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Auricular therapy for lactation: A systematic review
Abstract
Background:
Support for breastfeeding has been a matter of considerable interest in healthcare. In the field of traditional and complementary medicine, the effectiveness of auricular therapy on lactation has been investigated by several clinical studies.
Aim and objectives:
This review was mainly performed to assess the current evidence of auricular therapy on lactation. The objectives were to assess the current evidence of AT for lactation, examine the intervention protocols and outcome measures adopted by the studies included, and inform clinical application and future research in this area.
Study design:
Systematic review.
Method:
Narrative synthesis methodology was used to incorporate diverse forms of evidence within this systematic review.
Results:
Twenty-three randomized controlled trials and three non-randomized controlled trials were identified, of which 25 studies applied auricular acupressure with vaccaria seeds as the sole form of auricular therapy. Relative risks calculated on the onset of lactation and milk production are all less than 1. These results indicate that women in the auricular therapy group lactated earlier than their counterparts in the control group and the risk of low milk production was reduced while on auricular therapy. Absolute risk differences showed magnitude of effect ranging from small to medium. Standardized mean differences calculated on serum prolactin data generally favor auricular therapy over routine care. Overall, mothers treated by auricular therapy exhibited better lactation outcomes.
Conclusion:
The available data show evidence of benefits for postpartum lactation from auricular therapy. However, research using a more stringent design, standardized protocol, and valid outcome measures are warranted before it can be considered to be evidence-based practice. Issues from the current studies are highlighted and may serve to inform future trials.
... The lactation insufficiency in this case was likely caused by several factors: i) delay of breastfeeding initiation, which is a common finding in women following caesarean section (Chen et al., 2017;Prior et al., 2012); ii) invaginated nipple on the left breast; and iii) the perception of inadequate mother's milk supply in the primipara due to the invaginated nipple (Li et al., 2008). The initiation of sufficient lactation on the 6th DOL and the increase of milk production, which was finally sufficient to satisfy the needs of the child, certainly might have occurred due to the natural course of the condition. ...
... We believe that AS was the main factor that stimulated and enhanced milk production in this case. Moreover, our observation supports previous researchers' work, where the stimulation of acupuncture points, as compared to various control conditions, was suggested to accelerate the onset of lactation, enhance maternal milk production, and increase the level of serum prolactin (Chen et al., 2017;Lu et al., 2019). These previously suggested positive effects of AS were more pronounced in women after a Caesarean than after a vaginal birth (Chen et al., 2017;Lu et al., 2019). ...
... Moreover, our observation supports previous researchers' work, where the stimulation of acupuncture points, as compared to various control conditions, was suggested to accelerate the onset of lactation, enhance maternal milk production, and increase the level of serum prolactin (Chen et al., 2017;Lu et al., 2019). These previously suggested positive effects of AS were more pronounced in women after a Caesarean than after a vaginal birth (Chen et al., 2017;Lu et al., 2019). We are aware of the limitations of our statement, based as it is on a single case study. ...
Introduction
Breastfeeding is a recognized preferred method of infant feeding; however, for many women, difficulties in breastfeeding result in termination before the recommended period of time. Acupuncture is suggested to be a promising option to treat lactation insufficiency and enhance the production of maternal milk.
Main Issue
We have reported the case of a woman with lactation insufficiency due to Caesarean section and congenital unilateral invaginated nipple. Milk production started on the 3rd day following delivery. The newborn was not provided with any food or fluids other than mother’s milk. At 5 days of life, the newborn required long feeding periods and lost 4% of his birth weight, with the participant reporting lactation insufficiency described by the perception of inadequate milk production.
Management
Despite the implementation of conventional measures to improve lactation, the difficulties in breastfeeding persisted. Acupuncture was tried on Day 6 of life, and enhanced milk production was observed, which could be measured as the volume of residual milk extracted using the breast pump each time after the newborn achieved satiety. After acupuncture treatment there was an augmentation of maternal milk production from both breasts and successful lactation.
Conclusion
This case study provides information that might be useful for prospective investigation of acupuncture’s efficacy in women with lactation insufficiency.
... The results of a systematic review have shown the positive effects of auriculotherapy techniques on improving breastfeeding status. [10] Another research has pointed to the effectiveness of this method in reducing breastfeeding mothers. [11] This technique has also been used to reduce maternal anxiety during labor pain has also shown that it effectively reduces maternal anxiety and fatigue after the cesarean section. ...
... The results of a systematic review have shown that the use of auriculotherapy techniques in breastfeeding success is quite effective in increasing breast milk volume and increasing maternal self-efficacy in breastfeeding between the term births. [10] This result can be achieved both directly and following the reduction of stress and anxiety levels of mothers. In the present study, these results have been obtained. ...
Background
A preterm birth exposes the mother to many challenges in caring for and supporting the baby. This study aims to use training and auriculotherapy techniques as two simple methods to reduce anxiety and increase the mother's self-efficacy.
Materials and Methods
This single-blind three-group clinical trial study was conducted in the Bahar Hospital in Shahroud, Iran, in 2019. The target group of primiparous mothers was premature infants. For the first group, premature infant care training was provided, and for the second group, auriculotherapy techniques were performed, and the third group (the control group) received routine care. Anxiety, general self-efficacy, and maternal breastfeeding self-efficacy were measured at the beginning of the study and before neonatal discharge.
Results
Before the intervention, three groups were not significantly different in demographic characteristics, obvious and hidden anxiety scores, and general self-efficacy and lactation (p > 0.05). There was a significant difference between the control group and the two intervention groups with ANOVA test for self-efficacy (F2,87 = 6.60, p = 0.002), breastfeeding self-efficacy (F2,87 = 15.20, p < 0.001), obvious anxiety (F2,87 = 56.20, p < 0.001), hidden anxiety (F2.87 = 62.90, p < 0.001), after the intervention. In addition, there was no significant difference in the length of hospital stay in the neonatal intensive care unit (p = 0.732). Still, the neonate's infant's mean weight before discharge in the two intervention groups was significantly different from the control group (p = 0.034).
Conclusions
Teaching mothers how to care for premature infants and implement auriculotherapy techniques reduces anxiety and increases mothers' general self-efficacy and breastfeeding.
... All of the aforementioned prior studies did not report the dissatisfaction and serious side effects of participants. In the present study, breast massage combined with acupoint stimulation was chosen for the intervention because of the following reasons: (1) in traditional Chinese culture, for lactation, women can be unwilling to accept medicine; (2) the method of breast massage is simple and easy to master, which has been demonstrated by a previous study [14]; (3) acupuncture requires professionals to pierce the skin with needles, which is not easy to be mastered by participants; (4) acupoint stimulation has similar effects to acupuncture [33] and is easier to be accepted and mastered by participants owing to non-invasiveness. ...
... Secondly, the recruitment percentage was 90% (45/50) and the retention percentage was 82.5% (33/40); this suggests a higher level of satisfaction compared with several prior studies on breastfeeding support in preterm infants [32][33][34][35][36]. In said studies, the recruitment percentage varied from 70% (40/57) [32] to 95% (204/214) [36], while the retention percentage varied from 79% (85/108) [35] to 82.5% (33/40) [32]. is could potentially be attributed to the professional support given to the participants, which is anticipated by mothers with premature infants [37]. ...
