain VAS at T2 of 7.2 mm (95% CI 0.02 to 14.3, p=0.049) in favour of TAP. We also observed a statistically significant difference of 3.4 points in the physical component of the SF-12 in favour of TAP at T2 (95% CI 0.45 to 6.3, p=0.024). No severe adverse effects were detected or reported during treatment. Conclusions The application of auriculopressure in patients with non-specific spinal pain in primary healthcare is effective and safe, and therefore should be considered for inclusion in the portfolio of primary healthcare services. Trial Registration Number ISRCTN01897462.
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Affiliation(s)
- Jorge Vas
- Pain Treatment Unit, Doña Mercedes Primary Health Care Centre, Dos Hermanas, Spain
- Carlos III Health Institute, Network of Research in Health Services in Chronic Diseases (REDISSEC), Madrid, Spain
| | - Manuela Modesto
- Pain Treatment Unit, Doña Mercedes Primary Health Care Centre, Dos Hermanas, Spain
| | - Inmaculada Aguilar
- Pain Treatment Unit, Doña Mercedes Primary Health Care Centre, Dos Hermanas, Spain
| | | | - Francisco Rivas-Ruiz
- Carlos III Health Institute, Network of Research in Health Services in Chronic Diseases (REDISSEC), Madrid, Spain
- Support Research Unit, Costa del Sol Hospital, Marbella, Spain
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Bernardo-Filho M, de Sá-Caputo DDC, Marin PJ, Chang S. The mechanism of auriculotherapy: a case report based on the fractal structure of meridian system. AFRICAN JOURNAL OF TRADITIONAL, COMPLEMENTARY, AND ALTERNATIVE MEDICINES 2014; 11:30-7. [PMID: 25371561 DOI: 10.4314/ajtcam.v11i3.6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Chinese meridian system of acupuncture has recently been deciphered as the fractal continuum of neurovascular bundles and its smaller branches. The corresponding acupuncture mechanism of therapeutics has been attributed to the magneto-electric inductive effects of the meridian system via chaotic wave of nerve innervations and blood flow. Hence, based on the proposed theory, the important sensory organ of the ears should be able to exert its influence on visceral organs and peripheral limbs. This investigation aims to verify if such a possible correlation exists between an external region of the ear and the muscle of biceps brachii in the French auriculotherapy. MATERIALS AND METHODS A region between the points of elbow and shoulder in the scaphoid fossa (upper arm), was chosen. Before the recording of surface electromyograms (EMGs), of the muscle of biceps brachii, two subjects were asked to carry out maximum voluntary isometric contractions (MVICs), of the arm. In addition, the same volunteers would be served as control group. Consequently, each subject was required to perform the three treatments of control, sham, and acupressure in random order. EMG signals were recorded for later analysis. RESULTS Results indicate that the acupressure with finger at a specific point which bears possibly with a somatopic relation to the biceps brachii muscle can, in a man, modify the response of the EMGs associated with the corresponding muscle while the response of the acupressure of a sham point has different responses. Moreover, the MVIC parameters were higher in acupressure treatment than those of control and sham treatments for both subjects. CONCLUSION In conclusion, the analysis of the findings permits us to speculate that the stimulation with the fingers in the scaphoid fossa of the ear presents electromyographic responses related to the biceps brachii muscle. Hence, the mechanism of French auriculotherapy could be derived from the same principle as that of the Chinese acupuncture.
