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Science Say

What are the evidence for the Ear ?

Auriculotherapy, also known as auricular acupuncture or ear acupuncture, is one of the safest and most versatile treatments available for a wide range of conditions. Traditionally used for pain relief, recent studies have shown that auriculotherapy can be effective for a variety of other applications as well. This method often succeeds where other treatments have failed and offers the added benefit of having no side effects.

Due to these advantages, interest in auriculotherapy is growing, and research into this unique health approach is increasing.

Explore more about how auriculotherapy can assist with smoking cessation and other health concerns on our website.


Studies accessible on PubMed with Auriculotherapy

A meta-analysis of ear-acupuncture, ear-acupressure and auriculotherapy for cigarette smoking cessation

Yuan Ming Di 1Brian H May 2Anthony Lin Zhang 3Iris Wenyu Zhou 4Christopher Worsnop 5Charlie C L Xue 6

Affiliations expand


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 (3735 participants). Methodological quality was assessed using Cochrane Risk of Bias. Meta-analyses were conducted in two pools: POOL -1. SC-specific ear acupuncture/acupressure or auriculotherapy (EAP/R) vs. non-specific/inactive control; and POOL-2. SC-specific EAP/R vs. 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) vs. non-specific EAPR controls, with confirmed SC rates at 3 months post-treatment of 20.0% for test groups vs. 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.

Keywords: Cigarette; Ear acupressure; Ear acupuncture; Smoking; Systematic review; Tobacco.

Ear acupressure for smoking cessation: study protocol for a randomised controlled trial

Anthony L Zhang 1Yuan Ming DiChristopher WorsnopBrian H MayCharlie C L Xue

Affiliations expand


Background: Smoking is the largest preventable cause of death and disease worldwide but smokers often fail to quit due to nicotine withdrawal symptoms. Current available pharmaceutical therapies may assist with smoking cessation but may have side effects. Ear acupressure (EAP) and ear acupuncture have been used for smoking cessation, and some positive results have been reported. The aim of the study is to assess the efficacy and safety of EAP in assisting individuals to quit smoking and/or support them in the management of nicotine withdrawal symptoms.

Methods: This study will be a randomised, single-blind, sham-controlled study conducted at RMIT University in Melbourne, Australia. Adult smokers will be randomly assigned to receive EAP specifically for smoking cessation or nonspecific EAP treatments. After a 2-week run-in, participants will be treated once a week for 8 weeks and followed up for 12 weeks. The primary outcome measures will be 7 day point-prevalence cessation rate by self-report validated by expired carbon monoxide and nicotine withdrawal symptoms measured by the Mood and Physical Symptoms Score questionnaire. Secondary outcomes will be self-reported usage of nicotine replacement therapies, cigarette consumption, body weight change and quality of life. The safety end point will be self-reported adverse events associated with EAP. Intention-to-treat analysis will be applied.

Discussion: Findings from this study will determine if this EAP intervention alone can be an effective and safe therapy to assist with smoking cessation and the management of nicotine withdrawal symptoms.

© 2013 S. Karger GmbH, Freiburg.

Stress Study:

Efficacy of Chinese auriculotherapy for stress in nursing staff: a randomized clinical trial. Date: May, 2014 Summary: This randomized, single-blind clinical study aimed to evaluate the efficacy of auriculotherapy with and without a set protocol for reducing stress levels among nursing staff. A total of 175 subjects with medium and high stress scores participated in 3 groups: control, treatment with protocol, and treatment without protocol. Assessments were at baseline, after 12 sessions, and after 30 days. Conclusions: Statistically significant differences between the Control and Intervention groups were found in the two evaluations, with the treatment without protocol group showing the greatest effect. Individualized auriculotherapy without a set protocol may be helpful in reducing the effects of stress. Citation: Kurebayashi LF, Silva MJ. Rev Lat Am Enfermagem. Efficacy of Chinese auriculotherapy for stress in nursing staff: a randomized clinical trial. 2014 May-Jun;22(3):371-8. Page 5

Constipation Study:

Efficacy of auriculotherapy for constipation in adults: a systematic review and metaanalysis of randomized controlled trials. Date: August, 2014 Summary: This systematic review and meta-analysis assessed the clinical evidence of auriculotherapy for constipation treatment to identify the efficacy of groups using Semen vaccariae (seeds) or magnetic pellets as taped objects in managing constipation. Fifteen randomized, controlled trials were included in this analysis. Conclusions: The meta-analysis of 15 trials showed a moderate, significant effect of auriculotherapy in managing constipation compared with controls. The 15 RCTs also showed a moderate, significant effect of auriculotherapy in relieving constipation. Further rigorous RCTs from around the world are warranted to confirm the effect and safety of auriculotherapy for constipation. Citation: Yang LH1, Duan PB, Du SZ, Sun JF, Mei SJ, Wang XQ, Zhang YY. Efficacy of auriculotherapy for constipation in adults: a systematic review and meta-analysis of randomized controlled trials. J Altern Complement Med. 2014 Aug;20(8):590-605. doi: 10.1089/acm.2013.0324. Epub 2014 Jul 14.