Background. Preterm infant mothers have always encountered difficulties in human milk production. For this reason, an intervention of breast massage combined with acupoint stimulation was designed to increase the production. Purpose. Through a pilot randomized trial, we assessed the acceptability, feasibility, and effectiveness of breast massage combined with acupoint stimulation and the study procedures. Methods. 40 participants of preterm infants born at less than 34 weeks of gestation were randomly allocated to the CG (control group) or the EG (group with breast massage combined with acupoint stimulation). Data related to the acceptability, feasibility, and effectiveness of the intervention and research procedures were collected and analysed. Results. The daily volume progressively increased each day in the first 7 days in both groups and a significant difference was observed between the groups ( P < 0.001). The initiation time of lactogenesis stage II was 50.06 ± 6.78 (40.00–64.00) hours in the EG and 66.18 ± 14.64 (48.00–96.00) hours in the CG, where a significant difference was detected ( P < 0.05). The mean score of satisfaction with the intervention in the EG was 4.56 ± 0.32 (4.0–5.0), while the retention rates were 82.5% and 85.5% (17/20) in the CG, and 80% (16/20) in the EG. Conclusion. This pilot study was oriented towards the effectiveness of breast massage combined with acupuncture stimulation for the increase of human milk production in the participants. The intervention was accepted well and the study process was reasonable. A large-scale RCT will be able to determine the beneficial effects of this intervention on human milk production.
... These auricular pressure points stimulate and regulate their respective anatomical organ. Different clinical studies had shown beneficial results in variety of health problems like chronic pain, insomnia, lactation failure etc. [13][14][15][16] According to the theory of Acupuncture, a very thin needle is inserted through a person's skin at specific points on the body to various depths. It helps to relieve pain and bring the energy flow back in to proper balance. ...
Karnavedhana is one of the important Sanskara of Childhood. For overall wellbeing, it is advocated to be done in a healthy child by a trained and expert Vaidya. The main purpose of Karnavedhana Sanskara is for Raksha (protection against Grahas) and Karnaabhusana (ornamental purpose). The pierce is advised in the sixth or seventh month of age at the naturally designed hole in the ear of the child enlightened with the sun’s rays (Daivkrit chhidre). In male child right ear lobe and in female child left ear should be pierced first then the Pichhu varti be inserted. The central concha (Site of Daivekrite Chhidra) of the ear is innervated by the Vagus nerve and serves as the region for autonomic regulation of pain and pathology originating from internal organs. This part is found to be innervated by ABVN which regulates the parasympathetic functions. The physiological significance of the Vagus nerve is due to its widespread distribution. Vagus nerve stimulation has been approved by FDA as an alternative treatment for neuropsychiatric diseases such as epilepsy and depression. Karnavedhan stimulate the immune system in response to injury to the ear lobules which initiate antigen-antibody reaction in early life period so as to bring a secondary immunity against several infections. Theory of Acupuncture states that the earlier the ear is pierced it is good for the meridians connecting the brain passing through this area and helps in the quick development of the brain. Also, the site of Karnavedhan has least vascular innervation, hence most safe site for puncturing. Clinical trials are needed to evaluate the effect of Karnavedhan Sanskar.
Keywords: Karnavedhan Sanskar, Daivkrit chhidre, auricular branch of vagus nerve
... Acupressure is a non-pharmacological method based on the principles of acupuncture (10). Ear therapy or auricular therapy as part of acupressure includes the use of the ear and its relationship with different parts of the body in the diagnosis and treatment of diseases (11), which returns the body to a harmonious and balanced state. By stimulating the ear parts, its benefits can be enjoyed for days and even weeks (12). ...
... Acupressure is a non-pharmacological method based on the principles of acupuncture (10). Ear therapy or auricular therapy as part of acupressure includes the use of the ear and its relationship with different parts of the body in the diagnosis and treatment of diseases (11), which returns the body to a harmonious and balanced state. By stimulating the ear parts, its benefits can be enjoyed for days and even weeks (12). ...
Background and objectives: One of the potentially effective methods for relieving postpartum perineal pain is auricular acupressure. This review aimed to evaluate the clinical effect of auricular acupressure on postpartum perineal pain in a systematic review.
Material and Methods: An extensive systematic search was performed on online electronic databases, including Scopus, PubMed/MEDLINE, ProQuest, Web of Science, and Cochrane using the keywords related to the purpose, from the earliest to June 30, 2021.
Results: Of 263 articles, three studies were included in the review. A total of 386 women with a mean age of 29.79 years were included in the review. Of the participants, 192 women were in the intervention group. Of the studies included, two studies evaluated auricular acupressure, and one study evaluated battlefield auricular acupuncture plus standard analgesia. Overall, the number of acupressure points varied from 3 to 5. In most cases, auricular acupressure was used at points of Shen Men (n=3) and the external genital area (n=2). Overall, auricular acupressure in one study out of three studies had a significant effect on reducing postpartum perineal pain. Two out of three studies reported no side effects of auricular acupressure for participants.
Conclusion: It seems that auricular acupressure can be used as a simple, low-cost, and practical intervention to reduce postpartum perineal pain. However, future well-designed studies are needed to confirm the findings of this systematic review.
... A number of measures to stimulate efficient breast emptying have been explored, including massage, milk expression, breast pumping, cold and hot compression, acupuncture, auricular therapy, Gua-Sha therapy, ultrasonic treatment, and laser therapy [13][14][15][16][17][18][19][20]. When a single measure proves effective, combination of multiple measures should yield better results. ...
Introduction: Plugged ducts and mastitis are common conditions in lactating women. Milk excretion and relief of local symptoms are equally important for the treatment of plugged ducts and mastitis.This study aimed to describe clinical response to 5-step systematic therapy (FSST) in the management of plugged ducts and mastitis. FSST was a comprehensive milk stasis dredging treatment, which contained five steps to make the milk out of the plugged duct.
Materials and Methods: This retrospective study included 922 breastfeeding women, 714 with plugged ducts and 208 with mastitis who received FSST at the breast nursing outpatient department from June to September 2017. The breast pain score, swelling degree and range of breast induration were recorded pre-FSST and post-FSST.
Results: After a single FSST, pain score and degree of swelling were significantly improved (both, p < 0.001) in all cases. After receiving FSST, the mean breast pain relief score was 1.7±0.7, while the mean swelling fade-away degree was 1.6±0.6. In subgroup analysis, pain score and degree of swelling were significantly improved (both, p < 0.001) in the plugged ducts group and the mastitis group. The score of pain relief in the plugged ducts group was less than that in the mastitis group (1.6±0.7 vs. 1.9±0.7, t=-5.301, p=0.000), while improvement of swelling fade-away was greater in the plugged ducts group than the mastitis group (1.7±0.6 vs. 1.5±0.6, t=3.488, p=0.001). The composition ratio of the changes in induration range between the two groups was statistically different (Pearsonχ2=137.865, p = 0.000), of which more obvious improvement in the plugged ducts group than the mastitis group (χ2=25.653, p = 0.000).
Conclusion: FSST can relieve pain, reduce breast swelling and range of induration, and for plugged ducts or mastitis varied degree differently.
... The stimulation of auricular acupoints is intended to regulate qi, activate the meridians, and is proposed to affect the gross anatomical organ associated with that point. In so doing, a variety of health problems (for example, chronic pain, insomnia, and lactation disorder) have been successfully cured [53][54][55][56]. Systematic reviews of acupuncture therapy for psoriasis indicated that acupuncture-related techniques could be considered as an alternative or adjuvant therapy for psoriasis [20,57,58]. ...
Introduction:
Psoriasis vulgaris is a common skin disease characterized by persistent localized erythematous scaly plaques, typically on the elbows, knees, and scalp. It is an immune-abnormal disease that progresses slowly over a long period with frequent symptom recurrence. Current studies have shown that acupuncture is an effective therapy for psoriasis. However, the scientific evidence of the efficacy of auricular acupressure treatment for patients with psoriasis is still insufficient. Therefore, we designed a randomized controlled clinical trial to investigate the effect, safety, and cost-effectiveness of auricular acupressure in addition to medication in patients with psoriasis.
Methods and analysis:
This on-going study is a two-arm parallel, assessor-blinded, randomized controlled trial in which 180 participants with psoriasis will be recruited and then randomly allocated into two groups in a 1:1 ratio. Equal randomization will be conducted using a computer-generated random allocation sequence. Participants in the intervention group will receive auricular acupressure treatment once per week for 4 weeks, and calcipotriol betamethasone ointment for topical use once daily for 4 weeks. Participants in the control group will receive only calcipotriol betamethasone ointment treatment once daily for 4 weeks. All patients will be followed up for 12 weeks. The primary outcome is relapse rate. The secondary outcomes include time to relapse, rebound rate, time to new onset, Psoriasis Area and Severity Index score improvement rate, body surface area affected, a visual analogue scale, and Dermatology Life Quality Index. Cost-effectiveness analysis will be carried out from a health and community care provider perspective.
