THE EFFECT OF AURICULAR ACUPUNCTURE ON PSYCHOPHYSIOLOGICAL MEASURES OF COCAINE CRAVING

This study used a randomized pretest/posttest control group design to test the effectiveness of auricular acupuncture interventions in diminishing psychological and physiological changes associated with cocaine craving in 30 treatment-seeking cocaine-dependent patients. The experimental group received the real auricular acupuncture intervention, insertion of needles into ear point locations specifically targeted for drug withdrawal. The control group received sham or placebo auricular acupuncture, insertion of needles into ear point locations not targeted for any specific therapeutic benefit. Psychological (Cocaine Craving Questionnaire - Now) and physiological (skin conductance activity) changes associated with cocaine craving were measured. Results showed no differences between the control and the experimental group in diminishing psychological and physiological measures associated with craving. There were differences from pre- to posttest on measures of psychological but not physiological craving for the combined experimental and control groups.     

Effects of auricular transcutaneous electrical nerve stimulation on experimental pain threshold

This study was conducted to examine the effects of high intensity transcutaneous electrical nerve stimulation at auricular acupuncture points on experimental pain threshold. Forty-five healthy adult male and female subjects were assigned randomly to one of two treatment groups or to a control group. Subjects in the two treatment groups received high intensity TENS to either appropriate or inappropriate (placebo) acupuncture points on one ear. Experimental pain threshold at the ipsilateral wrist was determined with a painful electrical stimulus before and after ear stimulation. Only the group receiving stimulation of appropriate ear acupuncture points exhibited a significant increase (p less than .01) in experimental pain threshold after ear stimulation. The comparable placebo and control groups, again, did not exhibit significant pretest-posttest differences in experimental pain threshold. The results suggest that, if applied accurately, auricular TENS can increase pain threshold. Further research is needed to assess the effects of this technique on patient groups.     

耳针治疗灼口综合征的效果观察

目的了解耳针治疗灼口综合征的效果。方法灼口综合征病人80例,随机分为2组,实验组42例,采用耳针电刺激＋耳压治疗;对照组38例,口服维生素B2、维生素E和谷维素治疗,30 d为1个疗程。疗程结束后,实验组停止电刺激,继续耳压治疗;对照组按原剂量口服药物。两组分别于治疗前、治疗1个疗程、治疗后3个月进行疼痛程度评定,并进行比较。结果对照组治疗后3个月疼痛程度较治疗前及治疗1个疗程降低,差异有显著性（F=36.368,q=6.807、4.641,P〈0.01）;实验组治疗1个疗程、治疗后3个月疼痛程度均较治疗前降低,差异有显著性（F=24.191,q=3.808、8.513,P〈0.01）。实验组治疗1个疗程及3个月后疼痛程度较对照组降低,差异有显著性（t=18.000、17.902,P〈0.05）。结论耳针治疗灼口综合征病人有效。     

Interpreting conflicting findings from clinical trials of auricular acupuncture for cocaine addiction: does treatment context influence outcome?

OBJECTIVE: To compare findings from two consecutive clinical trials of auricular acupuncture for cocaine addiction conducted at the same site in order to explore consistency of treatment effects. SUBJECTS: One hundred and sixty-five (165) cocaine-dependent, methadone-maintained patients (study 1, n = 82; study 2, n = 83). INTERVENTIONS: Subjects in both studies were randomly assigned to auricular acupuncture, a needle insertion control condition, or a no-needle relaxation control. Treatment sessions were offered five times weekly for 8 weeks. The two studies were equivalent in design, except that unlike study 1, study 2 offered subject payments for attendance and did not include weekly group counseling. OUTCOME MEASURES: Cocaine use assessed by three times weekly urine screens constituted the primary outcome. Secondary measures included retention in treatment, treatment attendance, treatment credibility, therapeutic alliance, and acute effects of treatments. RESULTS: Intent-to-treat analysis showed that patients assigned to acupuncture in study 1, but not in study 2, were significantly more likely to provide cocaine-negative urine samples relative to the two control conditions. CONCLUSIONS: The positive effect for acupuncture found in study 1 was not found in study 2. Even though the two studies were similar, reasons for this inconsistency cannot be determined definitively, but may be because of differences in psychosocial context and payment contingencies between the two studies, or the lack of effectiveness of acupuncture in this application. The need to critically consider the influence of treatment context and other potential moderating variables on outcome in order to draw conclusions regarding treatment effectiveness is discussed.     