Weight Loss Study:

The effects of auricular electroacupuncture on obesity in female patients--a prospective randomized placebo-controlled pilot study. Date: February, 2014 Summary: Several studies show a significantly higher weight loss with acupuncture treatment. This is the first prospective, randomized, double-blinded study, testing the effects of auricular electroacupuncture on weight loss in obese female patients. 56 female obese patients (age>18, Body Mass Index, BMI>25) were randomized to receive either auricular acupuncture with electrical stimulation or placebo treatment for four days. The treatment was performed once a week for a period of six weeks. A follow-up visit was performed after 4 weeks. At each visit body weight, BMI (Body Mass Index) and body fat were measured. Conclusions: Relative reduction of body weight was significantly greater in the verum group (-3.73%; CI=-4.70 to -2.76) than in the placebo group (-0.70%; CI=-1.57 to +0.16; p<0.001) There was also a significant reduction of BMI (p<0.001) in the verum group (-3.62%; CI=-4.39 to -2.84) compared to placebo (-0.82%; CI=-1.55 to -0.10; p<0.001). No patient reported side effects related to acupuncture. Electrical auricular acupuncture could be a safe, additive, non-pharmacological treatment in obese patients. Citation: Schukro RP1, Heiserer C2, Michalek-Sauberer A3, Gleiss A4, Sator-Katzenschlager S3. The effects of auricular electroacupuncture on obesity in female patients--a prospective randomized placebo-controlled pilot study. Complement Ther Med. 2014 Feb;22(1):21-5. doi: 10.1016/j.ctim.2013.10.002. Epub 2013 Oct 31.

Hypertension Study:

Primary hypertension treated with acupuncture combined with auricular point sticking: a randomized controlled trial. Date: March, 2014 Summary: Ninety patients with primary hypertension were randomly divided into a medication group and a combination acupuncture group. In the combination group, acupuncture and auricular point treatment were used. Acupuncture was applied at ST 9, GB 20 and GV 20, while auricular point treatment was used at Shenmen (TF4), Xin (CO15), Jiangyagou and Jiaogan (AH6a), once a day for 4 weeks. After treatment, the changes of 24 h ambulatory blood Page 7 Schukro RP1, Heiserer C2, Michalek-Sauberer A3, Gleiss A4, SatorKatzenschlager S3. The effects of auricular electroacupuncture on obesity in female patients--a prospective randomized placebocontrolled pilot study. Complement TherDSF pressure, angiotensin II (Ang II) level, creatinine level and syndrome scores were observed and the clinical efficacy was assessed in the two groups. Blood pressure improved in both groups, but the reduction of 24 h ambulatory blood pressure in the combination group was superior to that in the medication group. Serum Ang II level and plasma creatinine level of the patients in both groups decreased with a more marked decrease in the combination group. Similarly, syndrome scores decreased in both groups, with the combination group showing the most improvement. The total effective rate of the combination group was 95.6% (43/45), which was superior to 71.1% (32/45) of the medication group. Conclusions: Acupuncture combined with auricular treatment for primary hypertension is better than captopril for the improvement of 24 h ambulatory blood pressure, AngII level and creatinine level, and can improve clinical symptoms. Citation: Zhongguo Zhen Jiu. 2015 Mar;35(3):227-31 Chinese.


Menstrual Irregularities Study:

Effect of auriculotherapy on menstrual irregularities in single girls with polycystic ovarian syndrome and aged 18-35 years Date: March, 2015 Summary: This is a clinical trial conducted on 60 females aged 18-35 years with clinical, laboratory, and sonography signs of polycystic ovary syndrome. The subjects were randomly assigned to two groups (auriculotherapy or medication) and underwent treatment for 2 and 3 months, respectively. Clinical signs were investigated in three steps in both groups. Data were collected through observation, laboratory tests, and sonography, and were analyzed by SPSS version 15. In 60 subjects, Chi-square test showed a significant difference in menstruation disorders in both groups 1 month after the start of intervention (P = 0.001); but 2 months after the start of intervention (P = 0.11) and immediately after the end of the intervention (P = 0.16), the difference was not significant. Three months after the end of the intervention, this variable showed a significant difference (P = 0.02). Conclusions: Pharmaceutical treatment and auriculotherapy are both effective for menstruation disorders, but auriculotherapy is more effective on reduction of menstruation disorders, compared to pharmaceutical therapy in women with polycystic ovarian syndrome. Citation: Iran J Nurs Midwifery Res. 2015 Mar-Apr;20(2):190-4.