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Affiliation(s)
- Mario Bernardo-Filho
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes, Universidade do Estado do Rio de Janeiro
| | - Danúbia da Cunha de Sá-Caputo
- Mestrado Profissional em Saúde, Medicina Laboratorial e Tecnologia Forense, Instituto de Biologia Roberto Alcântara Gomes, Universidade do Estado do Rio de Janeiro
| | - Pedro J Marin
- Faculty of Health Sciences, European University Miguel de Cervantes Valladolid, Spain
| | - Shyang Chang
- Department of Electrical Engineering, National Tsing Hua University, Hsinchu 300, Taiwan
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Romoli M, Avgerinos C, Baratto L, Giommi A. Auriculotherapy for Persisting Postoperative Pain Caused by Total Knee Replacement. Med Acupunct 2014. [DOI: 10.1089/acu.2014.1023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marco Romoli
- Center for Integrative Medicine, University of Florence, Fierenze, Italy
- Associazione Medici Agopuntori Bolognesi (A.M.A.B.), Bologna, Italy
| | | | - Luigi Baratto
- Rehabilitation Department of La Colletta Hospital, Genova, Genova, Italy
| | - Andrea Giommi
- Department of Statistics, Informatics and Applications, University of Florence, Firenze, Italy
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Zhang CS, Yang AW, Zhang AL, May BH, Xue CC. Sham control methods used in ear-acupuncture/ear-acupressure randomized controlled trials: a systematic review. J Altern Complement Med 2013; 20:147-61. [PMID: 24138333 DOI: 10.1089/acm.2013.0238] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Ear-acupuncture/ear-acupressure (EAP) has been used for a range of health conditions with numerous randomized controlled trials (RCTs) investigating its efficacy and safety. However, the design of sham interventions in these RCTs varied significantly. This study systematically reviewed RCTs on EAP for all clinical conditions involving a number of sham EAPs as a control intervention. The review is guided by the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 and investigated the types and differences of sham EAP interventions. Four electronic English databases (The Cochrane Library, PubMed, Embase, CINAHL®) and two Chinese databases (CQVIP, CNKI) were searched in December 2012 and 55 published RCTs comparing real and sham EAP for any clinical condition were included. Characteristics of participants, real and sham interventions, and outcomes were extracted. Four types of sham methods were identified. Among the 55 RCTs, 25 studies involved treatment on nonspecific ear acupoints as the sham method; seven studies used nonacupoints on the ear; nine studies selected placebo needles or placebo ear-acupressure on the same ear acupoints for the real treatment; 10 studies employed pseudo-intervention; and five studies combined two of the above methods to be the sham control. Other factors of treatment such as number of points, treatment duration, and frequency also varied greatly. Risk of bias assessment suggests that 32 RCTs were "high risk" in terms of participants blinding, and 45 RCTs were "high risk" in terms of personnel blinding. Meta-analysis was not conducted due to the high clinical heterogeneity across included studies. No relationship was found between the sham designs and efficacy outcomes, or between the sham types and dropout rate. No solid conclusion of which design is the most appropriate sham control of EAP could be drawn in this review.
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Affiliation(s)
- Claire Shuiqing Zhang
- 1 Discipline of Chinese Medicine, School of Health Sciences, RMIT University, Victoria, Australia
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He BJ, Tong PJ, Li J, Jing HT, Yao XM. Auricular acupressure for analgesia in perioperative period of total knee arthroplasty. PAIN MEDICINE 2013; 14:1608-13. [PMID: 23865512 DOI: 10.1111/pme.12197] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE We examined whether auricular acupressure (AA) can alleviate postoperative pain and decrease narcotic consumption and its adverse effects for osteoarthritis patients after total knee arthroplasty (TKA). DESIGN A prospective, randomized, sham control trial comparing AA and a sham control. SETTING Department of Orthopedics, the first Hospital affiliated to Zhejiang University of Traditional Chinese Medicine, Hangzhou, China. SUBJECTS Ninety patients with degenerative osteoarthritis undergoing TKA. INTERVENTIONS The AA group received true AA by embedding vaccaria seeds at four specific AA points (knee joint, shenmen, subcortex, sympathesis) ipsilateral to the surgery site, while the control group received four nonacupuncture points on the auricular helix. OUTCOME MEASURES Visual analog scale (VAS), the consumption of analgesic via patient-controlled analgesia, the incidence of analgesia-related adverse effects, Hospital for Special Surgery scores (HSS), and range of motion (ROM) were recorded. RESULTS VAS scores were similar at 12, 24, 36, and 48 h postsurgery (P > 0.05), but AA group scores were lower than those of the control group at 3, 4, 5, and 7 days (P < 0.05). Patients in the AA group consumed lower doses of analgesic than those in the control group after surgery (P < 0.05). The incidence of analgesia-related adverse effects in the AA group was lower than that in the control group (P < 0.05). Although HSS scores were similar in the two groups preoperatively and at 3 months postoperatively (P > 0.05), HSS scores 2 weeks postoperatively were higher in the AA group than in the control group (P < 0.05), but there was no difference between groups in ROM (P > 0.05). CONCLUSIONS Applying auricular acupoint acupressure in the perioperative period of TKA is favorable for alleviating postoperative pain, decreasing opioid consumption and its adverse effects, and promoting early rehabilitation. Also, this intervention has the advantage of lower costs, fewer complications, simple application, and high safety.