Effects of auricular acupuncture-like transcutaneous electric nerve stimulation on pain levels following wound care in patients with burns: a pilot study

This study was designed to test the hypothesis that auricular acupuncture-like transcutaneous electrical nerve stimulation would significantly reduce the pain experienced by patients with burns immediately after wound debridement, other wound care, and dressing changes. Subjects were 11 inpatients at the University of Alabama Hospital Burn Unit. A two-period crossover design was used, and each patient received one experimental treatment consisting of bilateral acupuncture-like transcutaneous electrical nerve stimulation to six ear points and one control treatment consisting of a placebo pill. The Visual Analogue Scale was used as a measure of pain and was completed immediately before and after treatments and at 15, 30, and 60 minutes after treatment. A two-factor repeated measures ANOVA indicated significant effects of measurement time (p less than 0.001) and treatment by time (p = 0.002). Post hoc analysis revealed significant differences (p less than 0.05) between experimental and control conditions at all times after treatment but not at pretreatment baseline. These results indicate that auricular acupuncture-like transcutaneous electrical nerve stimulation may be an effective pain management technique in patients with burns.     

耳穴压豆法对中风-中经络患者抑郁状况的影响研究

目的探讨耳穴压豆法在中风-中经络患者治疗中的实施方法及对患者抑郁状况的影响。方法将80例中风-中经络患者随机分为两组,每组40例。试验组在常规治疗护理基础上,于入院1周后开始给予耳穴压豆;对照组只接受常规治疗护理。比较两组患者干预后的抑郁状况。结果干预2周和4周后,试验组抑郁自测量表得分低于对照组(P<0.01)。结论耳穴压豆法能够有效改善中风-中经络患者抑郁状况,适当延长治疗时间疗效仍显著。     

Effect of transcutaneous electrical nerve stimulation at auricular points on experimental cutaneous pain threshold

The purposes of this study were 1) to examine the effect of high intensity, low frequency transcutaneous electrical nerve stimulation at auricular acupuncture points on experimental pain threshold measured at the wrist and 2) to determine the changes in effect over time. Forty-four healthy adult men and women were assigned randomly to one of three treatment groups. Group 1 (n = 15) received TENS to appropriate auricular points for wrist pain, Group 2 (n = 14) received TENS to inappropriate (placebo) auricular points, and Group 3 (n = 15) received no TENS. We measured experimental pain threshold at the wrist after an electrical stimulus during one pretreatment and three posttreatment time periods. Group 1 was the only group that had a statistically significant increase (p less than .05) in pain threshold after testing. This increase remained significant for all posttreatment measurements for Group 1. These results suggest that high intensity, low frequency TENS applied to appropriate auricular acupuncture points can increase pain threshold.     

Effects of unilateral and bilateral auricular transcutaneous electrical nerve stimulation on cutaneous pain threshold

This study compared the effects of unilateral and bilateral auricular transcutaneous electrical nerve stimulation on cutaneous pain threshold. Auricular acupuncture points were stimulated with low frequency, high intensity TENS for 45 seconds. Sixty healthy, adult subjects were assigned randomly to one of two treatment groups or to a control group. The two treatment groups received low frequency, high intensity TENS either unilaterally or bilaterally. The control group did not receive auricular stimulation. Experimental pain threshold at the left wrist was determined with a painful stimulus before and after auricular stimulation. Both unilateral and bilateral auricular stimulation groups exhibited a significant increase (p less than .05) in experimental pain threshold, but the control group did not. The mean change values between the unilateral and bilateral stimulation groups were not statistically different. These results suggest that both unilateral and bilateral auricular TENS can increase pain threshold.     

Comparison of effects of transcutaneous electrical nerve stimulation of auricular, somatic, and the combination of auricular and somatic acupuncture points on experimental pain threshold

This study compared the effects of high intensity, low frequency transcutaneous electrical nerve stimulation of auricular, somatic, and combined auricular and somatic acupuncture points on experimental pain threshold measured at the wrist. Sixty-seven healthy adults, aged 18 to 39 years, were assigned randomly to one of four groups: 1) the Auricular Group (n = 17) received TENS to auricular acupuncture points, 2) the Somatic Group (n = 17) received TENS to somatic acupuncture points, 3) the Combined Group (n = 17) received TENS to both auricular and somatic acupuncture points, and 4) the Control Group (n = 16) received no TENS and served as controls. Pain threshold was measured immediately before and after treatment or rest. Pain threshold significantly increased (p less than .05) in the Auricular, Somatic, and Combined Groups following treatment, with no statistically significant differences in mean pain threshold change scores among treatment groups. The Control Group demonstrated no statistically significant change in pain threshold. The results indicate that TENS applied to any of the three sets of acupuncture points equally increases pain threshold, thus possibly increasing options in choosing stimulation sites for treating patients with pain.     

