Auriculoterapia: eficácia clínica e comparação entre tecnologias / Auriculothérapie: efficacité clinique et comparaison entre les technologies

A auriculoterapia é uma prática diagnóstica e terapêutica que tem por princípio a estimulação de pontos no pavilhão auricular externo que correspondem a partes específicas do corpo (mapa somatotópico). Sua origem é derivada da acupuntura, prática da medicina tradicional chinesa. Desde seu surgimento em 1951, na França, várias tecnologias para a realização da auriculoterapia foram desenvolvidas. Considerando a existência de diferentes materiais para realização da auriculoterapia (esferas magnéticas, agulhas semipermanentes, agulhas filiformes, estimulação por laser, eletropuntura, cristais e outros), foi solicitada pela assistência da atenção primária revisão rápida para comparação da eficácia, segurança e efetividade das tecnologias relatadas na literatura científica. Quais tecnologias utilizadas para realização da auriculoterapia apresentam maior eficácia clínica quando comparadas entre si?

Acupressure therapy as a pain reliever for dysmenorrhea

BACKGROUND: According to survey conducted by researchers at SMAN 01 Tulang Bawang Tengah, it was found that 88.3% (53) female students from 60 students aged 16 to 18 had dysmenorrhea, which consisted of mild dysmenorrhea of 54.72%, moderate dysmenorrhea of 33.96%, and heavy dysmenorrhea is 11.32%. PURPOSE: Determine the differences of before and after acupressure therapy on decreasing dysmenorrhea pain. METHODS: The type of research used in this study is quantitative research using a quasi-experimental research design with one group pre-test and post-test approach. The study was conducted at SMAN 1 Tulang Bawang Tengah. The population in this study were all students of class X IPA as many as 60 students who experienced dysmenorrhea at SHS 1 Center Tulang Bawang. The size of the sample using the Slovin formula with the results of 52 female students. The selection of samples in this study was conducted by purposive sampling. The study used univariate and bivariate analysis with the Wilcoxon test. RESULTS: The results showed that most respondents were >14 years old, most of the respondents got menarche at age >12 years, most of respondents had menstrual period for >4 days and most respondent overcome pain dysmenorrhea without doing anything. Based on the analysis, the p value was 0.000. CONCLUSION: There is a difference before and after the administration of acupressure therapy to treat pain in dysmenorrhea

No disponible

Self-Administered Auricular Acupressure Integrated With a Smartphone App for Weight Reduction: Randomized Feasibility Trial.

BACKGROUND: Obesity is a common global health problem and increases the risk of many chronic illnesses. Given the adverse effects of antiobesity agents and bariatric surgeries, the exploration of noninvasive and nonpharmacological complementary methods for weight reduction is warranted. OBJECTIVE: The study aimed to determine whether self-administered auricular acupressure (AA) integrated with a smartphone app was more effective than using AA alone or the controls for weight reduction. METHODS: This study is a 3-arm randomized waitlist-controlled feasibility trial. A total of 59 eligible participants were randomly divided into either group 1 (AA group, n=19), group 2 (AA plus smartphone app, n=19), or group 3 (waitlist control, n=21). A total of 6 reflective zones or acupoints for weight reduction were chosen. The smartphone app could send out daily messages to the subjects to remind them to perform self-pressing on the 6 ear acupoints. A "date picker" of the 8-week treatment course was used to enable the users to input the compliance of pressing and the number of bowel movement daily instead of using the booklet for recordings. The app also served as a reminder for the subjects regarding the dates for returning to the center for acupoint changing and assessments. Treatment was delivered 2 times a week, for 8 weeks. Generalized estimating equations were used to examine the interactions among the groups before and after intervention. RESULTS: Subjects in group 2 expressed that the smartphone app was useful (7.41 out of 10). The most popular features were the daily reminders for performing self-pressing (88%), the ear diagram indicating the locations and functions of the 6 ear points (71%), and ear pressing method demonstrated in the video scripts (47%). Nearly 90% of the participants completed the 8-week intervention, with a high satisfaction toward the overall arrangement (8.37 out of 10). The subjects in group 1 and 2 achieved better therapeutic effects in terms of body weight, body mass index (BMI), waist circumference, and hip circumference and perceived more fullness before meals than the waitlist controls. Although no significant differences in the pairwise comparisons between the 2 groups were detected (P>.05), the decrease in body weight, BMI, body fat, visceral fat rating and leptin level, and increase in adiponectin level were notable in group 2 before and after the intervention. CONCLUSIONS: The high compliance rate and high satisfaction toward the trial arrangement indicate that AA can be used to achieve weight reduction and applied in future large-scale studies. AA integrated with the smartphone app has a more notable effect than using AA alone for weight reduction. Larger sample size should be considered in future trials to determine the causal relationship between treatment and effect. TRIAL REGISTRATION: ClinicalTrials.gov NCT03442712; https://clinicaltrials.gov/ct2/show/NCT03442712 (Archived by WebCite at http://www.webcitation.org/78L2tO8Ql).