Discussion:
This multicenter randomized controlled trial will provide important clinical evidence for the effect and safety of auricular acupressure as a complementary therapy in patients with psoriasis.
Trial registration:
Chinese Clinical Trial Registry, ChiCTR-TRC-14004916 . Registered on 20 May 2014. This protocol is version 3.0 which was updated on 24 September 2016.
Background:
Auricular acupressure influences pain reduction in patients with diseases. However, study results on its influence on breast pain, common among breastfeeding mothers, are insufficient.
Research aim:
This study aimed to explore the effectiveness of auricular acupressure on breast pain among breastfeeding mothers who also received a standard gentle hand technique.
Methods:
This was a placebo-controlled study wherein auricular acupressure was provided for 4 weeks to 52 breastfeeding mothers consulting a local breastfeeding clinic. In the intervention group, auricular acupressure was applied to specific acupoints, including Shenmen, central rim, breast, and endocrine, which are related to breast pain and postpartum lactation. For the placebo control group, auricular acupressure was applied to acupoints not related to breast pain. The degree of breast pain was assessed using a numeric rating scale and a pressure algometer.
Results:
After 4 weeks of auricular acupressure, numeric rating scale pain scores did not show a significant change. However, the pressure pain threshold for the upper left (Z = -2.202, p = .028) and upper right (t = 2.613, p = .012) areas of the right breast increased significantly in the intervention group.
Conclusion:
This study employed subjective and objective measurements to evaluate the efficacy of auricular acupressure in alleviating breast pain. The intervention shows potential as a nursing measure. Further research is required to determine the optimal intervention duration and frequency, particularly for breastfeeding parents with severe pain, and to evaluate long-term outcomes.
Objectives
To systematically evaluate the efficacy of auricular acupressure on sleep disorders, depression, pruritus, xerostomia and daily net weight gain (%) in maintenance haemodialysispatients.
Background
Auricular acupressure has been used for various complications in maintenance haemodialysispatients patients, such as sleep disorders, depression, pruritus and xerostomia, but the efficacy has not yet been unified.
Design
Systematic review and meta-analysis.
Methods
Randomised controlled trials comparing Auricular acupressure intervention with non-AA intervention in maintenance haemodialysispatients patients were included. We searched English databases (PubMed, Cochrane Library, Embase, Web of Science) and Chinese databases (CNKI, WanFang, CBM and VIP database) from the inception to 27 November 2020. The risk of bias was assessed by the Cochrane risk of bias tool. The RevMan 5.3 software was used to perform the meta-analysis. A descriptive analysis was conducted if the data were high of heterogeneity or could not be meta-analysed. The PRISMA statement was used to report systematic review and meta-analysis.
Results
A total of 12 RCTs with 805 MHD patients were included. Meta-analysis showed that auricular acupressure had a significant difference for improving sleep disorders (MD = −1.97 points, 95% CI: −2.62 to −1.32, p < .0001), pruritus (MD = −1.55 points, 95% CI: −2.01 to −1.08, p < .0001), and daily net weight gain (%) (MD = −0.29, 95% CI: −0.37 to −0.21, p < .0001). The efficacy of depression and xerostomia were analysed descriptively due to insufficient data.
Conclusions
The meta-analysis results indicated that auricular acupressure had a positive efficacy in maintenance haemodialysispatients patients to improve sleep disorders, pruritus and daily net weight gain (%). But the results should be treated conservatively on account of the low quality of included studies. Future researchers need to conduct more high-quality, large sample, multi-centre randomised controlled studies to provide a solid basis to demonstrate of the efficacy of auricular acupressure in maintenance haemodialysispatients patients.
Relevance to clinical practice
Auricular acupressure has the advantages of low cost, non-invasive and easy to be accepted by patients. This review suggested that auricular acupressure could be considered a non-pharmacological intervention for maintenance haemodialysispatients patients. Medical staff could teach maintenance haemodialysispatients patients auricular acupressure to help them self-manage some complications at home.
Purpose
This study aimed to describe clinical response to 5-step systematic therapy (FSST) in the management of plugged ducts and mastitis. FSST was a comprehensive milk stasis dredging treatment, which contained five steps to make the milk out of the plugged duct.
Methods
This retrospective study included 922 breastfeeding women, 714 with plugged ducts and 208 with mastitis who received FSST from June to September 2017. The breast pain score, swelling degree and range of breast induration were recorded pre-FSST and post-FSST.
Results
After a single FSST, pain score and swelling degree were significantly improved (both, p <.001) in all cases. After FSST, the mean breast pain relief score was 1.69±.70, while the mean swelling fade-away degree was 1.61±.62. In subgroup analysis, pain score and swelling degree were significantly improved (both, p <.001) in the plugged ducts group and the mastitis group. The score of pain relief in the plugged ducts group was less than that in the mastitis group (1.63±.68 vs. 1.91±.70, t=5.30, p <.001), while improvement of swelling fade-away was greater in the plugged ducts group than the mastitis group (1.65±.64 vs. 1.48±.56, t=3.49, p =0.001). The composition ratio of changes in induration range between the two groups was statistically different (Pearsonχ²=137.87, p <.001), of which more obvious improvement in the plugged ducts group than the mastitis group (χ²=25.65, p <.001).
Conclusion
FSST can relieve pain, reduce breast swelling and range of induration, and for plugged ducts or mastitis varied degree differently.
The international standardization of auricular acupuncture points (AAPs) is an important basis for auricular therapy or auricular diagnosis and treatment. The study on the international standardization of AAPs has gone through a long process, in which the location method is one of the key research projects. There are different points of view in the field of AAPs among experts from different countries or regions. By only analyzing the nine representative location methods, this paper tried to offer a proper location method to locate AAPs. Through analysis of the pros and cons of each location method, the location method applied in the WFAS international standard of AAPs is thoroughly considered as an appropriate method. It is important to keep the right direction during developing an International Organization for Standardization (ISO) international standard of auricular acupuncture points and to improve the research quality of international standardization for AAPs.
Objectives
To explore the commonly utilized sham acupressure procedures in existing acupressure trials, and to assess whether different types of sham interventions yield different therapeutic outcomes, and, as far as possible, to identify directions for the future development of an adequate sham acupressure method.
Methods
Randomized controlled trials comparing true acupressure with sham interventions were included. Thirteen electronic databases were adopted to locate relevant studies from inception to July 3, 2014. Meanwhile, eight Chinese journals on complementary and alternative medicine were manually searched to locate eligible articles. In addition, eligible studies listed in the reference lists of the included papers and other related systematic reviews on acupressure were also screened to further search any potentially eligible trials. Methodological quality of the included studies was evaluated using the risk of bias assessment tool developed by the Cochrane Back Review Group. Descriptive analysis was adopted to summarize the therapeutic outcomes.
Results
Sixty-six studies with 7265 participants were included. Methodological quality of the included trials was generally satisfactory. Six types of sham acupressure approaches were identified and “non-acupoint” stimulation was the most frequently utilized sham point while an acupressure device was the most commonly used approach for administering sham treatments. Acupressure therapy was a beneficial approach in managing a variety of health problems and the therapeutic effect was found to be more effective in the true acupressure groups than that in the sham comparative groups. No clear association could be identified between different sham acupressure modalities and the reported treatment outcomes.
Conclusions
A great diversity of sham acupressure controls have been used in clinical practice and research. A solid conclusion whether different sham alternatives are related to different treatment outcomes cannot be derived because of significant clinical heterogeneity among the analyzed trials. Non-acupoints are generally recommended but the definite locations should be identified with caution. For studies using single sham acupoints on hands or legs, it is suggested to apply identical acupressure devices on the same acupoint as in the active intervention without any stimulation. While for studies on pain, stimulation of sham acupoints should be avoided.
