Adverse Events of Auricular Therapy: A Systematic Review

Evidence-Based Complementary and Alternative Medicine, Nov 2014

The aim of this study was to systematically evaluate the literature on adverse events associated with auricular therapy (AT). Case reports, case series, surveys, and all types of clinical trials reporting adverse events of AT were included. Relevant articles were mainly retrieved from 13 electronic databases and seven Chinese journals on complementary medicine. AT-related adverse events were reported in 32 randomized controlled trials, five uncontrolled clinical trials, four case reports, and two controlled clinical trials. For auricular acupuncture, the most frequently reported adverse events were tenderness or pain at insertion, dizziness, local discomfort, minor bleeding and nausea, and so forth. For auricular acupressure, local skin irritation and discomfort, mild tenderness or pain, and dizziness were commonly reported. Skin irritation, local discomfort, and pain were detected in auricular electroacupuncture, and minor infection was identified in auricular bloodletting therapy. Most of these events were transient, mild, and tolerable, and no serious adverse events were identified. Our findings provide preliminary evidence that AT is a relatively safe approach. Considering the patient’s safety, prospective or retrospective surveys are needed in future research to gather practitioner-reported and patient-reported adverse events on AT, and the quality of adverse events reporting in future AT trials should be improved.

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Adverse Events of Auricular Therapy: A Systematic Review

Adverse Events of Auricular Therapy: A Systematic Review Jing-Yu Tan,1 Alexander Molassiotis,1 Tao Wang,2 and Lorna K. P. Suen1 1School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong 2The Second Affiliated People’s Hospital, Fujian University of Traditional Chinese Medicine, No. 13 Hudong Road, Gulou District, Fuzhou 350003, China Received 24 June 2014; Revised 26 August 2014; Accepted 27 August 2014; Published 10 November 2014 Academic Editor: Byung-Cheul Shin Copyright © 2014 Jing-Yu Tan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract The aim of this study was to systematically evaluate the literature on adverse events associated with auricular therapy (AT). Case reports, case series, surveys, and all types of clinical trials reporting adverse events of AT were included. Relevant articles were mainly retrieved from 13 electronic databases and seven Chinese journals on complementary medicine. AT-related adverse events were reported in 32 randomized controlled trials, five uncontrolled clinical trials, four case reports, and two controlled clinical trials. For auricular acupuncture, the most frequently reported adverse events were tenderness or pain at insertion, dizziness, local discomfort, minor bleeding and nausea, and so forth. For auricular acupressure, local skin irritation and discomfort, mild tenderness or pain, and dizziness were commonly reported. Skin irritation, local discomfort, and pain were detected in auricular electroacupuncture, and minor infection was identified in auricular bloodletting therapy. Most of these events were transient, mild, and tolerable, and no serious adverse events were identified. Our findings provide preliminary evidence that AT is a relatively safe approach. Considering the patient’s safety, prospective or retrospective surveys are needed in future research to gather practitioner-reported and patient-reported adverse events on AT, and the quality of adverse events reporting in future AT trials should be improved. 1. Introduction Being one of the most popular complementary therapeutic approaches, auricular therapy (AT) is defined as “a health care modality whereby the external surface of the ear, or auricle, is stimulated to alleviate pathological conditions in other parts of the body” [1]. The earliest record of AT can trace back to 500 to 300 B.C. in ancient China, where the Yellow Emperor’s Inner Canon (Huangdi Neijing) described that the ear is not isolated but intimately connected with the five viscera and the six bowels [2]. The modern system of AT was developed by the French neurologist Paul Nogier in the late 1950s, and it is recognized that the outer ear has a somatotopic arrangement with an inverted fetus pattern and each internal organ is corresponding to a sensitive point located in the auricle [3]. AT could produce a therapeutic effect for treating various types of disorders by stimulating the particular acupoint which corresponds to the targeted part of the body or organ [4]. Various modalities are adopted in AT practice including auricular acupuncture, acupressure, moxibustion, injection, and auricular bloodletting therapy. The WHO recognizes AT as a microacupuncture system that can produce a positive impact on regulating the whole body function [5], and its therapeutic effect has been investigated in a wide range of health problems in both oriental and western countries. Clinical trials and systematic reviews have shown that AT can be a promising modality in relieving preoperative anxiety [6], psychosomatic disorders [7], and various types of pain [8], managing hypertension [9] and cocaine dependence [10], and controlling obesity [11]. The wide use of AT in clinical practice requires continual safety evaluation. It is said that the popularity of AT is partially attributed to its convenience and safety, and in some oriental countries, AT is usually conducted by healthcare professionals only with AT short-term training or even by unqualified practitioners without any experience in performing AT [12]. However, this kind of intervention is not entirely risk-free, where adverse events, such as chest tightness, dizziness, perichondritis, and nausea, are also reported in the literature [13]; meanwhile, when applying AT to special populations such as pregnant women and immunocompromised patients, unwanted miscarriage and infection could have occurred [13]. The ear possesses abundant capillaries which make it highly vulnerable to skin inflammations and other infections [13]. To minimize potential harms caused by AT, practitioners need to strictly follow standardized procedures of AT administration as well as fully understand the potential adverse events associated with it. It is important to assess the safety of AT in clinical practice (...truncated)


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Jing-Yu Tan, Alexander Molassiotis, Tao Wang, Lorna K. P. Suen. Adverse Events of Auricular Therapy: A Systematic Review, Evidence-Based Complementary and Alternative Medicine, 2014, 2014, DOI: 10.1155/2014/506758