Depression Associated with Obesity Study:

Effects of ear acupuncture therapy for obesity on the depression of obese women. Page 8 Date: August, 2014 Summary: After baseline testing, 30 eligible patients with body mass index (BMI) >29.9 kg/m(2) were included. The Beck Depression Inventory for Primary Care (BDI-PC) was used to assess changes in depression. BMI was also measured. Patients had six ear acupuncture sessions, every 15 days and were followed up for 3 months. Twenty four patients completed the study. The mean±SD age of patients was 42.9±9.0 years. Their mean±SD BMI was 39.0±4.7 kg/m(2) before acupuncture, decreasing to 37.2±4.3 kg/m(2) after acupuncture therapy (p<0.001). The mean depression score was 4.4±2.3 before acupuncture, decreasing to 2.7±1.4 (p<0.001) after treatment. There was no significant correlation between BMI and depression score before acupuncture therapy (p=0.104). After acupuncture therapy, no significant correlation was found between the percentage reduction of BMI and percentage reduction of the depression score (p=0.119). Conclusions: Ear acupuncture therapy for obesity appears to also reduce depression of obese women. Further research into the effects of ear acupuncture in the management of obesity and depression is justified. Citation: Acupunct Med. 2014 Oct;32(5):427-9. doi: 10.1136/acupmed-2014-010626. Epub 2014 Aug 6.


Methamphetamine Withdrawal Study:

Comparative study on effects between electroacupuncture and auricular acupuncture for methamphetamine withdrawal syndrome. Date: March, 2014 Summary: Ninety male patients of methamphetamine addiction were randomized into an electroacupuncture group, an auricular acupuncture group and a control group, 30 cases in each one. In the electroacupuncture group, Neiguan (PC 6), Shenmen (HT 7), Zusanli (ST 36), Sanyinjiao (SP 6), Jiaji (EX-B 2) at T5 and L2 were selected bilaterally. In the auricular acupuncture group, jiaogan (AH(6a)), shenmen (TF4), fei (CO14) and gan (CO12) were selected unilaterally. The treatment was given 3 times a week, with 12 treatments total. In the control group, no treatment was applied. Before treatment and after 1, 2, 3 and 4 weeks treatment, the scores of methamphetamine withdrawal syndrome, Hamilton anxiety scale and Hamilton depression scale were measured in each group. Both treatment groups showed declines in withdrawal syndrome, anxiety and depression scores in weeks 2, 3 and 4, and in every assessment, treatment groups were significantly lower than control. Conclusions: Electroacupuncture at the body points and auricular acupuncture play a significant therapeutic role in the treatment of methamphetamine withdrawal syndrome, anxiety and Page 9 depression. The longer time the treatment is with electroacupuncture at the body points, the more obvious the efficacy will be on the above symptoms. Citation: Zhongguo Zhen Jiu. 2014 Mar;34(3):219-24.


Migraine Therapy Study Title:

Somatic acupuncture versus ear acupuncture in migraine therapy: a randomized, controlled, blind study. Date: 2012 Summary: This study compares the clinical effectiveness of somatic and ear acupuncture for treatment of migraine without aura. 35 patients were divided into 2 groups, one receiving somatic and the other ear acupuncture. Both groups were treated once a week for 8 weeks and needles were stimulated manually. The severity of pain was evaluated with the Migraine Index and the visual analogue of Scott-Huskisson; other 2 tests were used to monitor the pain threshold and Zung's Self-rating Depression Scale was applied to assess variations in patients' mood. These tests were performed before the beginning and at the end of treatment and, for the follow up, after 1, 3 and 6 months from the end of therapy. On the basis of the migraine index, pain at the end of therapy was significantly lower than before the treatment, being residual pain 54.83% and 63.43%, respectively for somatic and ear acupuncture. Apparently, the 2 treatments were equally effective, as no significant difference could be assessed. On the contrary, a significant difference between the 2 groups was clear during the follow up: in fact, after 6 months residual pain was 16.80% and 48.83% for somatic and ear acupuncture, respectively (p=0.038). These results were confirmed by the Visual Analogue Scale (VAS) test and by the evaluation of pain threshold. It is noteworthy that also Zung's depression test showed a significant decrease of score was present in both groups, at all the times investigated with no difference between the two treatments. Conclusions: These results, though preliminary, are quite promising in supporting the effectiveness of ear acupuncture for treatment of migraine without aura. Citation: Acupunct Electrother Res. 2012;37(4):277-93. 