Acupressure bands do not improve chemotherapy-induced nausea control in pediatric patients receiving highly emetogenic chemotherapy: A single-blinded, randomized controlled trial.

BACKGROUND: Chemotherapy-induced nausea and vomiting remain common, distressing side effects of chemotherapy. It has been reported that acupressure prevents chemotherapy-induced nausea in adults, but it has not been well studied in children. METHODS: In this multicenter, prospective, randomized, single-blind, sham-controlled trial, the authors compared acute-phase nausea severity in patients ages 4 to 18 years who were receiving highly emetic chemotherapy using standard antiemetic agents combined with acupressure wrist bands, the most common type of acupressure, versus sham bands. Patients wore acupressure or sham bands continuously on each day of chemotherapy and for up to 7 days afterward. Chemotherapy-induced nausea severity in the delayed phase and chemotherapy-induced vomiting control in the acute and delayed phases also were compared. RESULTS: Of the 187 patients randomized, 165 contributed nausea severity assessments during the acute phase. Acupressure bands did not reduce the severity of chemotherapy-induced nausea in the acute phase (odds ratio [OR], 1.33; 95% confidence limits, 0.89-2.00, in which an OR <1.00 favored acupressure) or in the delayed phase (OR, 1.23; 95% CL, 0.75-2.01). Furthermore, acupressure bands did not improve daily vomiting control during the acute phase (OR, 1.57; 95% CL, 0.95-2.59) or the delayed phase (OR, 0.84; 95% CL, 0.45-1.58). No serious adverse events were reported. CONCLUSIONS: Acupressure bands were safe but did not improve chemotherapy-induced nausea or vomiting in pediatric patients who were receiving highly emetic chemotherapy. Cancer 2018;124:1188-96. © 2017 American Cancer Society.

Acupressure as adjuvant treatment for the inpatient management of nausea and vomiting in early pregnancy: A double-blind randomized controlled trial.

AIM: To evaluate the efficacy of acupressure at the Neiguan point (Pericardium [P]6) as adjuvant treatment during inpatient management of severe nausea and vomiting in pregnancy. METHODS: Low risk, spontaneously conceived singleton pregnancies were randomly assigned to a treatment group, who received an acupressure band placed at the Neiguan point (P6) or a placebo group who received an otherwise identical non-stimulating wristband. Participants wore the band for 12 h daily for the first three days of admission. The primary outcome measure was the severity of symptoms of nausea, vomiting and retching, recorded according to Pregnancy-Unique Quantification of Emesis and Nausea score. RESULTS: There was a statistically significant improvement in Pregnancy-Unique Quantification of Emesis and Nausea scores from day 1 until day 3 of admission in the treatment group compared with the placebo. Patients who received Neiguan point acupressure also showed a significant improvement in their ketonuria scores. The treatment group required a shorter hospital stay compared with the placebo. The only reported side effect of the acupressure band was redness on the wrist. CONCLUSIONS: The use of the acupressure band at the Neiguan point (P6) for 12 h daily for three days for inpatients with hyperemesis gravidarum significantly reduced the symptoms of nausea, vomiting and retching and ketonuria and led to a reduction in hospital stay. We recommend the use of the acupressure band at the Neiguan point (P6) as an adjunct/supplementary therapy to co-exist with the standard care of management for hyperemesis gravidarum, particularly in low-risk pregnant women.

Effects of Nei-Guan (P6) Acupressure Wristband: On Nausea, Vomiting, and Retching in Women After Thyroidectomy.

