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Background and aim: Chronic back pain causes physical, functional, and emotional disabilities. Traditional Chinese Medicine therapies have been shown as interventions to treat chronic back pain. The present study aimed to clinically evaluate the effects of ear acupuncture combined with cupping therapy on people with chronic back pain. Experimental procedure: We conducted an open-label, randomized, parallel-group controlled clinical trial. Following the CONSORT statement recommendations, 198 participants were randomized into 'ear acupuncture' and 'ear acupuncture and cupping therapy' groups. Data were collected in three different points; before the first session (initial) with the patient, after the last session (final), and seven days after the end of the treatment (follow-up). The Brief Pain Inventory, a digital algometer, and the Rolland Morris Disability Questionnaire were used for data collection. Generalized Estimation Equation model was used to examine the association between the interventions and the primary outcome pain severity. Results: Pain severity, pressure pain threshold, and physical disability improved over time in both groups. However, for the patients being treated with both ear acupuncture and cupping therapy, significant changes were seen in pain severity, pain relief, and physical disabilities between the initial and final sessions. For the 'ear acupuncture and cupping therapy' group, significant changes were also seen for pain relief and physical disability in the follow-up session. Conclusion: Ear acupuncture combined with cupping therapy was shown to be more effective in the treatment of chronic back pain when compared to treatment using only ear acupuncture.

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A prostatectomia radical pode causar efeitos urinários indesejáveis como incontinência urinária, noctúria, urgência miccional, frequência e esvaziamento incompleto da bexiga. Disfunções miccionais acarretam sentimentos e vivência de exclusão social e, consequente diminuição na qualidade de vida. Para casos de incontinência urinária pós-prostatectomia radical é indicada a realização do treinamento muscular do soalho pélvico como primeira escolha para auxiliar no mecanismo de fechamento uretral. Dentre as práticas integrativas e complementares que têm contribuições na área da saúde, pode-se citar a acupuntura auricular. Esta baseia-se na estimulação de acupontos no pavilhão auricular para aliviar sinais e sintomas de diversas condições, dentre elas, os sintomas do trato urinário inferior. O objetivo deste estudo foi avaliar a efetividade da acupuntura auricular associada ao treinamento muscular do soalho pélvico na incontinência urinária pós-prostatectomia radical. Trata-se de um ensaio clínico randomizado baseado nas recomendações do Consolidated Standards of Reporting Trials e Standards for Reporting Interventions in Clinical Trials of Acupuncture. Os dados foram coletados entre abril de 2019 e abril de 2020. A amostra foi constituída por 60 homens com incontinência urinária após retirada do cateter vesical de demora, alocados em dois grupos: controle (n=30) que recebeu orientações sobre treinamento muscular do soalho pélvico; e intervenção (n=30) que recebeu acupuntura auricular associada às orientações sobre treinamento muscular do soalho pélvico. As orientações sobre treinamento muscular ocorreram durante oito sessões presenciais semanais associadas à entrega de um livreto que auxiliava a continuidade dos exercícios em domicílio. Para o grupo intervenção, a acupuntura auricular também foi ofertada em oito sessões semanais. A avaliação ocorreu em dois momentos: antes de qualquer tratamento (pré-teste) e após oito semanas de acompanhamento (9ª sessão ­ pós-teste). Foram utilizados os instrumentos questionário sociodemográfico e clínico, daily pad used, pad test de uma hora, escala de incontinência urinária pós-prostatectomia radical, International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) e King's Health Questionnaire (KHQ). O modelo longitudinal, com o uso das equações de estimações generalizadas e teste de diferença de proporções, foi empregado na análise estatística. O nível de significância adotado foi de 0,05. Resultados: a gravidade da incontinência urinária diminuiu entre o pré-teste e pós-teste no grupo intervenção e, também, no grupo controle sem diferenças estatísticas na evolução entre os dois grupos. Em relação ao impacto da incontinência na qualidade de vida, identificou-se diferença estatisticamente significativa entre os grupos no pós-teste ao nível do domínio "medidas de gravidade" (p=0,013), o que indicou menor impacto da IU para este domínio apenas no grupo intervenção. Na análise da frequência dos itens deste domínio, detectou-se diferença estatisticamente significativa entre os grupos no pós-teste para o item "troca suas roupas íntimas quando elas estão molhadas" (p=0,018). Evidenciou-se também que o grupo intervenção teve, respectivamente, 20,8% (p=0,007) e 25,3% (p=0,002) menos chance de apresentar noctúria e urgência miccional. Verificou-se também redução estatisticamente significativa no impacto da incontinência na qualidade de vida nos domínios "emoções" (p<0,001) e "sono e disposição" (p=0,008) no grupo intervenção. Conclusão: a AA não mostrou-se efetiva para potencializar a ação do treinamento muscular na redução da gravidade da incontinência urinária. Por outro lado, quanto ao impacto da incontinência urinária na qualidade vida, a associação da acupuntura auricular ao treinamento mostrou-se mais efetiva, principalmente pela diferença estatisticamente significativa entre os grupos no pós-teste para o domínio "medidas de gravidade", bem como pela redução da chance dos sintomas de noctúria e urgência miccional. Frente a esses achados, recomenda-se a associação das terapias como um cuidado efetivo aos homens com incontinência urinária pós-prostatectomia radical. Registro Brasileiro de Ensaios Clínicos: RBR-3jm5y2.