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Affiliation(s)
- Bang Jian He
- Department of Orthopedics, the third Hospital affiliated to Zhejiang University of TCM, Hangzhou, China
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Integrative acupoint stimulation to alleviate postoperative pain and morphine-related side effects: a sham-controlled study. Int J Nurs Stud 2013; 51:370-8. [PMID: 23866092 DOI: 10.1016/j.ijnurstu.2013.06.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Revised: 06/06/2013] [Accepted: 06/11/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND Although it can be reduced, postoperative pain remains a problem. Acupressure with electric stimulation may be more effective for postoperative pain management than acupressure alone. OBJECTIVES This study aimed to evaluate the effects of integrative acupoint stimulation (IAS) on the relief of postoperative pain and on the reduction of morphine-related side effects. DESIGN A single-blinded, sham-controlled study with three groups. SETTING An orthopedic ward in a 2900-bed teaching medical center. PARTICIPANTS Forty-five subjects in each of three groups. METHODS Each subject received a multimedia course on patient-controlled analgesia (PCA) before surgery to learn about the use of narcotic analgesics and the operation of the PCA device. Treatment was as follows: (1) for the IAS group, auricular acupressure combined with transcutaneous electric acupoint stimulation (TEAS) at the true acupoint; (2) for the sham group, acupoint stimulation in the same manner but at a sham acupoint or without embedding seeds and pressure; (3) for the control group, no IAS intervention. RESULTS Pain scores were significantly lower in the IAS group than the other two groups at 2h and 4h after returning to the ward, and 24h after surgery. The analgesic requirement during the 72h after surgery and the overall incidence of morphine-related side effects were significantly lower in the IAS group. CONCLUSION The study demonstrates that combined auricular acupressure and TEAS decreased postoperative pain, the use of equianalgesic morphine, and morphine-related side effects. IAS provides better analgesia when used in conjunction with PCA after lumbar spine surgery and can be regarded as a component of multimodal analgesia.
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The effect of complementary therapies on post-operative pain control in ambulatory knee surgery: a systematic review. Complement Ther Med 2013; 21:529-34. [PMID: 24050592 DOI: 10.1016/j.ctim.2013.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 06/11/2013] [Accepted: 06/20/2013] [Indexed: 11/22/2022] Open
Abstract
Ambulatory knee surgery is a common procedure with over 100,000 knee arthroscopies performed in the U.K. in 2010-2011. Pain after surgery can decrease patient satisfaction, delay discharge, and decrease cost effectiveness. Multi-modal therapies, including complementary therapies, to improve pain control after surgery have been recommended. However, a comprehensive review of the literature regarding the use of complementary therapies to enhance pain control after ambulatory knee surgery is lacking, and this article aims to address this deficit. CINHAL, EMBASE, MEDLINE, AMED and CENTRAL databases were searched. Only Randomised Controlled Trials were included. All eligible papers were quality assessed using the Jadad system, and data was extracted using piloted forms. Two independent reviewers performed each stage of the review. Full details of the study methodology can be found on Prospero, a systematic review register. Five studies satisfied our eligibility criteria: three reporting on acupuncture, one on homeopathy, and one on acupoints. Acupoint pressure was the only study that demonstrated reduced pain compared with placebo. This study was the least methodologically robust. Arnica, although demonstrating a significant reduction in swelling, did not affect post-operative pain. Acupuncture did not affect post-operative pain; however, a reduction in ibuprofen use was demonstrated in two studies. Before recommending complementary therapy for routine use in ambulatory knee surgery, further work is required. Two areas of future research likely to bear fruit are demonstrating robust evidence for the effect of acupoint pressure on post-operative pain, and quantifying the positive effect of homeopathic arnica on post-operative swelling.