BACKGROUND: Postoperative nausea and vomiting (PONV) after thyroidectomy is a common health problem in the recovery room. OBJECTIVE: The aim of this study is to examine the effect of the Nei-Guan (P6) acupressure wristband for PONV among patients undergoing thyroidectomy. METHODS: Sixty Korean female participants were assigned to 1 of 3 groups (n = 20 each). The control group received usual care without the wristband. The placebo group received usual nursing care plus a wristband at the non-P6 site. The treatment group received usual care plus a wristband at the P6 acupoint 30 minutes before anesthesia; the wristband was removed before leaving the recovery room. Data were collected at 3 periods: in the recovery room and at 6 and 24 hours after surgery. RESULTS: The nausea scores of the treatment group were significantly lower than the scores of the placebo or control groups in the recovery room (F = 6.229, P = .044). There were no significant differences in vomiting or retching among the groups. CONCLUSIONS: The P6 stimulation with wristband suppressed nausea right after thyroidectomy in the recovery room but did not suppress subsequent vomiting or retching. IMPLICATION FOR PRACTICE: The findings indicate that P6 acupressure has the short-term effect of relieving nausea but not vomiting and retching. Use of P6 wristband holds promise and suggests the need for further testing in a larger randomized clinical trial. Identifying other acupoints is recommended to achieve successful management of PONV.

Acupressure Bead in the Eustachian Tube.

In this article, we aim to enlighten practitioners and patients involved with acupressure beads and to contribute to their safer use by reporting a unique case of insidious intrusion of an acupressure bead into the eustachian tube. A metallic object was found in the eustachian tube of a patient while conducting a magnetic resonance imaging (MRI) examination. The object was later confirmed to be an auricular acupressure bead, and was successfully removed by performing a tympanoplasty and a canal wall down mastoidectomy. The bead was assumed to have passed through an existing perforation of the tympanic membrane. According to previously published literature, tympanic membrane perforations exist in ∼1% of the population. Therefore, middle-ear foreign bodies are relatively common occurrences for otolaryngologists. However, metallic objects such as acupressure beads are especially important in the sense that they can cause severe burns during MRI. To avoid potential complications, acupressure-bead practitioners should be aware of the possibility that intrusions through the tympanic membrane could go unnoticed.

The effect of an acupressure backrest on pain and disability in office workers with chronic low back pain: A randomized, controlled study and patients' preferences.

OBJECTIVE: This study investigated the effects of an acupoint-stimulating lumbar backrest on pain and disability in office workers who suffering from low back pain (LBP) as well as the preference influence on pain and disability. METHODS: Sixty-four participants were randomly assigned to two groups: one with no intervention (n=32) and another with 1 month of backrest use (n=32). An additional group (n=37) who wished to try 1 month of acupressure backrest were recruited to indicate the preference effect. Pain and disability were two key outcomes. RESULTS: Significant differences between control and randomized acupressure backrest groups were found at 2 week period for disability and at 4 weeks for pain after the backrest use. Also, significant differences were found in both groups for 3 month period with an increase of the treatment effect on pain and disability. Both control and randomized acupressure backrest groups showed greater improvement in pain and disability scores which were more than the minimal clinically important change (30% improvement for both outcomes). No significant difference was found for pain and disability between the randomized and preferred backrest groups. CONCLUSION: These findings suggested 1-month of acupressure backrest use could improve LBP conditions. Preference was not a powerful moderator to the significant treatment effect.

The efficacy of P6 acupressure with sea-band in reducing postoperative nausea and vomiting in patients undergoing craniotomy: a randomized, double-blinded, placebo-controlled study.