Radical prostatectomy can cause undesirable urinary effects such as urinary incontinence, nocturia, urinary urgency, frequency and incomplete emptying of the bladder. Voiding dysfunctions cause feelings and experience of social exclusion and, consequently, decrease in quality of life. For cases of urinary incontinence after radical prostatectomy, muscle training of the pelvic floor is indicated as the first choice to assist in the urethral closure mechanism. Among the integrative and complementary practices that have contributions in the health area, we can mention auricular acupuncture. This is based on the stimulation of acupoints in the ear to relieve signs and symptoms of several conditions, including lower urinary tract symptoms. The aim of this study was to evaluate the effectiveness of auricular acupuncture associated with pelvic floor muscle training in urinary incontinence after radical prostatectomy. This is a randomized clinical trial based on the recommendations of the Consolidated Standards of Reporting Trials and Standards for Reporting Interventions in Clinical Trials of Acupuncture. Data were collected between April 2019 and April 2020. The sample consisted of 60 men with urinary incontinence after removal of the indwelling bladder catheter, allocated into two groups: control (n = 30) who received guidance on floor muscle training pelvic; and intervention (n = 30) that received auricular acupuncture associated with guidelines on muscle training of the pelvic floor. The guidelines on muscle training took place during eight weekly face-to-face sessions associated with the delivery of a booklet that helped to continue the exercises at home. For the intervention group, auricular acupuncture was also offered in eight weekly sessions. The evaluation took place in two moments: before any treatment (pre-test) and after eight weeks of follow-up (9th session - post-test). The socio-demographic and clinical questionnaire, daily pad used, one-hour pad test, urinary incontinence scale after radical prostatectomy, International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) and King's Health Questionnaire (KHQ) were used. The longitudinal model, using generalized estimation equations and proportional difference test, was used in the statistical analysis. The level of significance adopted was 0.05. Results: the severity of urinary incontinence decreased between the pre-test and post-test in the intervention group and also in the control group without statistical differences in the evolution between the two groups. Regarding the impact of incontinence on quality of life, a statistically significant difference was identified between the groups in the post-test at the level of the "severity measures" domain (p = 0.013), which indicated a lower impact of UI for this domain only in the intervention group. In the analysis of the frequency of the items in this domain, a statistically significant difference was detected between the groups in the post-test for the item "change your underwear when they are wet" (p = 0.018). It was also evident that the intervention group had, respectively, 20.8% (p = 0.007) and 25.3% (p = 0.002) less chance of presenting nocturia and urinary urgency. There was also a statistically significant reduction in the impact of incontinence on quality of life in the domains "emotions" (p <0.001) and "sleep and mood" (p = 0.008) in the intervention group. Conclusion: AA was not effective in potentiating the action of muscle training in reducing the severity of urinary incontinence. On the other hand, regarding the impact of urinary incontinence on quality of life, the association of ear acupuncture with training proved to be more effective, mainly due to the statistically significant difference between the groups in the post-test for the "severity measures" domain, as well as by reducing the chance of nocturia symptoms and urinary urgency. In view of these findings, the association of therapies as an effective care for men with urinary incontinence after radical prostatectomy is recommended. Brazilian Registry of Clinical Trials: RBR-3jm5y2.