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Round R, Litscher G, Bahr F. Auricular acupuncture with laser. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:984763. [PMID: 23935695 PMCID: PMC3710613 DOI: 10.1155/2013/984763] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 06/12/2013] [Indexed: 11/18/2022]
Abstract
Auricular acupuncture is a method which has been successfully used in various fields of medicine especially in the treatment of pain relief. The introduction of lasers especially low-level lasers into medicine brought besides the already existing stimulation with needles and electricity an additional technique to auricular acupuncture. This literature research looks at the historical background, the development and the anatomical and neurological aspects of auricular acupuncture in general and auricular laser acupuncture in detail. Preliminary scientific findings on auricular acupuncture with laser have been described in detail and discussed critically in this review article. The results of the studies have shown evidence of the effect of auricular laser acupuncture. However, a comparison of these studies was impossible due to their different study designs. The most important technical as well as study parameters were described in detail in order to give more sufficient evidence and to improve the quality of future studies.
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Affiliation(s)
- Regina Round
- Frank Bahr Research Group “Auriculomedicine and Pharmacopuncture”, Stronach Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering, Anesthesia and Intensive Care Medicine, and the TCM Research Center Graz, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria
| | - Gerhard Litscher
- Frank Bahr Research Group “Auriculomedicine and Pharmacopuncture”, Stronach Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering, Anesthesia and Intensive Care Medicine, and the TCM Research Center Graz, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria
| | - Frank Bahr
- European Academy for TCM, 81245 Munich, Germany
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Ceccherelli F, Lovato A, Piana E, Gagliardi G, Roveri A. Somatic acupuncture versus ear acupuncture in migraine therapy: a randomized, controlled, blind study. ACUPUNCTURE ELECTRO 2013; 37:277-93. [PMID: 23409612 DOI: 10.3727/036012912x13831831256375] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This study compares the clinical effectiveness of somatic and ear acupuncture for treatment of migraine without aura. 35 patients were divided into 2 groups, one receiving somatic and the other ear acupuncture. Both groups were treated once a week for 8 weeks and needles were stimulated manually. The severity of pain was evaluated with the Migraine Index and the visual analogue of Scott-Huskisson; other 2 tests were used to monitor the pain threshold and Zung's Self-rating Depression Scale was applied to assess variations in patients' mood. These tests were performed before the beginning and at the end of treatment and, for the follow up, after 1, 3 and 6 months from the end of therapy. On the basis of the migraine index, pain at the end of therapy was significantly lower than before the treatment, being residual pain 54.83% and 63.43%, respectively for somatic and ear acupuncture. Apparently, the 2 treatments were equally effective, as no significant difference could be assessed. On the contrary, a significant difference between the 2 groups was clear during the follow up: in fact, after 6 months residual pain was 16.80% and 48.83% for somatic and ear acupuncture, respectively (p=0.038). These results were confirmed by the Visual Analogue Scale (VAS) test and by the evaluation of pain threshold. It is noteworthy that also Zung's depression test showed a significant decrease of score was present in both groups, at all the times investigated with no difference between the two treatments. These results, though preliminary, are quite promising in supporting the effectiveness of ear acupuncture for treatment of migraine without aura.
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Affiliation(s)
- Francesco Ceccherelli
- Department of Pharmacology and Anesthesiology, University of Padova, A.I.R.A.S., Padova, Italy.