三阴交穴位注射新斯的明对腹式全子宫切除术后患者留置尿管的影响

目的探讨新斯的明三阴交穴位注射配合膀胱区热按摩对腹式全子宫切除术后使用硬膜外自控镇痛（PCEA）患者留置尿管时间及预防尿潴留的效果。方法将200例腹式全子宫切除术后PCEA患者随机分为实验组和对照组各100例。实验组采用新斯的明三阴交穴位注射配合膀胱区热按摩,对照组采用维生素B,三阴交穴位注射配合膀胱区热按摩,干预后拔出尿管,分别观察两组患者首次自行排尿时间,测定膀胱残余量（RUV）,评定预防尿潴留的效果和不良反应的发生情况。结果实验组首次自行排尿时问早于对照组,差异有统计学意义（x^2=43．8,P〈0．01）;实验组预防尿潴留总有效率为98％,明显优于对照组的6l％,差异有统计学意义（X^2=41．7,P〈0．01）;两组患者均无心动过缓、呼吸抑制及低血压发生。结论新斯的明三阴交穴位注射配合膀胱区热按摩能有效缩短腹式全子宫切除术后PCEA患者留置尿管时问,预防尿潴留效果显著。     

耳穴压豆与温水足浴治疗肾虚不寐的疗效观察

目的观察耳穴压豆治疗肾虚不寐的临床疗效。方法将91例肾虚不寐患者随机分为治疗组46例和对照组45例。治疗组采用耳穴压豆进行治疗,左右耳交替,每3天更换1次;对照组采用温水足浴进行治疗,每日1次。两组疗程均为1个月。结果治疗组疗效显著优于对照组（P〈0．01）;PSQI除睡眠效率和日间功能因子评分外,其他各因子评分显著低于对照组（均P〈0．05）;治疗后治疗组SAS评分有明显改善（P〈0．01）,而对照组则无此效应（P〉0．05）;治疗组与对照组在不良反应的发生率上无显著差异（P〉0．05）;焦虑或抑郁症状较对照组明显减少。结论耳穴压豆能明显改善肾虚不寐患者的睡眠质量和心理健康状况,其不适症状发生率与温水足浴疗法并无差异。     

Effects of mindfulness-based stress reduction (MBSR) on health among breast cancer survivors

The purpose of this study was to examine the effects of a MBSR program on physiological and psychological outcomes among early-stage breast cancer survivors. A quasi-experimental, pre-and posttest control group design was selected. The intervention group received the MBSR intervention. The control group received no MBSR intervention. ANOVA and ANCOVA were used to analyze data. The intervention group demonstrated statistically significant improvement in physiological and psychological outcomes including reduced blood pressure, heart rate, and respiratory rate and increased mindfulness state at the level of p = .05 to p = .001. The effects of MBSR on reducing stress in this sample were statistically significant on the physiological outcome (morning cortisol) at the measurement after the intervention completion, but this effect was not sustained at 1-month follow-up. MBSR showed a trend toward improving psychological outcomes by reducing mood disturbance in this sample.     

耳穴贴压对ICU患者紧急抢救时邻床清醒患者应激反应的影响

目的探讨耳穴贴压对重症监护病房（intensiveeareunit,ICU）患者紧急抢救时邻床清醒患者应激反应的影响。方法采用随机数字表法,将50例入住ICU的清醒患者分为试验组和对照组,每组各25例。抢救时两组患者均常规给予干预措施（所有邻床清醒患者用围帘隔开、专职护士进行心理护理）,试验组在此基础上采用耳穴贴压。观察两组患者在抢救时即刻（0min）、30min、1h心率、收缩压、血糖、血浆儿茶酚胺（肾上腺素、去甲肾上腺素）、皮质醇指标情况的差异。结果抢救时30min、1h试验组患者各项应激指标均低于对照组,两组比较,差异具有统计学意义（均P〈0．05）。结论耳穴贴压对降低ICU患者紧急抢救时邻床清醒患者应激反应具有较好的效果。     