Auricular therapy (AT) has been historically viewed as a convenient approach adjunct to pharmacological therapy for cancer patients with chemotherapy-induced nausea and vomiting (CINV). The aim of this study was to assess the evidence of the therapeutic effect of AT for CINV management in cancer patients. Relevant randomized controlled trials were retrieved from 12 electronic databases without language restrictions. Meanwhile, manual search was conducted for Chinese journals on complementary medicine published within the last five years, and the reference lists of included studies were also checked to identify any possible eligible studies. Twenty-one studies with 1713 participants were included. The effect rate of AT for managing acute CINV ranged from 44.44% to 93.33% in the intervention groups and 15% to 91.67% in the control groups. For delayed CINV, it was 62.96% to 100% and 25% to 100%, respectively. AT seems to be a promising approach in managing CINV. However, the level of evidence was low and the definite effect cannot be concluded as there were significant methodological flaws identified in the analyzed studies. The implications drawn from the 21 studies put some clues for future practice in this area including the need to conduct more rigorously designed randomized controlled trials.
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.
Objective.
The objective of this systematic review and meta-analysis was to assess the efficacy of auricular therapy by including a sham therapy control group.
Methods.
Relevant, randomized clinical trials (RCTs) were identified by searching medical related databases from, depending on journal, 1900 (at the earliest) to 1994 (at the latest) through May 2013. The outcome measure was a pain intensity score.
Results.
Twenty-two RCTs were identified and 13 RCTs were included for meta-analysis. In these studies, auricular therapy provided significant pain relief when compared to a sham or control group. The overall standardized mean differences (SMD) was 1.59 (95% CI [−2.36, −0.82]) (13 trials, total subject numbers = 806), indicating that, on average, the mean decrease in pain score for auricular therapy group was 1.59 standard deviations greater than the mean decrease for the sham control. In terms of the efficacy of the different treatment methods, auricular acupressure boasts the largest strength of evidence for pain relief, followed by auricular acupuncture. Electroacupuncture stimulation did not show significant evidence for efficacy, which may be due to the small sample size (i.e., only 19 subjects were included).
Conclusion.
Further large-scale RCTs are needed to determine the efficacy of auricular therapy for pain.
Auricular acupuncture has been utilized in the treatment of diseases for thousands of years. Dr. Paul Nogier firstly originated the concept of an inverted fetus map on the external ear. In the present study, the relationship between the auricular acupuncture and the vagal regulation has been reviewed. It has been shown that auricular acupuncture plays a role in vagal activity of autonomic functions of cardiovascular, respiratory, and gastrointestinal systems. Mechanism studies suggested that afferent projections from especially the auricular branch of the vagus nerve (ABVN) to the nucleus of the solitary tract (NTS) form the anatomical basis for the vagal regulation of auricular acupuncture. Therefore, we proposed the "auriculovagal afferent pathway" (AVAP): both the autonomic and the central nervous system could be modified by auricular vagal stimulation via projections from the ABVN to the NTS. Auricular acupuncture is also proposed to prevent neurodegenerative diseases via vagal regulation. There is a controversy on the specificity and the efficacy of auricular acupoints for treating diseases. More clinical RCT trials on auricular acupuncture and experimental studies on the mechanism of auricular acupuncture should be further investigated.
The rate of exclusive breastfeeding remains low in many countries. Furthermore, cesarean delivery (CD) is increasing and may affect breastfeeding success.
The objective was to conduct a systematic review and meta-analysis of observational studies to determine whether CD (prelabor or in-labor) is associated with a lower rate of breastfeeding compared with vaginal delivery (VD).
Studies published before January 2011 that reported breastfeeding up to 6 mo postpartum and compared outcomes after CD or VD, including foreign language publications, were identified through PubMed and bibliographic review. Prespecified data were extracted independently by multiple observers. The types of CD [prelabor (elective/scheduled) or in-labor (emergency)] were compared by subgroup analyses. Potential sources of study-level bias were analyzed by using meta-regression and sensitivity analyses.
The systematic review included 53 studies (554,568 subjects, 33 countries); 25 authors contributed additional data (245,455 subjects), and 48 studies (553,306 subjects, 31 countries) were included in the meta-analysis. Rates of early breastfeeding (any initiation or at hospital discharge) were lower after CD compared with after VD (pooled OR: 0.57; 95% CI: 0.50, 0.64; P < 0.00001) and lower after prelabor but not after in-labor CD (prelabor OR: 0.83; 95% CI: 0.80, 0.86; P < 0.00001; in-labor OR: 1.00; 95% CI: 0.97, 1.04; P = 0.86). In mothers who initiated breastfeeding, CD had no significant effect on any breastfeeding at 6 mo (OR: 0.95; 95% CI: 0.89, 1.01; P = 0.08).
There was a negative association between prelabor CD and early breastfeeding. If breastfeeding is initiated, mode of delivery has no apparent effect on the number of mothers still breastfeeding at 6 mo. Women and health care workers should be aware of the negative associations between CD and early breastfeeding and consequent implications for infants' well-being.
Objective: Lactation performance depends on stress surrounding labor and delivery, and it is likely to be different in women who underwent elective cesarean delivery (ECD) or vaginal (VD). The aim of this study was to assess the relationship between cortisol and human prolactin (hPRL), following ECD and lactation performance, from the delivery room to the 6th month of life. Methods: A total of 106 mothers were consecutively enrolled: 38 after ECD, 28 after emergency cesarean delivery (EmCD), and 40 after VD. Results: Basal stress-, lactogenic-hormones, cortisol, and hPRL were comparable on day 3 postpartum in all the women. Multivariate analysis indicated that ECD has a negative impact (OR; 95% CI) on breastfeeding prevalence on the seventh day (0.14; 0.0–0.44, p = 0.008) and at third month post partum (0.19; 0.05–0.71, p = 0.05) in comparison to VD. In addition, hPRL levels proved to have a statistically significant role in early breastfeeding (1.01; 1–1.01, p = 0.002). Conclusions: ECD is a risk factor for successful lactation performance. This information should be provided to mothers and caregivers for extra breastfeeding guidance.
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.
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.
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.
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.
This report presents selected estimates of complementary and alternative medicine (CAM) use among U.S. adults and children, using data from the 2007 National Health Interview Survey (NHIS), conducted by the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS). Trends in adult use were assessed by comparing data from the 2007 and 2002 NHIS.
Estimates were derived from the Complementary and Alternative Medicine supplements and Core components of the 2007 and 2002 NHIS. Estimates were generated and comparisons conducted using the SUDAAN statistical package to account for the complex sample design.
In 2007, almost 4 out of 10 adults had used CAM therapy in the past 12 months, with the most commonly used therapies being nonvitamin, nonmineral, natural products (17.7%) and deep breathing exercises (12.7%). American Indian or Alaska Native adults (50.3%) and white adults (43.1%) were more likely to use CAM than Asian adults (39.9%) or black adults (25.5%). Results from the 2007 NHIS found that approximately one in nine children (11.8%) used CAM therapy in the past 12 months, with the most commonly used therapies being nonvitamin, nonmineral, natural products (3.9%) and chiropractic or osteopathic manipulation (2.8%). Children whose parent used CAM were almost five times as likely (23.9%) to use CAM as children whose parent did not use CAM (5.1%). For both adults and children in 2007, when worry about cost delayed receipt of conventional care, individuals were more likely to use CAM than when the cost of conventional care was not a worry. Between 2002 and 2007 increased use was seen among adults for acupuncture, deep breathing exercises, massage therapy, meditation, naturopathy, and yoga. CAM use for head or chest colds showed a marked decrease from 2002 to 2007 (9.5% to 2.0%).