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42
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Burns S, York A, Niemtzow RC, Garner BK, Steele N, Walter JA. Moving Acupuncture to the Frontline of Military Medical Care: A Feasibility Study. Med Acupunct 2013. [DOI: 10.1089/acu.2012.0933] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | | | - Nancy Steele
- Landstuhl Regional Medical Center, Landstuhl, Germany
- Current affiliation: Womack Army Medical Center, Fort Bragg, NC
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Auricular acupressure for managing postoperative pain and knee motion in patients with total knee replacement: a randomized sham control study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:528452. [PMID: 22844334 PMCID: PMC3403627 DOI: 10.1155/2012/528452] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 05/21/2012] [Indexed: 11/18/2022]
Abstract
Background. Postoperative pain management remains a significant challenge for all healthcare providers. A randomized controlled trial was conducted to examine the adjuvant effects of auricular acupressure on relieving postoperative pain and improving the passive range of motion in patients with total knee replacement (TKR). Method. Sixty-two patients who had undergone a TKR were randomly assigned to the acupressure group and the sham control group. The intervention was delivered three times a day for 3 days. A visual analog scale (VAS) and the Short-Form McGill Pain Questionnaire were used to assess pain intensity. Pain medication consumption was recorded, and the knee motion was measured using a goniometer. Results. The patients experienced a moderately severe level of pain postoperatively (VAS 58.66 ± 20.35) while being on the routine PCA. No differences were found in pain scores between the groups at all points. However, analgesic drug usage in the acupressure group patients was significantly lower than in the sham control group (P < 0.05), controlling for BMI, age, and pain score. On the 3rd day after surgery, the passive knee motion in the acupressure group patients was significantly better than in the sham control group patients (P < 0.05), controlling for BMI. Conclusion. The application of auricular acupressure at specific therapeutic points significantly reduces the opioid analgesia requirement and improves the knee motion in patients with TKR.
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Exercise and Auricular Acupuncture for Chronic Low-back Pain: A Feasibility Randomized-controlled Trial. Clin J Pain 2012; 28:259-67. [PMID: 21753728 DOI: 10.1097/ajp.0b013e3182274018] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
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.
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Ning S, Li F, Qian L, Xu D, Huang Y, Xiao M, Duan G, Li Y. The successful treatment of flat warts with auricular acupuncture. Int J Dermatol 2012; 51:211-5. [PMID: 22250633 DOI: 10.1111/j.1365-4632.2011.05232.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Flat warts are a common presenting complaint in adolescents and adults and may be a cosmetic problem as well. Patients suffering from flat warts are often unsatisfied with conventional medical care because of adverse effects such as intolerable pain, hyperpigmentation, hypopigmentation, or occasionally allergic contact dermatitis. To offset the possibilities of hyperpigmentation, hypopigmentation, and scar formation, the method of auricular acupuncture was used. METHODS Single-blind method adopted, 60 subjects with flat warts were all outpatients and randomly allocated to a treatment group or a control group, with 30 patients in each group. Thirty subjects in the treatment group were treated with weekly auricular acupuncture for 10 weeks while the other subjects in the control group were treated with 0.1% of tretinoin ointment topically for 10 weeks. RESULTS Sixteen subjects in the treatment group (53.33%) recovered fully from flat warts without recurrence during the ensuing six months' follow-up after 10 weeks' surgery compared with only one subject in the control group (3.33%). The therapeutic effect of the treatment group was statistically better than that of the control group by Mann-Whitney U-test with SPSS software (P < 0.01). During the treatment period and the ensuing six months' follow-up, no adverse effects were observed by the investigators or reported by patients. CONCLUSIONS Our findings suggest that auricular acupuncture may be a viable alternative for the treatment of flat warts. Larger randomized studies are needed to fully evaluate auricular acupuncture against more conventional treatments, and these are planned.