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Sleep bruxism is defined as a behavior that causes masticatory muscle activities during sleep. Sleep bruxism in childhood leads to consequences, which may vary from teeth wear in deciduous dentition to temporomandibular disfunction symptoms. There's no data that demonstrates improvement of children with sleep bruxism during and after auricular acupuncture treatment. Objective: Therefore, this case report series aimed to evaluate the effect of auriculotherapy on children presenting sleep bruxism. Methods: Twelve patients were included in this study, in the mean age of 6,9. The diagnosis was evaluated by the question: "Does your kid grind their teeth while sleeping?". Treatment was performed by an acupuncture specialist in a standardized way. The therapy was given for three weeks and the effect was evaluated through a sleep diary, in which the parents noted whether or not their child grinded teeth while sleeping before (baseline) and during therapy (T1 to T3). Sleep bruxism was categorized as presence or absence of nocturnal teeth grinding and the frequency varied from 0 to 7 (baseline), 0 to 5 (T1), 0 to 7 (T2) and 0 to 4 (T3) between patients. The intensity of the reported sleep bruxism was compared according to the periods by pared T-test ( =0.05). Results: It was observed that the frequency of reports decreased significantly from baseline to T3. Conclusion: These results suggest that ear acupuncture may be an alternative therapy for sleep bruxism in childhood, once it demonstrated to reduce its frequency in this study, although patients may present different effects to therapy due to biological variability.

Introdução: Bruxismo do sono é definido como um comportamento que causa atividades musculares durante o sono. Na infância, leva a consequências que podem variar de desgaste dentário na dentição decídua a sintomas de disfunção temporomandibular. Não há estudos que demonstrem melhora de casos de crianças com bruxismo do sono durante e após tratamento com auriculoterapia. Objetivo: portanto, esta série de casos visou avaliar o efeito da auriculoterapia em crianças apresentando este quadro. Métodos: Doze pacientes foram inclusos neste estudo, com a media de idade de 6,9. O diagnóstico foi avaliado pela pergunta "Seu filho range os dentes quando dorme?". O tratamento foi executado por um especialista em acupuntura de forma padronizada. A terapia foi feita por três semanas e o efeito foi avaliado através de um diário do sono, no qual os pais anotavam se a criança rangeu os dentes enquanto dormia antes (baseline) e durante a terapia (T1 a T3). Bruxismo do sono foi categorizado como presença ou ausência de ranger de dentes e a frequência variou de 0 a 7 (baseline), 0 a 5 (T1), 0 a 7 (T2) e 0 a 4 (T3) entre os pacientes. A intensidade foi comparada de acordo com os períodos pelo teste-T pareado (=0,05). Resultados: Foi observado que a frequência de relatos diminuiu significativamente de baseline a T3. Conclusão: Estes resultados sugerem que auriculoterapia pode ser uma terapia alternativa para o bruxismo do sono na infância, uma vez que demonstrou reduzir sua frequência neste estudo, embora os pacientes possam apresentar efeitos diferentes devido à variabilidade biológica.

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Objective: The study's goal has been to identify in the literature the use of auriculotherapy with needles as an intervention to improve cancer patients' life quality. Methods: It is an Integrative Literature Review of articles published in Portuguese, English, Spanish and/or German, available in full at the databases VHL, CAPES, CINHAL, PubMed, Web of Science and Scopus. The study was carried out in January 2017. The descriptors employed were cancer, neoplasms, auriculotherapy, ear acupuncture, and auricular acupuncture, and six studies were then selected. Results: The use of auricular therapy with needles as interventions in the clinical symptoms due to cancer and its treatment, as well as in the improvement of the domains affected in people's life quality have indicated satisfactory evidence. Conclusion: The evidences have identified an improvement in the quality of life of oncology patients that underwent auriculotherapy with needles, therefore, this intervention is a safe, effective and economical complementary therapy, which is very well accepted by the patients