Test weighing is the "gold standard" for documenting lactogenesis stage II. However, this method is impractical for use in population studies. Maternal perception of the timing of the onset of lactation may be a useful proxy for lactogenesis stage II. This study seeks to validate maternal perception of the onset of lactation as a marker of lactogenesis stage II. Women (n = 60) were recruited after cesarean delivery. Beginning at 24 h postpartum (pp), the onset of lactation was assessed 3 times daily by both test weighing and maternal perception. Delayed onset of lactation was defined as follows: 1) milk transfer < 9.2 g/feeding at 60 h pp and 2) maternal perception >/= 72 h pp. Misclassification analyses were conducted. Multivariate logistic regression, bivariate analyses and Cox survival analyses were used to evaluate the determinants and consequences of delayed onset of lactation, using both definitions. The sensitivity and specificity of delayed maternal perception as an indicator of delayed lactogenesis were 71.4 and 79.3%, respectively. Four risk factors for low milk transfer were significant (P: < 0.05) or nearly significant (P: </= 0.08) predictors of delayed perception of the onset of lactation. The effects of low milk transfer and delayed maternal perception on breast-feeding duration were similarly modified by intended breast-feeding duration. The magnitude and directionality of the ss coefficients for the milk transfer and perception variables were consistent. On the basis of these results, we conclude that maternal perception of the onset of lactation is a valid public health indicator of lactogenesis stage II.
The most important factors in initiation of the cascade of changes in the mammary epithelium that constitute lactogenesis stage II seem to be a prepared mammary epithelium, progesterone withdrawal, maintained plasma prolactin (in most species), and removal of milk from the breast within an undefined interval after birth. Although the molecular mechanisms by which prolactin regulates milk protein synthesis are the subject of intense and productive studies, the specific mechanisms by which progesterone and milk removal interact with the mammary epithelial cell at parturition have not been studied, perhaps because no in vitro model system exists that mimics lactogenesis stage II, or because of the complexity of the changes that must be coordinated during this process, or because of a lack of general understanding of the complex progression of changes in the function of the breast as it goes from the quiescent state of pregnancy to the active secretory state of lactation. With new technologies designed to investigate the biology of complex systems arising from the growing knowledge of the genome of human and animal species and the growing availability of animal and tissue culture models for these processes, physicians can expect a rapid increase in the molecular understanding of lactogenesis in the near future. These fundamental studies must be coupled with good prospective clinical studies if physicians are to obtain a useful, comprehensive understanding of lactogenesis in women.
Lactogenesis stage II, the onset of copious milk secretion, takes place during the first 4 d postpartum in women and involves a carefully programmed set of changes in milk composition and volume. The evidence is summarized that progesterone withdrawal at parturition provides the trigger for lactogenesis in the presence of high plasma concentrations of prolactin and adequate plasma concentrations of cortisol. Although the process is generally robust, delayed lactogenesis does occur with stressful deliveries and in poorly controlled diabetes. Failure of early removal of colostrum from the breast is associated with high milk sodium and poor prognosis for successful lactation in many women. We speculate that this problem may result from accumulation of a substance in the mammary alveolus that inhibits lactogenesis, even in the face of appropriate hormonal changes after parturition.
Accurate assessment of infant feeding is needed for clinical practice and research. We identified 32 studies that evaluated the validity of direct observation, test weighing, or doubly labeled water methods. Correlations with validation standards were highest for doubly labeled water and test weighing, and lowest for observation. Cost and availability of isotope may limit the doubly labeled water method to research studies, whereas observation may be useful for clinical practice. Test weighing could be applied to either setting, but it may be practical to sample less frequently over 24 hours. Validity results and intended use of the measurement should be considered when selecting a method.
To review trials on the efficacy and safety of auricular acupuncture (AA) treatment for insomnia and to identify the most commonly used auricular acupoints for treating insomnia in the studies via a frequency analysis.
The international electronic databases searched included: (1) AMED; (2) the Cochrane library; (3) CINAHL; (4) EMBASE; and (5) MEDLINE. Chinese electronic databases searched included: (1) VIP Information; (2) CBMdisc; and (3) CNKI.
Any randomized controlled trials using AA as an intervention without using any co-interventions for insomnia were included. Studies using AA versus no treatment, placebo, sham AA, or Western medicine were included.
Two (2) independent reviewers were responsible for data extraction and assessment. The efficacy of AA was estimated by the relative risk (RR) using a meta-analysis.
Eight hundred and seventy eight (878) papers were searched. Six (6) trials (402 treated with AA among 673 participants) that met the inclusion criteria were retrieved. A meta-analysis showed that AA was chosen with a higher priority among the treatment subjects than among the controls (p < 0.05). The recovery and improvement rates produced by AA was significantly higher than those of diazepam (p < 0.05). The rate of success was higher when AA was used for enhancement of sleeping hours up to 6 hours in treatment subjects (p < 0.05). The efficacy of using Semen vaccariae ear seeds was better than that of the controls (p < 0.01); while magnetic pearls did not show statistical significance (p = 0.28). Six (6) commonly used auricular acupoints were Shenmen (100%), Heart (83.33%), Occiput (66.67%), Subcortex (50%), Brain and Kidney (each 33.33%, respectively).
AA appears to be effective for treating insomnia. Because the trials were low quality, further clinical trials with higher design quality, longer duration of treatment, and longer follow-up should be conducted.
Delayed or failed achievement of lactogenesis II--the onset of copious milk volume--occurs as a result of various maternal and/or infant factors. Early recognition of these risk factors is critical for clinicians who interact with breastfeeding women so that intervention and achievement of full or partial breastfeeding can be preserved. This article describes the maternal and infant conditions that contribute to the unsuccessful establishment of a full lactation. Treatment modalities that can maximize maternal lactation capacity and infant growth rates are offered.
We investigated whether there had been an improvement in quality of reporting for randomised controlled trials of acupuncture since the publication of the STRICTA and CONSORT statements. We conducted a before-and-after study, comparing ratings for quality of reporting following the publication of both STRICTA and CONSORT recommendations.
Ninety peer reviewed journal articles reporting the results of acupuncture trials were selected at random from a wider sample frame of 266 papers. Papers published in three distinct time periods (1994-1995, 1999-2000 and 2004-2005) were compared. Assessment criteria were developed directly from CONSORT and STRICTA checklists. Papers were independently assessed for quality of reporting by two assessors, one of whom was blind to information which could have introduced systematic bias (e.g. date of publication). We detected a statistically significant increase in the reporting of CONSORT items for papers published in each time period measured. We did not, however, find a difference between the number of STRICTA items reported in journal articles published before and 3 to 4 years following the introduction of STRICTA recommendations.
The results of this study suggest that general standards of reporting for acupuncture trials have significantly improved since the introduction of the CONSORT statement in 1996, but that quality in reporting details specific to acupuncture interventions has yet to change following the more recent introduction of STRICTA recommendations. Wider targeting and revision of the guidelines is recommended.
The second edition of this innovative work again provides a unique perspective on the clinical discovery process by providing input from experts within the NIH on the principles and practice of clinical research. Molecular medicine, genomics, and proteomics have opened vast opportunities for translation of basic science observations to the bedside through clinical research. As an introductory reference it gives clinical investigators in all fields an awareness of the tools required to ensure research protocols are well designed and comply with the rigorous regulatory requirements necessary to maximize the safety of research subjects. Complete with sections on the history of clinical research and ethics, copious figures and charts, and sample documents it serves as an excellent companion text for any course on clinical research and as a must-have reference for seasoned researchers. *Incorporates new chapters on Managing Conflicts of Interest in Human Subjects Research, Clinical Research from the Patient's Perspective, The Clinical Researcher and the Media, Data Management in Clinical Research, Evaluation of a Protocol Budget, Clinical Research from the Industry Perspective, and Genetics in Clinical Research *Addresses the vast opportunities for translation of basic science observations to the bedside through clinical research *Delves into data management and addresses how to collect data and use it for discovery *Contains valuable, up-to-date information on how to obtain funding from the federal government.