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Affiliation(s)
- Suli Ning
- Department of Dermatology of Shanghai Eighth People's Hospital, Shanghai, China
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Liu HP, Liang B, Zhang HM, Liu XY, Liu SH. Specificity of auricular acupoints in reflecting changes of qi and blood measured by diffuse reflectance spectroscopy. ZHONG XI YI JIE HE XUE BAO = JOURNAL OF CHINESE INTEGRATIVE MEDICINE 2012; 10:186-192. [PMID: 22313886 DOI: 10.3736/jcim20120209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE This study aimed to assess the specificity of auricular acupoints in responding to changes of qi and blood which, in traditional Chinese medicine, are considered as the fundamental substances in the human body for sustaining normal vital activity. METHODS A miniature fiber optic system was used to invasively measure the diffuse reflectance spectra of three auricular acupoints, namely, Uterus (TF2), Gan (CO12) and Neifenmi (CO18), at different stages of menstruation, when the female body exhibits regular changes of qi and blood. The spectra of different acupoints were compared to find their difference in responding changes of qi and blood, especially the reflectivity of absorption peaks of hemoglobin. RESULTS The reflectivity of the same auricular acupoint during menstruation is higher than that before and after menstruation, and this trend is more obvious for the Uterus point compared with the points Gan and Neifenmi. The average reflectivity of the Uterus point during menstruation was significantly higher than that before or after menstruation (P<0.01). The D-values during and after menstruation of the Uterus point were greater than those of the points Gan and Neifenmi at 544.06 and 577.47 nm, respectively (P<0.05). CONCLUSION The diffuse reflectance light of auricular acupoints changes as qi and blood fluctuates, and there is relative specificity among different auricular acupoints in reflecting changes of qi and blood. The Uterus point may be the most sensitive auricular acupoint in reflecting uterus function and subsequent changes of qi and blood.
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Affiliation(s)
- Han-ping Liu
- Laboratory of Photonics Chinese Medicine, South China Normal University, Guangzhou 510631, Guangdong Province, China.
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Lee C, Wallerstedt D, Duncan A, York A, Hollifield M, Niemtzow RC, Burns SM, Jonas WB. Design and Rationale of a Comparative Effectiveness Study to Evaluate Two Acupuncture Methods for the Treatment of Headaches Associated with Traumatic Brain Injury. Med Acupunct 2011. [DOI: 10.1089/acu.2011.0836] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - Alaine Duncan
- Healingworks: Restoring & Renewing Military Families, Silver Spring, MD
| | | | | | | | - Stephen M. Burns
- United States Air Force Acupuncture Center, Joint Base Andrews, MD
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A randomized controlled trial of auricular transcutaneous electrical nerve stimulation for managing posthysterectomy pain. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2011:276769. [PMID: 21716709 PMCID: PMC3118782 DOI: 10.1155/2011/276769] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 02/26/2011] [Accepted: 03/29/2011] [Indexed: 11/29/2022]
Abstract
Background. A patient- and assessor-blinded randomized controlled trial was conducted to examine the effectiveness of auricular transcutaneous electrical nerve stimulation (TENS) in relieving posthysterectomy pain.
Method. Forty-eight women who had undergone a total abdominal hysterectomy were randomly assigned into three groups (n = 16 each) to receive either (i) auricular TENS to therapeutic points (the true TENS group), (ii) auricular TENS to inappropriate points (the sham TENS group), or (iii) 20 minutes of bed rest with no stimulation (the control group). The intervention was delivered about 24 hours after the operation. A visual analogue scale was used to assess pain while resting (VAS-rest) and upon huffing (VAS-huff) and coughing (VAS-cough), and the peak expiratory flow rate (PEFR) was assessed before and at 0, 15, and 30 minutes after the intervention.
Result. As compared to the baseline, only the true TENS group reported a significant reduction in VAS-rest (P = .001), VAS-huff (P = .004), and VAS-cough (P = .001), while no significant reduction in any of the VAS scores was seen in the sham TENS group (all P > .05). In contrast, a small rising trend was observed in the VAS-rest and VAS-huff scores of the control group, while the VAS-cough score remained largely unchanged during the period of the study. A between-group comparison revealed that all three VAS scores of the true TENS group were significantly lower than those of the control group at 15 and 30 minutes after the intervention (all P < .02). No significant between-group difference was observed in PEFR at any point in time. Conclusion. A single session of auricular TENS applied at specific therapeutic points significantly reduced resting (VAS-rest) and movement-evoked pain (VAS-huff, VAS-cough), and the effects lasted for at least 30 minutes after the stimulation. The analgesic effects of auricular TENS appeared to be point specific and could not be attributed to the placebo effect alone. However, auricular TENS did not produce any significant improvement in the performance of PEFR.