BACKGROUND: Postoperative nausea and vomiting (PONV) is a multifactorial problem after general anesthesia. Despite antiemetic prophylaxis and improved anesthetic techniques, PONV still occurs frequently after craniotomies. P6 stimulation is described as an alternative method for preventing PONV. The primary aim of this study was to determine whether P6 acupressure with Sea-Band could reduce postoperative nausea after elective craniotomy. Secondary aims were to investigate whether the frequency of vomiting and the need for antiemetics could be reduced. METHODS: In this randomized, double-blinded, placebo-controlled study, patients were randomized into either a P6 acupressure group (n=43) or a sham group (n=52). Bands were applied unilaterally at the end of surgery, and all patients were administered prophylactic ondansetron. Postoperative nausea was evaluated with a Numerical Rating Scale, 0 to10, and the frequency of vomiting was recorded for 48 hours. RESULTS: We found no significant effect from P6 acupressure with Sea-Band on postoperative nausea or vomiting in patients undergoing craniotomy. Nor was there any difference in the need for rescue antiemetics. Altogether, 67% experienced PONV, and this was especially an issue at >24 hours in patients recovering from infratentorial surgery compared with supratentorial surgery (55% vs. 26%; P=0.014). CONCLUSIONS: Unilateral P6 acupressure with Sea-Band applied at the end of surgery together with prophylactic ondansetron did not significantly reduce PONV or the need for rescue antiemetics in patients undergoing craniotomy. Our study confirmed that PONV is a common issue after craniotomy, especially after infratentorial surgery.

[The efficiency of Lyapko applicators usage in the treatment of patients with comorbidity of hypertension and chronic pancreatitis based on the heart rate variability].

Efficiency of the acupressure methodics of Lyapko applicators including in the treatment of patients with comorbidity of hypertension and chronic pancreatitis is estimated based on the study of the dynamics of the clinic and the state of autonomic nervous system using heart rate variability. The significant autonomic disorders were found in the studied group. More pronounced effect of this method of acupuncture was confirmed for the treatment of comorbidity of the studied pathologies, especially with regard to autonomic disorders.

"Until the trial is complete you can't really say whether it helped you or not, can you?": exploring cancer patients' perceptions of taking part in a trial of acupressure wristbands.

BACKGROUND: Nested qualitative studies within clinical trials provide data on patients' experiences of receiving trial interventions and can inform and improve trial designs. The present study explored patients' experiences of participating in a randomised controlled trial of acupressure wristbands for chemotherapy related nausea. METHODS: A randomised three-group sham-controlled trial was carried out to evaluate the effectiveness of acupressure wristbands in the management of chemotherapy-related nausea. A convenience sample of 26 patients volunteered to participate in a qualitative study to explore their experiences of using acupressure wristbands, and taking part in the clinical trial. Participants were recruited from each of the three UK geographical sites from which the trial was conducted: Manchester, Liverpool and Plymouth. In-depth semi-structured interviews were conducted with the participants in their own homes or other location convenient for participating patients. Interviews were audio-taped, transcribed verbatim and analysed using Framework methodology. RESULTS: The main motivational factors influencing participants to take part in the trial were a desire to 'give something back' and limit their own experience of nausea. Participants were largely satisfied with the organisation and running of the acupressure wristband trial. Many participants experienced positive outcomes as a result of taking part in the trial. Lapses in memory, or poor health as a result of their chemotherapy treatment, led to some participants failing to complete trial paperwork on designated days. Two sham wristband participants reported wearing the bands inappropriately resulting in pressure being applied to the acupoint. Almost all of the participants interviewed had only experienced mild nausea or vomiting during the trial. Participants were pragmatic on the extent to which the wristbands were responsible for this lack of nausea and vomiting during the trial. However, many participants, including some patients receiving sham acupressure, believed the wristbands to have had a positive impact on their nausea and vomiting; there was a perception that the wristbands were, at least in part, responsible for the lack of nausea and vomiting they had experienced. CONCLUSIONS: Participants perceive acupressure wristbands as reducing the level of nausea and vomiting experienced during chemotherapy treatment. Reports that some participants wore wristbands inappropriately, and/or delayed completion of trial paperwork could represent confounding variables and have implications for the trial results, and the design of clinical trials within the field of cancer.

Efficacy of two different materials used in auricular acupressure on weight reduction and abdominal obesity.

The current study was designed to test the efficacy of different materials used in an auricular acupressure program on weight reduction, changes to waist circumference and waist-to-hip ratio. This study used a randomized design with two groups who were treated with auricular acupressure using Semen Vaccariae or the Japanese Magnetic Pearl. Both groups consisted of Asian young adults with a waist circumference ≥ 80 cm in the females and ≥ 90 cm in the males. At completion of the eight-week treatment period, the total sample size was 56 young adults who ranged in age from 18 to 20 years old. Each participant was met with weekly for ten-minute sessions during which ear acupressure treatment was performed. Sessions continued for eight weeks wherein both groups received acupressure with the Japanese Magnetic Pearl or Semen Vaccariae on the ear acupoints. While both groups showed significant reductions (p ≤ 0.05) to body weight and waist circumference after eight weeks of treatments, the group treated with Semen Vaccariae group showed a more effective weight loss over the short term. Given that auricular acupressure is a safe and cost-effective treatment for weight loss, our results suggest that auricular acupressure is a reasonable option for the treatment of overweight and obesity in young adults.