Health professionals from a wide range of backgrounds apply auriculotherapy to successfully relieve chronic pain and treat addictions. The most popular book on the subject, this practical handbook combines information on Chinese and French systems of ear acupuncture to offer treatment plans for over 250 medical conditions. Presenting the ear reflex points based on extensive research conducted at the UCLA Pain Management Center, it provides a standardized auricular nomenclature system for designating different anatomical zones of the ear, and it represents each ear reflex point with both a number and an auricular zone location.
Little is known regarding complementary and alternative medicine (CAM) use during pregnancy and the preconception period. Since half of all pregnancies in the United States are unintended, understanding the patterns of CAM use among women of childbearing age has implications for fetal and maternal health.
Descriptive statistics were generated from the 2012 National Health Interview Study (NHIS) to estimate weighted prevalence and patterns of CAM use by women of childbearing age. Comparisons were made between pregnant and nonpregnant respondents.
In this sample of 10,002 women, 7 percent (n = 727) were recently pregnant. Over one-third of all the women used CAM during the previous year (34/38%, pregnant/nonpregnant, respectively) and only half disclosed CAM use to conventional providers (50/49%). In the adjusted model, taking multivitamins (OR 2.52 [CI 2.22-2.86]) and moderate to heavy alcohol use (OR 1.92 [CI 1.53-2.41]) were more likely associated with CAM use. The two most commonly used modalities were herbs (14/17%) and yoga (13/16%). The top reasons for CAM use were to improve general wellness or to prevent disease (33/35%) and to treat back pain (16/18%). When examining all pregnancy-related symptoms treated with CAM, no difference was found in the rates of CAM use between pregnant and nonpregnant users.
CAM use by women of childbearing age in the United States is common, with over a third of the population using one or more therapies. However, only half disclosed their use to conventional providers despite limited evidence on safety and effectiveness. This study highlights the important need for further research in this area.
© 2015 Wiley Periodicals, Inc.
This study aimed to investigate the association between auricular reflective points and the status of lower urinary tract symptoms (LUTS) among Chinese aging males.
A total of 113 male participants, with 69 having LUTS (LUTS+ve) and 44 having no LUTS (LUTS-ve), were recruited for this case-control study. Ear diagnosis was conducted in three ways: inspection, electrical skin resistance measurement, and tenderness testing.
Quality of life was lower among the LUTS+ve cases than among the LUTS-ve cases. The tenderness and electrical conductivity of a number of auricular points, including the "angle of superior concha", the "urinary bladder", the "ureter", the "kidney", the "urethra", and the "internal genitals" were associated with LUTS in the Chinese aging males. In terms of electrical conductivity, the "angle of superior concha" on both ears exhibited the highest sensitivity among the other auricular points under testing. This auricular point also demonstrated considerable sensitivity, specificity, and positive/negative predictive values for both ears during the tenderness testing.
Auricular diagnosis has a pre-diagnostic value and could be considered as a screening method for the aging population with relatively high LUTS risk.
The clinical efficacy and safety of auricular acupuncture (AA) for treatment of primary insomnia was evaluated. After a comprehensive retrieval in domestic and foreign databases, literatures were strictly screened and Revman 5.2 software was applied to perform a Meta-analysis on eligible randomized controlled trials (RCTs). The evidence quality was assessed with GRADE profiler 3.6 software. As a result, 8 articles were included involving 894 patients. Compared among AA and sham AA, placebo AA, blank control, there was significant difference in Pittsburgh sleep quality index (PSQI) [WMD = -3.48, 95% CI (-3.96, -3.00)], sleep latency LWMD = -10.14, 95% CI (-17.16, -3.12)] and sleep awakening times [WMD = -9.98, 95% CI (-1.10,-0.48)]. Compared between AA and western medication, there was significant difference in PSQI [WMD = -3.62, 95% CI (-4.59, -2.65)]. The evidence quality was moderate in AA vs. sham AA, placebo AA or blank control, while that of the rest was extremely low. No reports of adverse events were described in all studies. In conclusion, for the treatment of primary insomnia, AA could effectively improve sleep quality, but due to the low evidence quality, cautious attitude should be taken on this conclusion, and clinical trials with large sample and high quality were needed in the further.
Objectives:
To assess the clinical evidence of auriculotherapy for constipation treatment and to identify the efficacy of groups using Semen vaccariae or magnetic pellets as taped objects in managing constipation.
Methods:
Databases were searched, including five English-language databases (the Cochrane Library, PubMed, Embase, CINAHL, and AMED) and four Chinese medical databases. Only randomized controlled trials were included in the review process. Critical appraisal was conducted using the Cochrane risk of bias tool.
Results:
Seventeen randomized, controlled trials (RCTs) met the inclusion criteria, of which 2 had low risk of bias. The primary outcome measures were the improvement rate and total effective rate. A meta-analysis of 15 RCTs showed a moderate, significant effect of auriculotherapy in managing constipation compared with controls (relative risk [RR], 2.06; 95% confidence interval [CI], 1.52- 2.79; p<0.00001). The 15 RCTs also showed a moderate, significant effect of auriculotherapy in relieving constipation (RR, 1.28; 95% CI, 1.13-1.44; p<0.0001). For other symptoms associated with constipation, such as abdominal distension or anorexia, results of the meta-analyses showed no statistical significance. Subgroup analysis revealed that use of S. vaccariae and use of magnetic pellets were both statistically favored over the control in relieving constipation.
Conclusions:
Current evidence illustrated that auriculotherapy, a relatively safe strategy, is probably beneficial in managing constipation. However, most of the eligible RCTs had a high risk of bias, and all were conducted in China. No definitive conclusion can be made because of cultural and geographic differences. Further rigorous RCTs from around the world are warranted to confirm the effect and safety of auriculotherapy for constipation.
Background
This systematic review evaluated the effects of ear acupuncture, ear acupressure and auriculotherapy for cigarette smoking cessation (SC) at end-of-treatment (EoT), three, six and 12 months follow-up.
Methods
Searches of six English and Chinese databases located 25 randomized controlled trials (3,735 participants). Methodological quality was assessed using Cochrane Risk of Bias. Meta-analyses were conducted in two pools: 1. SC-specific ear acupuncture/acupressure or auriculotherapy (EAP/R) versus non-specific/inactive control; and 2. SC-specific EAP/R versus other SC-specific treatment. Sensitivity analyses were conducted based on the validity of interventions as SC-specific treatments or non-specific/inactive interventions; and the use of biochemical SC confirmation.
Results
Pool 1: the 12 valid SC-specific EAP/R interventions were superior to inactive EAP/R controls at EoT (RR = 1.77 [1.39, 2.25]), three months follow-up (RR = 1.54 [1.14, 2.08]), and six months follow-up (RR = 2.01, [1.23, 3.28]) but data were insufficient at 12 months. In Pool 2: there was no superiority or inferiority for EAP/R at EoT or at 3 and 6 month follow-ups compared to SC-specific behavioural therapy or SC-specific body acupuncture.
Conclusions
Pool 1 data appeared most consistent for studies of ear acupressure (EAPR) versus non-specific EAPR controls, with confirmed SC rates at 3 months post-treatment of 20.0% for test groups versus 7.5% for controls. In Pool 2 the EAP/R interventions appeared neither inferior nor superior to the behavioural interventions at 3 and 6 month follow-ups. However, meta-analysis results derived from relatively small-sized trials with no biochemical validation of SC in Pool 2. Larger, well-controlled studies using biochemical confirmation of SC are needed.