个体化音乐干预联合耳穴贴压疗法对肺癌术后患者睡眠质量的影响

目的：探讨个体化音乐干预联合耳穴贴压疗法对肺癌术后患者睡眠质量的影响。 方法：将240例患者随机分为耳穴组、音乐组、音乐联合耳穴组及对照组各60例。对照组给予常规术后护理,其余各组均在常规护理的基础上,音乐组给予个体化音乐干预,耳穴组给予耳穴贴压,音乐联合耳穴组给予个体化音乐联合耳穴贴压干预,对所有入组患者均于术前晚及出院前采用匹兹堡睡眠质量指数(PSQI)量表进行睡眠质量评定。结果：4组患者术前晚PSQI各维度得分比较差异无统计学意义（P＞0.05）。4组患者出院时PSQI各维度得分比较显示,音乐组、耳穴组、音乐联合耳穴组3组分别与对照组比较,差异均有统计学意义（P＜0.05）;音乐组、耳穴组与音乐联合耳穴组3组间两两比较,差异无统计学意义（P＞0.05）。结论：个体化音乐干预、耳穴贴压、音乐干预联合耳穴贴压均可改善肺癌术后患者的睡眠质量,但音乐干预联合耳穴贴压疗法并不优于单独音乐干预或耳穴贴压疗法。     

Effect of auricular pellet acupressure on antioxidative systems in high-risk diabetes mellitus

OBJECTIVES: Free radicals and lipid peroxides, both of which are easily formed in the diabetic state, play an important role in the development of diabetic complications. Antioxidative therapy may help prevent diabetic complications caused by lipoperoxidation and free-radical formation in diabetes mellitus (DM). A number of findings suggest that oxidative stress exists in persons with high-risk DM. Auricular pellet acupressure has reportedly been an effective treatment method for a variety of medical conditions, including anxiety, juvenile myopia, essential hypertension, and senile vascular dementia. However, its effects on antioxidative enzymes have not been elucidated. We therefore evaluated the impact of auricular pellet acupressure on antioxidative status in persons with high-risk DM. SUBJECTS: Our study involved 69 persons with high-risk DM, who were allocated either to undergo acupressure as active treatment for the experimental group or to a control group. INTERVENTIONS: The experimental group in the study received auricular pellet acupressure three times daily for 5 consecutive days. After a 2-day rest period, the procedure was performed on the contralateral ear. Acupressure was performed twice on each ear, with each application followed by its application to the contralateral ear, over a total treatment period of 20 days. The control groups did not undergo auricular pellet acupressure. DESIGN AND OUTCOME MEASURES: At the end of the 20-day period of treatment of the experimental group, blood was collected from all of the study participants for assay of serum superoxide dismutase (SOD) and catalase concentrations, as was also done for the control group. RESULTS: Serum concentrations of SOD (p < 0.05) and catalase (p < 0.0001) were significantly higher in the experimental group than in the control group. CONCLUSIONS: Our findings suggest that auricular pellet acupressure can increase the concentration of antioxidative enzymes in persons with high-risk DM.     

Can acupuncture reduce the induction time of a local anaesthetic?--A pilot study

We report on a pilot study we undertook to investigate if segmental acupuncture treatment, given two minutes prior to a regional inferior dental block (ID) with Prilocaine Hydrochloride, would reduce the onset time of a local anaesthetic. Thirty healthy people, who needed a regional inferior dental block (ID) as part of dental treatment in the lower jaw, were randomly allocated to three groups. They received segmental acupuncture, heterosegmental superficial acupuncture, or standard treatment (regional inferior dental block) without acupuncture. In the segmental acupuncture group, acupuncture was given within the innervation of the trigeminal nerve. The needles were left in for two minutes, followed by a regional inferior dental block (ID). In the second group, acupuncture needles were inserted superficially in extra-segmental points and left in for two minutes without stimulation, followed by the regional inferior dental block. A control group received standard treatment only, of a regional inferior dental block. The concept 'pain free for dental work' was defined as 'patients reporting pins and needles in the lower lip' and measured by a drilling test. Patients who reported no pain during the drilling test were included in the study. The time from administration of the injection to the patients' reporting pins and needles was recorded by an independent dental nurse. All tested patients reported sufficient anaesthesia during the drilling test. In the segmental acupuncture group, anaesthesia was achieved after 62 seconds, compared to the heterosegmental superficial acupuncture group, who took 115 seconds and the control group, who received standard treatment only, and took 119 seconds. The difference between the segmental acupuncture group and the heterosegmental superficial acupuncture group was statistically significant (p < 0.015); the difference between the segmental acupuncture group and the control, who received a regional inferior dental block only, was also significant (p < 0.032). No significant difference was found between the heterosegmental superficial acupuncture group and the control group who received a regional inferior dental block only (p < 0.84). It appears from this pilot study that the onset time of local anaesthesia is reduced if segmentally administered acupuncture is given prior to the regional inferior dental block. However, it needs to be reproduced including objective measurements.     