Temporomandibular (Jaw) Disorders with Stress Study:

Role of Auriculotherapy in the Treatment of Temporomandibular Disorders with Anxiety in University Students. Date: October 1, 2015 Summary: 44 college students with high levels of anxiety and temporomandibular disorders (TMDs) were divided into 2 groups for treatment: an auriculotherapy (AA) group and an AA sham group. Seeds were applied to the shenmen, rim, sympathetic, brain stem, and temporomandibular joint (TMJ) points in the AA group. While for the AA sham group, seeds were applied to sham points in the external ear and wrist. Anxiety was significantly reduced in the AA group. This group also showed a decrease in tender points in the mandibular posterior region and in the right side of the submandibular region. Complaints of bilateral pain were reduced in the temporal tendon and in the left side of the ATM. In addition, electromyographic (EMG) activity was reduced during temporal muscle contraction. Conclusions: Auriculotherapy was effective in the treatment of students with anxiety and TMDs. Auriculotherapy was found to be effective in the treating anxiety and TMDs of university students. Citation: Denise H. L., Erika D. L. C., Caroline D. M, Bruna, C., Leonardo C. C., Andrea, M. S. &, Emilia C. C., (2015). Role of Auriculotherapy in the Treatment of Temporomandibular Disorders with Anxiety in University Students. Evid Based Complement Alternat Med. 281-284. Doi: 10.1155/2015/430143


Post Traumatic Stress Disorder Study:

Exploring Self-Reported Benefits of Auricular Acupuncture Among Veterans With Posttraumatic Stress Disorder. Date: November 3, 2015 Summary: In the study, 17 active-duty veterans with posttraumatic stress disorder (PTSD) provided written comments to describe their experience after receiving a standardized auricular acupuncture treatment for a 3-week period. After the intervention, a variety of symptoms experienced by veterans with PTSD were improved. Four themes were observed from the data including: improved sleep quality, increased relaxation, decreased pain, and veterans were very receptive to the auricular acupuncture treatments. Page 12 Conclusions: Numerous benefits were observed following the auricular acupuncture treatments given to the veterans with PTSD. These treatments may facilitate healing and recovery for veterans experiencing PTSD. Further investigations are warranted into the mechanisms of action for auricular acupuncture in this population. Citation: King C. H., Moore L. C., &, Spence C. D., (2015). Exploring Self-Reported Benefits of Auricular Acupuncture Among Veterans With Posttraumatic Stress Disorder. Journal of Holistic Nursing 34(3) 291-9. Doi: 10.1177/0898010115610050


Acute Sore Throat Study:

Ear Acupuncture for Acute Sore Throat: A Randomized Controlled Trial. Date: June 8, 2015 Summary: The study aimed to determine whether auricular acupuncture reduces pain, medication usage, and missed work hours when added to standard therapy in adult patients with acute sore throat. A total of 54 patients participated in the study and observed for 48 hours after treatment. Patients receiving auricular acupuncture reported lower pain scores than those who did not at 15 minutes, 6 hours, and 24 hours. They also reported taking fewer cumulative doses of pain medication at 6 hours, 24 hours, and 48 hours. There was no difference in time missed from work between the auricular acupuncture and standard therapy groups. Conclusions: Battlefield auricular acupuncture is effective in reducing sore throat pain for 24 hours and decreased use of pain medication for up to 48 hours. Also, there was no visible effect on hours missed from work. Citation: David, M., & Paul, C., (2015). Ear Acupuncture for Acute Sore Throat: A Randomized Controlled Trial. Journal of the American Board of Family Medicine 28(6). 607-705. Doi: 10.3122/jabfm.2015.06.150014


Chronic Low Back Pain Study:

Effect of a single session of ear acupuncture on pain intensity and postural control in individuals with chronic low back pain: a randomized controlled trial. Date: June 16, 2016 Summary: 80 adults with low back pain (LBP) and pain intensity equal or greater than 4, in a 0-10 scale, were divided into 2 groups: one to Ear Acupuncture group (EAG), the other to placebo group (PG). Pain level and posture were assessed before intervention. The EAG Page 13 received ear acupuncture for 20 min and the PG was treated with detuned ultrasound. After the treatment, pain intensity was assessed again and the postural test was repeated. Pain intensity was the primary outcome and center of pressure sway area and speed were the secondary outcomes measured. Results revealed that pain intensity decreased in both groups after treatment, but decreased more in the EAG. For postural control, no effect of treatment and no interaction between treatment and postural condition on body sway were found. Conclusions: Findings show that Ear Acupuncture is better than placebo in treating pain, but neither of the two has effect on postural condition on body sway. Citation: Andrea, U., Bianca, C., Leonardo C., Ana, B., & Paulo, F., (2016). Effect of a single session of ear acupuncture on pain intensity and postural control in individuals with chronic low back pain: a randomized controlled trial. Brazilian Journal of Physical Therapy 20(4). 328-335. Doi: 10.1590/bjpt-rbf.2014.0158

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