In recent years research explored different acupuncture stimulation techniques but interest has focused primarily on somatic acupuncture and on a limited number of acupoints. As regards ear Acupuncture (EA) there is still some criticism about the clinical specificity of auricular points/areas representing organs or structures of the body. The aim of this study was to verify through (Functional magnetic resonance imaging) fMRI the hypothesis of EA point specificity using two auricular points having different topographical locations and clinical significance. Six healthy volunteers underwent two experimental fMRI sessions: the first was dedicated to the stimulation of Thumb Auricular Acupoint (TAA) and the second to the stimulation of Brain Stem Auricular Acupoint (BSAA). The stimulation of the needle placed in the TAA of the left ear produced an increase in activation bilaterally in the parietal operculum, region of the secondary somatosensory area SII. Stimulation of the needle placed in the BSAA of the left ear showed a pattern that largely overlapped regions belonging to the pain matrix, as shown to be involved in previous somatic acupuncture studies but with local differences in the left amygdala, anterior cingulate cortex, and cerebellum. The differences in activation patterns between TAA and BSAA stimulation support the specificity of the two acupoints. Moreover, the peculiarity of the regions involved in BSAA stimulation compared to those involved in the pain matrix, is in accordance with the therapeutic indications of this acupoint that include head pain, dizziness and vertigo. Our results provide preliminary evidence on the specificity of two auricular acupoints; further research is warranted by means of fMRI both in healthy volunteers and in patients carrying neurological/psychiatric syndromes.
To explore an effective method for puerperant to lactate.
One hundred and seven cases that were about to giving a birth in our hospital were randomly divided into an observation group (52 cases) and a control group (55 cases). Based on the routine hospital care, the patients in the observation group received auricular point sticking with vaccaria seed at Endocrine (CO18), Mammary Gland, etc. after 1 hour of childbirth, which was pressed 3 times daily, for 1-2 min each time. In the control group, routine hospital care was given, which didn't include auricular point sticking. The lactation volume, starting time of lactation and serum prolactin (PRL) were observed after 5 days of treatment.
Compared with the control group, lactation volume in the observation group was more superior (P < 0.01). Rate I of lactation volume in the observation group was 51.9% (27/52), which was obviously higher than 27.3% (15/55) in the control group (P < 0 01). The starting time of lactation in the observation group was obviously earlier than that in the control group (P < 0 05). The content of PRL was apparently improved after one or two days of childbirth (both P < 0.05), and significantly increased after 5 days (P < 0.01).
The auricular point sticking is a better method to promote lactation for puerperant, which could be beneficial to increasing the success rate of breastfeeding.
Previous randomized controlled trials (RCTs) have shown that acupuncture may be efficacious for insomnia. Instead of needling, acupressure, reflexology, and auricular acupressure are procedures involving physical pressure on acupoints or reflex areas. These variants of acupuncture are gaining popularity, perhaps due to their non-invasive nature. A systematic review has therefore been conducted to examine their efficacy and safety for insomnia. Two independent researchers searched five English and 10 Chinese databases from inception to May 2010. Forty RCTs were identified for analysis. Only 10 studies used sham controls, four used double-blind design, nine studies scored three or more by the Jadad scale, and all had at least one domain with high risk of bias. Meta-analyses of the moderate-quality RCTs found that acupressure as monotherapy fared marginally better than sham control. Studies that compared auricular acupressure and sham control showed equivocal results. It was also found that acupressure, reflexology, or auricular acupressure as monotherapy or combined with routine care was significantly more efficacious than routine care or no treatment. Owing to the methodological limitations of the studies and equivocal results, the current evidence does not allow a clear conclusion on the benefits of acupressure, reflexology, and auricular acupressure for insomnia.
Breastfeeding rates in many developed countries remain low, and maternal perception of insufficient milk production is a major contributing factor. Mothers with a perception of insufficient milk should be advised that normal breastfeeding frequencies, suckling times, and amounts are very variable. If objective assessment confirms insufficient milk production, mothers should ensure optimal milk removal frequency and thorough breast drainage. In addition, galactogogues can be prescribed. Understanding physiological principles underlying milk production will help clinicians reassure and assist mothers.
To determine whether clinical trials originating in certain countries always have positive results.
Abstracts of trials from Medline (January 1966-June 1995).
Two separate studies were conducted. The first included trials in which the clinical outcome of a group of subjects receiving acupuncture was compared to that of a group receiving placebo, no treatment, or a nonacupuncture intervention. In the second study, randomized or controlled trials of interventions other than acupuncture that were published in China, Japan, Russia/USSR, or Taiwan were compared to those published in England.
Blinded reviewers determined inclusion and outcome and separately classified each trial by country of origin.
In the study of acupuncture trials, 252 of 1085 abstracts met the inclusion criteria. Research conducted in certain countries was uniformly favorable to acupuncture; all trials originating in China, Japan, Hong Kong, and Taiwan were positive, as were 10 out of 11 of those published in Russia/USSR. In studies that examined interventions other than acupuncture, 405 of 1100 abstracts met the inclusion criteria. Of trials published in England, 75% gave the test treatment as superior to control. The results for China, Japan, Russia/USSR, and Taiwan were 99%, 89%, 97%, and 95%, respectively. No trial published in China or Russia/USSR found a test treatment to be ineffective.
Some countries publish unusually high proportions of positive results. Publication bias is a possible explanation. Researchers undertaking systematic reviews should consider carefully how to manage data from these countries.
A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. These guidelines are not intended to be all-inclusive, but to provide a basic framework for physician education regarding breastfeeding.
xvii, 269 leaves : ill. (some col.) ; 30 cm. PolyU Library Call No.: [THS] LG51 .H577P NHS 2001 Suen Sleep disturbances are a particularly common problem in the elderly. According to the principles of traditional Chinese diagnosis, insomnia can be deficient or excessive in nature. Sleep efficiency declines with an increase in time spent in bed and a decrease in the total time spent asleep in people with insomnia. Medication such as hypnotics has been widely adopted by the elderly to overcome their sleeping problems; however the adverse effects of these drugs such as decreased reaction time and withdrawal insomnia will further compound the sleeping problems of the elderly. The purpose of this study is to examine the effectiveness of auricular therapy on sleep behaviours in the elderly. One hundred and twenty participants of 60 or above and have sleep disturbances were invited to participate in this study. Eligible participants were randomly assigned to receive auricular therapy using Junci Medulla (Group A=30), Semen Vaccariae (Group B=30) or magnetic pearls (Group C=60). Group A and Group B were the control groups, while Group C being the experimental group. Seven auricular points which are thought to have an effect on promoting sleep were selected. Junci Medulla/Semen Vaccariae/Magnetic pearls were replaced every three to four days to avoid the possibility of local irritation of auricular points under treatment. The total treatment course lasted for three weeks (21 days). Objective measurement using actigraphic monitoring was performed before the therapy commenced, in the middle period of the therapy, and within one week after the therapy has been completed. After the therapy, there were significant differences among the three groups in terms of the nocturnal sleep time (NST) (F2, 117 = 6.84, p<0.05) and sleep efficiency (SE) (F2, 117 = 7.69, p<0.05). Significant improvement in the sleep behaviours was observed in the experimental group using magnetic pearls. No significant difference in the therapeutic effect on sleep could be found between clients with 'excessive' and 'deficiency' syndrome even when the treatment protocol was standardized. In a backward multiple regression, the effect of auricular therapy on sleep efficiency after allowing for age in female participants is of high statistical significance (F3, 106 = 9.04, p<0.001). It is argued that auricular therapy using magnetic pearls is an effective means towards improving the quantity and quality of sleep in the elderly, and is recommended that nurses should incorporate this in their nursing therapeutics for improvement of clients' sleep. Ph.D., Dept. of Nursing and Health Sciences, The Hong Kong Polytechnic University, 2001.
Constipation is a common health problem that adversely affects an individual's general health and quality of life. Constipated people usually manage the problem by taking laxatives and by modifying their lifestyle even if such have questionable therapeutic effects. Auriculotherapy, a safe treatment modality in Chinese medicine, has been reported to be effective in managing constipation. Despite previous studies reported encouraging results in using auriculotherapy, its effectiveness in managing constipation has not been systematically reviewed. This review, therefore, examines previous studies that have investigated the effectiveness of auriculotherapy in managing constipation.