Objetivo: Identificar na literatura o uso da auriculoterapia com agulhas como intervenção para melhoria da qualidade de vida de pacientes com câncer. Método: Revisão integrativa de artigos publicados em português, inglês, espanhol e/ou alemão, disponíveis na íntegra nas bases de dados BVS, CAPES, CINHAL, PUBMED, WEB of SCIENCE e SCOPUS. A pesquisa ocorreu no período de janeiro de 2017. Foram utilizados os descritores câncer, neoplasia, auriculoterapia, acupuntura orelha e acupuntura auricular, sendo selecionados seis estudos. Resultados: O uso da auriculoterapia com agulhas como intervenções nos sintomas clínicos decorrentes do câncer e de seu tratamento bem como na melhoria dos domínios afetados na qualidade de vida apontou evidências satisfatórias. Conclusão: As evidências identificaram melhora na qualidade de vida de pacientes oncológicos que foram submetidos a auriculoterapia com agulhas e que esta intervenção é uma terapia complementar segura, eficaz e econômica, muito bem aceita pelos pacientes

Objetivo: Identificar la producción disponible relacionada al uso de la acupuntura auricular como intervención para la mejora de la calidad de vida de pacientes con cáncer. Método: Revisión integrativa de literatura con búsqueda en bases electrónicas y bibliotecas virtuales BVS, CAPES, CINHAL, PUBMED, WEB of SCIENCE y SCOPUS En el período de enero de 2017 con los descriptores cáncer, neoplasia, auriculoterapia, acupuntura o acupuntura auricular y acupuntura auricular, la acupuntura auricular y la acupuntura auricular. La revisión integrativa propuesta tuvo lugar en seis etapas distintas y complementarias. Resultados: Se identificaron seis artículos con evidencias satisfactorias de las intervenciones en los síntomas clínicos inherentes al cáncer y su tratamiento que demostraron impactos positivos de la auriculoterapia como intervención. Conclusión: Los estudios relacionados con el tema son escasos, apuntan una realidad científica poco explorada. Un número mayor de estudios clínicos debe ocurrir para fortalecer las evidencias de las intervenciones terapéuticas efectivas, subsidiar la práctica y asegurar asistencia cualificada

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AIMS AND OBJECTIVES: To compare the efficacy of Chinese and French ear acupuncture in people with chronic back pain. BACKGROUND: Chronic back pain is a common public health problem worldwide. An intervention for this condition is ear acupuncture. Several approaches are used for ear acupuncture, particularly the Chinese and French guidelines. METHODS: An open, randomised and controlled clinical trial, followed the recommendations of the CONSORT Checklist. One hundred and eleven people were selected and randomised into three groups: Chinese ear acupuncture, French ear acupuncture and Control. Evaluations were performed before the first intervention session (initial), 1 week after the fifth session (final) and after a fifteen-day follow-up period (follow-up), using the Brief Pain Inventory, Rolland Morris Disability Questionnaire, and a thermal imaging camera. For data analysis, the Generalized Estimating Equation Model was applied, with significance level set at 5%. RESULTS: Pain severity was significantly decreased by Chinese ear acupuncture throughout intervention period. Both types of ear acupuncture affected pain interference with daily activities. However, in the comparison between initial and final evaluations, only Chinese ear acupuncture produced statistically significant results. A reduction in physical disability was observed in both ear acupuncture-treated groups during the intervention period and, although Chinese ear acupuncture failed to induce significant changes in tissular temperature at individual time points, a significant increase in cutaneous temperature was detected after the follow-up period in the dorsal region of individuals treated with Chinese ear acupuncture. Importantly, at this time point, the mean difference between Chinese and French ear acupuncture revealed a more benefic effect of Chinese procedure on this parameter. CONCLUSIONS: The individualised treatment based on the Chinese precepts showed, in an overall evaluation, better results for management of chronic back pain in the present study. RELEVANCE TO CLINICAL PRACTICE: Ear acupuncture can be implemented in the nurse's clinical practice to assist the treatment of people with chronic back pain.