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Asher GN, Motsinger-Reif AA, Jonas DE, Viera AJ. Quality of Reporting on Randomised Controlled Trials of Auriculotherapy for Pain. Acupunct Med 2011; 29:122-6. [DOI: 10.1136/aim.2010.003475] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective The authors investigated the quality of reporting for randomised controlled trials of auriculotherapy for pain before and after the implementation of the Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) guidelines. Methods The authors identified randomised controlled trials of auriculotherapy that measured pain or pain medication use as a primary outcome and were published in English in peer-reviewed journals. Proportions of studies that reported STRICTA and CONSORT items were compared for the years before and after implementation of STRICTA (2001) using Fisher's exact tests. Global differences across all study factors were investigated using hierarchical clustering and principle component analysis (PCA). Results 15 studies met our inclusion criteria. On average, 11 studies (74%) reported STRICTA items and eight studies (54%) reported CONSORT items. Differences in reporting between pre and post-STRICTA studies were found for two CONSORT items (randomised sequence and treatment provider) but no STRICTA items. However, the results of cluster analysis and PCA detected global differences over time for both STRICTA and CONSORT items. Conclusion Quality of reporting for studies of auriculotherapy for pain appears to have generally improved since the implementation of STRICTA and CONSORT guidelines.
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Affiliation(s)
- Gary N Asher
- Department of Family Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Daniel E Jonas
- Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Anthony J Viera
- Department of Family Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
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Asher GN, Jonas DE, Coeytaux RR, Reilly AC, Loh YL, Motsinger-Reif AA, Winham SJ. Auriculotherapy for pain management: a systematic review and meta-analysis of randomized controlled trials. J Altern Complement Med 2011; 16:1097-108. [PMID: 20954963 DOI: 10.1089/acm.2009.0451] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Side-effects of standard pain medications can limit their use. Therefore, nonpharmacologic pain relief techniques such as auriculotherapy may play an important role in pain management. Our aim was to conduct a systematic review and meta-analysis of studies evaluating auriculotherapy for pain management. DESIGN MEDLINE,(®) ISI Web of Science, CINAHL, AMED, and Cochrane Library were searched through December 2008. Randomized trials comparing auriculotherapy to sham, placebo, or standard-of-care control were included that measured outcomes of pain or medication use and were published in English. Two (2) reviewers independently assessed trial eligibility, quality, and abstracted data to a standardized form. Standardized mean differences (SMD) were calculated for studies using a pain score or analgesic requirement as a primary outcome. RESULTS Seventeen (17) studies met inclusion criteria (8 perioperative, 4 acute, and 5 chronic pain). Auriculotherapy was superior to controls for studies evaluating pain intensity (SMD, 1.56 [95% confidence interval (CI): 0.85, 2.26]; 8 studies). For perioperative pain, auriculotherapy reduced analgesic use (SMD, 0.54 [95% CI: 0.30, 0.77]; 5 studies). For acute pain and chronic pain, auriculotherapy reduced pain intensity (SMD for acute pain, 1.35 [95% CI: 0.08, 2.64], 2 studies; SMD for chronic pain, 1.84 [95% CI: 0.60, 3.07], 5 studies). Removal of poor quality studies did not alter the conclusions. Significant heterogeneity existed among studies of acute and chronic pain, but not perioperative pain. CONCLUSIONS Auriculotherapy may be effective for the treatment of a variety of types of pain, especially postoperative pain. However, a more accurate estimate of the effect will require further large, well-designed trials.
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Affiliation(s)
- Gary N Asher
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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