A search in the databases of MEDLINE EMBASE, AMED, and China Academic Journals Full-text Database and manual searching were performed to identify relevant clinical studies.
A total of 29 relevant clinical studies conducted from 1994 to 2008 were identified. All of the studies reported that auriculotherapy was effective in managing constipation. However, generalization of their findings was limited because of two significant methodological flaws: (1) uncertainty in accurate acupoints identification and subjects' compliance to instructions resulted in varied doses of intervention received; and (2) inconsistent intervention protocols and therapeutic outcome criteria made comparison among different studies difficult.
The findings of this review could provide pertinent information for researchers in terms of study designs and methodologies that may be used for future studies. The use of randomized controlled trials on a sample of sufficient size and of standard intervention protocol is recommended to provide empirical evidence that will support auriculotherapy as a complementary strategy in managing constipation.
To explore the effect of auricular points sticking-pressing (APSP) in treating post-cesarean hypogalactia (PCH).
A randomized, controlled, single-blinded clinical trial on 116 patients with PCH was carried out. They were equally assigned to the treatment group and the control group. The treatment group received APSP, with the pellets pressed for 4 times daily, while the control group was only asked to do lactation to meet infant demand. The therapeutic efficacy and the changes in scores of traditional Chinese medicine (TCM) syndrome, volume of milk secretion, supplementary feeding and serum level of prolactin (PRL) in the two groups were estimated and compared after the patients had been treated for 5 days.
The cured and markedly effective rate in the treatment group was 89.7%, which was significantly higher than that in the control group (27.6%, P<0.05), 95% CI (0.1543, 0.2527). The improvement of TCM syndrome, elevation of milking volume, decrease of the supplementary feeding and increase of PRL level revealed in the treatment group were all superior to those in the control group, showing statistical significance (P<0.01).
APSP shows an apparent efficacy in treating PCH and is worthy of application in clinical practice.
The aim of this study was to find out whether the hormonal patterns of oxytocin, prolactin and cortisol differed between women delivered by emergency section or by the vaginal route and if these patterns show any relation to the duration of breastfeeding. Seventeen mothers with emergency section (C.S.) and 20 mothers with normal vaginal deliver (V.D.) were blood sampled in connection with breastfeeding on day 2 post partum for oxytocin, prolactin and cortisol. The number of oxytocin pulses as calculated with the PULSAR program occurring during the first 10 min of the breastfeeding session varied between 0 and 5. The V.D. mothers had significantly more pulses than the C.S. ones. Furthermore the C.S. women lacked a significant rise in prolactin levels at 20-30 min after the onset of breastfeeding. Logistic regression analysis revealed mode of delivery and infant's age at first breastfeed to be the most important, independent variables showing a relation to the release pattern of oxytocin on day 2. Correlations between oxytocin pulsatility on day 2 and the duration of the exclusive breastfeeding period in the V.D. group suggest that development of an early pulsatile oxytocin pattern is of importance for breastfeeding.
Surveys show that a significant percentage of Americans are using alternative therapies. Women are more likely than men to seek alternative health care and often use alternative therapies for childbirth-related concerns. Despite abundant anecdotal evidence supporting the efficacy of alternative practice for the enhancement of breastfeeding, surprisingly little corroborating empirical evidence exists in the medical literature. This article reviews the studies pertaining to the use of several alternative techniques for breastfeeding women including herbalism, acupuncture, imagery, massage, diet, and the application of cabbage leaves. Speculation is made regarding the psychological value of women's use of alternative treatments during breastfeeding.
The authors tested indicators of effective breastfeeding to identify those that provide reliable estimates of human milk intake. Human milk intake of 82 full-term infants was measured by test weights before and after feeding and compared with commonly used breastfeeding indicators: rooting, length of time before latch-on, latch-on, suckle, observable swallowing, and audible swallowing. Two models were tested: model 1, describing indicators at 96 hours postpartum, and model 2, describing indicators at >96 hours postpartum. Median (interquartile) milliliters of mother's milk consumed per feeding was 26 ml (range, 4-47) at 96 hours and 54 ml (range, 26-73) at >96 hours. Significant predictors of human milk intake in model 1 were rooting and observable swallowing (R2=26%, P<.01). In model 2, audible swallowing alone estimated human milk intake (R2=29%, P<.001). Observed swallowing and rooting during the first 4 days (96 hours) following birth and audible swallowing after that time should be included in the breastfeeding assessment of full-term infants.
171 2.5. Data synthesis
- ................................................................................................................................................................................................................ Results....................................................................................................................................................................................................................................................................................................................................................................... Assessment Of Risk Of Bias
Assessment of risk of bias.................................................................................................... 171
2.5.
Data synthesis............................................................................................................... 172
3.
Results.......................................................................................................................... 172
3.1.
Description of included studies................................................................................................ 172
3.2.
Characteristics of study participants........................................................................................... 172
3.3.
Description of AT protocols................................................................................................... 177
Auricular Medicine: a Complete Manual of Auricular Diagnosis and Treatment
- L C Huang
L.C. Huang, Auricular Medicine: a Complete Manual of Auricular Diagnosis and
Treatment, Auricular International Research & Training Center, Orlando,
Florida, 2005.
Auricular acupuncture for insomnia: a systematic review
- M S Lee
- B C Shin
- L K P Suen
- T Y Park
- E Ernst
M.S. Lee, B.C. Shin, L.K.P. Suen, T.Y. Park, E. Ernst, Auricular acupuncture for
insomnia: a systematic review, Int. J. Clin. Pract. 62 (11) (2008) 1744e1752,
http://dx.doi.org/10.1111/j.1742-1241.2008.01876.
The efficacy of auricular seed pressing on treating 32 cases of postpartum hypogalactia
- F Tang
F. Tang, The efficacy of auricular seed pressing on treating 32 cases of postpartum hypogalactia, Forum Tradit. Chin. Med. 31 (4) (2016) 34, http://
dx.doi.org/10.13913/j.cnki.41-1110/r.2016.04.022.
The effect of auricular acupoints pressing on lactation after cesarean section
- L L Li
- Y Feng
- J E Ye
- J X Pei
- L Y Lu
- F F Zhu
L.L. Li, Y. Feng, J.E. Ye, J.X. Pei, L.Y. Lu, F.F. Zhu, The effect of auricular acupoints
pressing on lactation after cesarean section, Nurs. Res. 30 (2) (2016) 419e422,
http://dx.doi.org/10.3969/j.is sn.1009-6493.2016.04.011.
The effect of auricular acupoints pressing and intravenous analgesia infusion pump on postpartum lactation
- L L Li
- Y Feng
L.L. Li, Y. Feng, The effect of auricular acupoints pressing and intravenous
analgesia infusion pump on postpartum lactation, Clin. Educ. General Pract. 13
(1)
(2015)
83e85,
http://dx.doi.org/10.13558/j.cnki.issn1672-3686.2015.01.033.
The effect of auricular acupoints pressing on postpartum lactation
- J Liu
J. Liu, The effect of auricular acupoints pressing on postpartum lactation,
World Latest Med. Inf. 15 (60) (2015) 72, http://dx.doi.org/10.3969/
j.issn.1671-3141.2015.60.064.
The care of auricular acupoints seeds pressing on promoting postpartum lactation
- C X Jie
- Z H Chen
- Y Wang
C.X. Jie, Z.H. Chen, Y. Wang, The care of auricular acupoints seeds pressing on
promoting postpartum lactation, Nei Mongol J. Tradit. Chin. Med. 34 (11)
(2015) 171, http://dx.doi.org/10.3969/j.issn.1006-0979.2015.11.156.
The efficacy of auricular acupoints seeds pressing in promoting postpartum lactation
- X Y Xu
X.Y. Xu, The efficacy of auricular acupoints seeds pressing in promoting
postpartum lactation, Guide China Med. 13 (23) (2015) 197, http://dx.doi.org/
10.15912/j.cnki.gocm.2015.23.156.