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The National Acupuncture Detoxification Association (NADA)-standardized 3- to 5-point ear acupuncture protocol, born of a community-minded response to turbulent times not unlike today, has evolved into the most widely implemented acupuncture-assisted protocol, not only for substance abuse, but also for broad behavioral health applications. This evolution happened despite inconsistent research support. This review highlights the history of the protocol and the research that followed its development. Promising, early randomized-controlled trials were followed by a mixed field of positive and negative studies that may serve as a whole to prove that NADA, despite its apparent simplicity, is neither a reductive nor an independent treatment, and the need to refine the research approaches. Particularly focusing on the last decade and its array of trials that elucidate aspects of NADA application and effects, the authors recommend that, going forward, research continues to explore the comparison of the NADA protocol added to accepted treatments to those treatments alone, recognizing that it is not a stand-alone procedure but a psychosocial intervention that affects the whole person and can augment outcomes from other treatment modalities.

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As mães de recém-nascidos prematuros vivenciam a ansiedade oriunda da fragilidade e incerteza sobre as condições de vida de seu filho e a convivência com o estressante ambiente hospitalar, com implicações no aleitamento materno. Na tentativa de amenizar esta situação, o objetivo deste estudo foi avaliar o efeito da acupuntura na ansiedade de mães de recém-nascidos de muito baixo peso (RNMBP). Trata-se de um ensaio clínico randomizado realizado em um hospital universitário do norte do Paraná. A pesquisa foi aprovada pelo Comitê de Ética e Pesquisa da instituição na qual foi realizado o estudo e foi submetida a registro em base de dados para ensaios clínicos Australian New Zealand Clinical Trials Registry. Todas as participantes assinaram o Termo de Consentimento Livre e Esclarecido. A coleta de dados ocorreu no Banco de Leite Humano da instituição, entre agosto de 2011 e novembro de 2012. As participantes foram alocadas em dois grupos: grupo acupuntura (GA) e grupo placebo (GP) e receberam sessões semanais de acupuntura auricular chinesa nos pontos Shenmen, Tensão, Ansiedade 1 e 2 e Relaxamento Muscular. A acupuntura placebo foi realizada com agulhas auriculares adaptadas, sem perfurar a pele. Houve cegamento entre as participantes e o estatístico que realizou a análise dos dados. Utilizaram-se o Inventário de Ansiedade Traço-Estado e a mensuração do cortisol salivar, antes e após a intervenção. Participaram do estudo 29 mães de RNMBP, 14 pertencentes ao GA e 15 pertencentes ao GP. A idade das participantes variou entre 16 e 40 anos, com mediana de 27 anos. A maioria tinha escolaridade até o ensino médio (57%), vivia com o companheiro (72%) e possuía trabalho remunerado (65%). Quanto às variáveis de aleitamento materno, 48% relataram experiência prévia com amamentação, sendo que 13% apresentaram intercorrências durante este período. A incidência de aleitamento materno exclusivo entre as participantes, na data da alta do recém-nascido, foi de 76%, nove pertencentes ao GA (64%) e 13, ao GP (87%), sem relevância estatística entre estes valores (p=0,215). Os resultados para o cortisol salivar, antes da intervenção, variaram entre 0,02 e 0,33 ug/dL para o total de participantes, com média de 0,13 para ambos os grupos (DP=0,08). Após a intervenção, ambos os grupos apresentaram média de 0,14 ug/dL (DP=0,12), variando entre 0,02 e 0,49 ug/dL. A diferença média entre as medidas de cortisol salivar, antes e após a intervenção, foi de -0,02 ug/dL (DP=0,11), mostrando que os níveis de cortisol aumentaram após a intervenção em ambos os grupos, sem significância estatística (p=0,480), e contrariando o esperado. Após a intervenção, o escore de ansiedade-estado das participantes teve redução média de oito pontos, não havendo diferença estatística entre os grupos (p=0,888), com a possibilidade de que tanto a acupuntura real quanto a placebo tenham produzido resultados positivos na redução da ansiedade. Sugere-se que estudos com maior amostra e um terceiro grupo controle sejam conduzidos para melhor esclarecer os efeitos da acupuntura para a redução da ansiedade nesta população.(AU)