Acupressure in the control of migraine-associated nausea.

Migraine is a disabling neurological disorder, aggravated by accompanying symptomatology, such as nausea. One of the most interesting approaches to nausea adopted by traditional Chinese medicine is the stimulation of the acupoint PC6 Neiguan. Actually there are no studies in medical literature as to the efficacy of treating PC6 acupoint for gastrointestinal symptoms in migraine attacks. Our study aimed at verifying if pressure applied to the acupoint PC6 was effective on nausea during migraine. Forty female patients suffering from migraine without aura were enrolled, if nausea was always present as accompanying symptomatology of their migraine. The patients were treated randomly for a total of six migraine attacks: three with the application of a device, the Sea-Band(®) wristband, which applies continual pressure to the PC6 acupoint (phase SB), and three without it (phase C). The intensities of nausea at the onset, at 30, 60, 120 and 240 min were evaluated on a scale from 0 to 10. The values were always significantly lower in phase SB than in phase C. Also the number of patients who reported at least a 50 % reduction in the nausea score was significantly higher in phase SB than in phase C at 30, 60 and 120 min. Moreover, the consistency of the treatment (response in at least two out of three treated attacks) was reached in 28 % patients at 60 min; in 40 % at 120 min and 59 % at 240 min. Our results encourage the application of PC6 acupressure for the treatment of migraine-associated nausea.

Use of a disposable acupressure device as part of a multimodal antiemetic strategy for reducing postoperative nausea and vomiting.

BACKGROUND: There is still controversy regarding the optimal strategy for managing postoperative nausea and vomiting (PONV) in high-risk surgical populations. Although acustimulation at the P6 acupoint has been demonstrated to be effective in preventing PONV, the effect of this nonpharmacologic therapy on the patient's recovery with respect to resumption of normal activities of daily living has not been previously assessed when it is used as part of a multimodal antiemetic regimen. Therefore, we designed this randomized, sham-controlled, and double-blind study to assess the efficacy of a disposable acupressure device (Pressure Right®; Pressure Point Inc., Grand Rapids, MI) on the incidence of emetic episodes and quality of recovery when used in combination with ondansetron and dexamethasone for antiemetic prophylaxis. METHODS: One hundred ASA physical status I and II patients undergoing major laparoscopic procedures were randomly assigned to either a control group (n = 50) receiving a "sham" acustimulation device or an acupressure group (n = 50) receiving a disposable Pressure Right device placed bilaterally at the P6 point 30 to 60 minutes before induction of anesthesia. All patients received a standardized general anesthetic. A combination of ondansetron, 4 mg IV, and dexamethasone, 4 mg IV, was administered during surgery for antiemetic prophylaxis in both study groups. The incidence of nausea and vomiting and the need for "rescue" antiemetic therapy were assessed at specific time intervals for up to 72 hours after surgery. The recovery profiles and quality of recovery questionnaires were evaluated at 48 hours and 72 hours after surgery. Patient satisfaction with the management of their PONV was assessed at the end of the 72-hour study period. RESULTS: The 2 study groups did not differ in their demographic characteristics or risk factors for PONV. The incidence of vomiting at 24 hours was significantly decreased in the acupressure group (10% vs 26%, P = 0.04, 95% confidence interval for absolute risk reduction 1%-31%). The overall incidence of vomiting from 0 to 72 hours after surgery was also significantly decreased from 30% to 12% in the acupressure group (P = 0.03, 95% confidence interval 2%-33%). Furthermore, adjunctive use of the acupressure device seemed to enhance patient satisfaction with their PONV management and quality of recovery at 48 hours after surgery. However, the recovery times to hospital discharge, resumption of normal physical activities, and return to work did not differ significantly between the 2 study groups. CONCLUSION: Use of the Pressure Right acupressure device in combination with antiemetic drugs provided a reduction in the incidence of vomiting from 0 to 72 hours after surgery with an associated improvement in patient satisfaction with their PONV management. However, recovery and outcome variables failed to demonstrate any improvement with the addition of the acupressure device.