Auricular acupuncture versus sham acupuncture in the treatment of women who have insomnia

BACKGROUND: Improvement in sleep parameters in relation to acupuncture treatment is often found and referred to as being a positive side-effect in the treatment of other illnesses. There is a lack of randomized studies, which primarily study the direct effect of acupuncture on sleep. OBJECTIVES: To investigate whether or not auricular acupuncture has an effect on sleep parameters among people with insomnia. DESIGN: A single-blind, randomized pilot study where the treatment group received auricular acupuncture treatment (AAT) on active points and the control group received AAT on sham points during a 6-week treatment period. SETTING: Participants were recruited from the psychiatric outpatient clinics in the geographical area connected to a local hospital in central Sweden. SUBJECTS: In all, 28 women were included in the study, with 14 in each group. Their mean and median age was 53 years. OUTCOME MEASURES: Sleep parameters were obtained by using the Karolinska Sleep Diary. RESULTS: No statistically significant differences were observed between the groups relating to parameters associated with the definition of insomnia. The treatment group experienced that it was easier to wake up in the morning compared with the control group (repeated-measures analysis of variance, p = 0.04). Both groups showed a statistically significant recovery in subjective sleep parameters during the study period (weeks 1-6) compared with baseline values (week 0). CONCLUSIONS: Only modest evidence was found supporting the hypothesis that AAT may have an effect on insomnia. Least improvements were found in total sleep time and number of awakenings, 2 parameters directly associated with the definition of insomnia. AAT may have a role in the treatment of insomnia, especially in combination with other treatments such as cognitive behavioral therapy. This study provides an example of how to perform studies using alternative therapies for sleep disorders.     

耳针干预对儿童抑郁症模型小鼠情绪及外周催产素表达的影响

目的观察针灸干预对断奶前母本隔离模型小鼠情绪、下丘脑室旁核(PVN)神经元C-Fos及血清催产素(OT)表达的影响,探讨针灸耳穴治疗儿童抑郁症的机制及临床价值。方法将30只健康新生C57小鼠随机分为对照组(n=10)、模型组(n=10)、模型+针刺组(n=10),除对照组外,其余小鼠进行断奶前母本隔离构建儿童抑郁症模型。采用旷场实验检测各组小鼠抑郁样行为,以免疫荧光检测PVN脑区C-Fos表达数量,以ELISA法检测血清OT的表达水平,分析组间比较结果。结果模型组的旷场中央时间百分比显著低于对照组及模型+针刺组,差异具有统计学意义(P<0.05);模型组的总移动距离显著短于模型+针刺组和对照组,差异具有统计学意义(P<0.05);对照组和模型+针刺组的旷场中央时间百分比及总移动距离比较,差异均不显著(P>0.05)。模型组的PVN脑区C-Fos阳性神经元数量显著高于对照组及模型+针刺组,差异具有统计学意义(P<0.05);对照组和模型+针刺组的PVN脑区C-Fos阳性神经元数量无显著差异(P>0.05)。模型组的OT表达水平显著低于对照组及模型+针刺组,差异具有统计学意义(P<0.05);对照组和模型+针刺组的OT表达水平比较,差异无统计学意义(P>0.05)。结论断奶前母本隔离可显著增加小鼠的焦虑样行为及PVN脑区C-Fos阳性神经元表达,降低小鼠血清OT表达;而针灸耳穴干预可显著缓解因早期生活压力所致的情绪异常,逆转PVN脑区C-Fos阳性神经元及血清OT表达。本研究为针灸治疗儿童抑郁症提供了理论及实验依据。