Mothers of preterm infants experience anxiety due to the child's frail and uncertain health condition. Spending time in a stressful hospital environment has implications to lactation and breastfeeding. In the attempt to diminish this situation, the aim of this study was to assess the effect of acupuncture in mothers with very low birth weight infants (VLBW). This is a randomized, patient-assessor blind, sham-controlled clinical trial, conducted in a school hospital in northern Paraná. This research has been approved by the ethics review board of the institution where it took place. The trial is registered at Australian New Zealand Clinical Trials Registry, number 12611000025932. All participants signed the written informed consent. Data was collected at the institution's Human Milk Bank from August 2011 to November 2012. Subjects were allocated into two groups: acupuncture - AG or placebo-acupuncture - PG and treatment sessions occurred once a week. The Chinese ear acupoints used were Shenmen, Tension, Anxiety 1 and 2, Muscle relaxation. For placebo- acupuncture, custom-designed noninvasive ear needles were used. Participants were submitted to the STAI-Y scale and salivary cortisol measurements before and after treatment. Twenty-nine mother's with VLBW infants took part in the study (GA = 14, GP = 15). Participants' age ranged from 16 to 40, median age was 27 years old. Most subjects had high school educational levels (57%); lived with their partners (72%) and had paid jobs (65%). 48% mothers had previous experiences with breastfeeding and 13% mentioned some problems while doing so. Exclusive breastfeeding rate at infant's hospital discharge was 76%, AG = 9 (64%), PG = 13 (87%), not significant (p=0,215). Salivary cortisol levels before intervention ranged from 0,02 to 0,33 ug/dL and both groups presented mean 0,13 ug/dL (SD = 0,08). After treatment both groups had 0,14 ug/dL (SD = 0,12) mean levels, with a 0,02 - 0,49 ug/dL range. Mean difference between salivary cortisol levels before and after treatment was -0,02 ug/dL (SD = 0,11), showing increase in cortisol levels after treatment for both groups, not significant and contrary to expected. After treatment, mean STAI-Y1 (state) scores dropped 8 points, not significant between groups (p=0,888). This result indicate that both real and placebo acupuncture may have produced positive effects in anxiety reduction. We suggest other studies are conducted with bigger sample sizes and that include a third arm with routine care as control group to better understand the effects of acupuncture for anxiety in this population.(AU)

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Se realizó un estudio de dos grupos de 30 pacientes cada uno, el grupo 1 se trató con aurículoterapia solamente y en el grupo 2 combinamos la aurículoterapia con la tuina. Logramos que el 65 % evolucionara favorablemente y el resto (35 %) obtuvo alguna mejoría, lo que confirmó la eficacia del tratamiento. La edad que predominó fue entre los 45 y 54 años, para un 70 %, el dolor disminuyó su intensidad en el 98% y el ángulo de movimientos aumentó en todos los pacientes tratados. Los resultados indican que ambos tratamientos son inocuos, útiles, eficaces y económicos, pues con el tratamiento combinado (grupo 2) se obtuvo éxito terapéutico a partir de la cuarta sesión, mientras que con aurículoterapia sola se alcanzó a partir de la séptima sesión. No hubo reacciones adversas en ninguno de los dos métodos de tratamiento.

A study of two groups of 30 patients each of them was carried out, group 1 was treated with auriculotherapy only and in group 2 we combined auriculotherapy with tuina. We found that 65 % evolved favorably and the remaining (35 %) had some improvement, which confirmed the effectiveness of treatment. The prevailing age was among 45 and 54 years for 70 % pain reduced its intensity in 98 % and the movement angle increased in all patients treated. Results indicate that both treatments are innocuous, useful, effective and economic, because with combined treatment (group 2), a therapeutic success was obtained from fourth sessions, while with auricolotherapy alone it was in the seventh. These were no adverse reactions in any of the two treatment methods.