Acupressure at acupoint P6 for prevention of postoperative nausea and vomiting: a randomised clinical trial.

BACKGROUND AND OBJECTIVE: Postoperative nausea and vomiting causes discomfort in many patients despite both antiemetic prophylactics and improved anaesthetic techniques. Stimulation of acupoint P6 is described as an alternative method for prophylaxis of postoperative nausea and vomiting.In a randomised, double-blinded study, we aimed to investigate the effect of P6 acupoint stimulation on the incidence of postoperative nausea and vomiting within 24 h postoperatively with an acupressure wristband: Vital-Band. METHODS: One hundred and thirty-four healthy, non-smoking women scheduled for breast surgery were randomised either to P6 stimulation or to sham control. Wristbands were applied and covered with a dressing before induction of anaesthesia. Follow-up was carried out three times within 24 h postoperatively. Primary outcomes were postoperative nausea and/or vomiting. RESULTS: One hundred and twelve patients completed the study. There were no statistically significant differences in the incidence of nausea [P6 stimulation, 35.1% (95% confidence interval, CI 22.7-47.5%) versus sham control, 43.1% (95% CI 29.5-56.7%; P = 0.433)] or vomiting [P6 stimulation, 25.9% (95% CI 14.6-37.2%) versus sham control, 26.9% (95% CI 14.8-39.0%; P = 1.000)]. Approximately, one third of the patients reported side effects caused by the wristband, for example, redness, swelling and tenderness. CONCLUSION: We did not find the Vital-Band effective in preventing either nausea or vomiting after operation in women undergoing breast surgery.

Acupressure bands are effective in reducing radiation therapy-related nausea.

Previous studies have shown that acupressure bands can reduce chemotherapy-related nausea. Patients' expectations of efficacy account for part of this outcome. We conducted a three-arm randomized clinical trial to investigate the effectiveness of acupressure bands in controlling radiation therapy-induced nausea and to test whether an informational manipulation designed to increase expectation of efficacy would enhance the effectiveness of the acupressure bands. Patients who experienced nausea at prior treatments were randomized to either standard care (Arm 1, n=29) or standard care plus acupressure bands with either neutral (Arm 2, n=30) or positive (Arm 3, n=29) information regarding the efficacy of the bands. Patients reported nausea for two days prior to randomization (baseline) and for five days following using a seven-point semantic rating scale (1=not nauseated to 7=extremely nauseated). Patients in Arms 2 and 3 combined reported greater reduction in average nausea than patients in Arm 1 (P=0.01; mean(bands)=0.70, mean(no bands)=0.10). This equates to a 23.8% decrease in nausea in the band groups compared to a 4.8% decrease in the control group, a 19% difference. The informational manipulation failed to alter efficacy expectations and there was no statistically significant difference in nausea between patients in Arms 2 and 3. Acupressure bands are an effective, low-cost, nonintrusive, well-accepted, and safe adjunct to standard antiemetic medication. An attempt to boost the efficacy of the acupressure bands by providing positive information was not successful.

Efficacy of HT 7 point acupressure stimulation in the treatment of insomnia in cancer patients and in patients suffering from disorders other than cancer.

AIM: The induction of sleep would depend on interaction between gabaergic system and the pineal gland through its main hormone melatonin. Until few years ago benzodiazepines were the only drugs effective in the treatment of insomnia. Recently, however, both melatonin and acupressure have appear to be active in sleep disorders. The aim of study was to evaluate the efficacy of HT 7 point acupressure in insomnia. METHODS: The study enrolled 25 patients affected by sleep disorders, 14 of whom had a neoplastic disease. They were treated by HT 7 stimulation for al least two consecutive weeks using a medical device named H7 Insomnia Control. RESULTS: An improvement in the quality of sleep was achieved in 15/25 (60%) patients, with a more evident efficacy in cancer patients (11/14 [79%]). CONCLUSION: This study confirms previous clinical data showing the efficacy of acupressure in the treatment of sleep disorders, particularly in cancer-related insomnia.