Table 1.
Characteristics of the included studies.
| Study (year) | Country | Population | Modified Jadad score | Sample size | Characteristics of participants (gender, age) | Intervention group treatment | Control group treatment | Frequency/treatment course | Main outcome | Adverse effect |
|---|---|---|---|---|---|---|---|---|---|---|
| Allison et al. (1995) [20] | USA | Obese adults | 5 | 96 | 16 M/80 F 41.1 |
AA device (Acu-Stop 2000) on dominant ear, massaged, 4 times a day | Subjects received wrist acupressure device in dominant side massaged, 4 times a day | Every 2 wks/12 wks | (1) BW, BF, BFM (2) BP (3) Compliance |
3 bleeding ears in treatment group |
|
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| Shafshak (1995) [21] | Egypt | Obese female adults | 3 | 30 | 0 M/30 F 21–35 |
Stainless needle AA with ES to AP1 or AP2. ES duration = 25 mins AP1: CO4 AP2: HG |
Stainless needle AA with ES to sham AP on ear ES duration = 25 mins |
Every day/3 wks | BW | NR |
|
| ||||||||||
| Richards and Marley (1998) [22] | Australia | Overweight adults | 7 | 60 | NR >18 |
ES with AcuSlim device to AP ES duration = 15–20 mins AP: CO4, TF4 |
ES with AcuSlim device to thumb (without AP) ES duration = 15–20 mins |
Twice daily/4 wks | (1) BW∗ (2) Appetite change∗ |
NR |
|
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| Hsu et al. (2009) [23] | Taiwan | Obese female adults | 7.5 | 45 | 0 M/45 F 39.5 ± 12.0 |
Stainless steel needle (0.2 cm needle point) to AP; no apply any pressure to AP AP: CO4, CO18, HG, TF4 |
Sham AA using placebo needles (without needle point) AP: CO4, CO18, HG, TF4 |
Twice a wk/6 wks | (1) BW, BMI, WC, HC (2) FBG, TG, TCH, HDL-C, LDL-C (3) Insulin, leptin, adiponectin, ghrelin, HOMA-IR |
1 mild inflammation; 9 mild tenderness cases |
|
| ||||||||||
| Hsieh (2010) [24] | Taiwan | Overweight adolescents | 4 | 84 | 8 M/76 F 18–20 |
Auricular acupressure to Japanese Magnetic Pearl or Vaccaria seeds | Acupressure tape (0.5∗0.5 cm) on ear | NR/8 wks | (1) BMI (2) TCH, TG, HDL-C, LDL-C |
NR |
|
| ||||||||||
| Hsieh et al. (2011) [26] | China | Overweight adults | 3 | 200 | NR 18–65 |
Vaccaria seeds to AP; applied pressure to each AP for 30–50 times before eating AP: CO4, CO17, CO18, TF4 |
Needle AA on sham AP on the body | Every two days/12 wks | (1) BW, BMI, BF (2) TCH, TG (3) FINS, HOMA-IR |
NR |
|
| ||||||||||
| Hsieh et al. (2011) [25] | Taiwan | Young adults with abdominal obesity | 4 | 55 | 5 M/50 F 18–20 |
Acupressure with Japanese Magnetic Pearl on AP AP: CO1, CO4, CO6, CO18, TF4 |
Adhesive tape to AP AP: CO1, CO4, CO6, CO18, TF4 |
NR/8 wks | BW, WC | NR |
|
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| Abdi et al. (2012) [27] | Iran | Overweight adults | 4 | 169 | NR 38 |
Ear pressing plaster with seed to AP Apply pressure to AP before eating for 20 sec AP: CO1, CO4, CO17, HG, HX1, TF4 |
Ear pressing plaster without seed to sham AP AP: AH5, CO2, CO13 |
Twice a wk/12 wks | (1) BW∗, BMI∗, BF∗, WC∗, HC∗, WHR (2) FBG, TCH, TG, HDL-C, LDL-C, hs-CRP (3) Anti-HSP27∗, Anti-HSP60∗, Anti-HSP65∗, anti-HSP70∗ |
No adverse effect |
|
| ||||||||||
| Ching et al. (2012) [28] | Taiwan | Overweight schizophrenia patients | 7.5 | 72 | 33 M/39 F 47.8 |
Vaccaria seeds to AP. Apply pressure to AP before eating Each AP for 1 min AP: CO4, CO18, HG, TF4 |
Surgical tape to AP. AP points were not pressed AP: CO4, CO18, HG, TF4 |
Twice a wk/8 wks | BW, BMI, BF | NR |
|
| ||||||||||
| Darbandi et al. (2012) [29] | Iran | Overweight adults | 6 | 86 | 12 M/74 F 37.7 ± 9.5 |
Vaccaria seeds to AP. Apply pressure to AP before eating AP: CO1, CO4, CO17, HG, HX1, TF4 |
Ear plaster without seeds to AP AP: AH5, CO2, CO13, Nose |
Twice a wk/6 wks | (1) BW, BMI, BFM (2) Leptin∗ |
No adverse effect |
|
| ||||||||||
| He et al. (2012) [30] | China | Obese female adults | 4.5 | 60 | 0 M/60 F 34 |
Vaccaria seeds to AP. Apply pressure on each seed for 30 secs/day AP: CO4, CO7, CO13, CO18, HG, TF4 |
No AA | Every three days/4 wks | BW, BMI, WC | NR |
|
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| Lien et al. (2012) [31] | Taiwan | Obese female adults | 7.5 | 71 | 0 M/71 F 40.7 ± 11.3 |
Apply stainless needles with a 0.2 cm tip or magnetic metal beads to AP AP: CO4, CO18, HG, TF4 |
Sham AA to AP with auricular needle with tips removed (needle without needle points) AP: CO4, CO18, HG, TF4 |
Three times a wk/4 wks | (1) BW, BMI, WC, HC, WHR (2) FBG, TG, TCH, HDL-C, LDL-C (3) Adiponectin, insulin, ghrelin, Leptin, HOMA-IR (4) WHO BREF life-quality scores |
1 account of dizziness after AA |
|
| ||||||||||
| Darbandi et al. (2014) [32] | Iran | Obese male adults | 7.5 | 40 | 40 M 38.5 |
Vaccaria seeds to AP on both ears for 3 days. Apply pressure to AP before eating AP: CO1, CO4, CO17, HG, HX1, TF4 |
Sham AA with plasters to AP on both ears for 3 days. Apply pressure to AP before eating AP: CO2, CO13, AH5 |
Twice a wk/6 wks | BW, BMI, BFM, HC | No adverse effect |
|
| ||||||||||
| Kim et al. (2014) [33] | South Korea | Obese female young adults | 5 | 49 | 0 M/49 F 20.7 ± 1.1 |
Three Sinapis alba seeds to each AP. Apply pressure to AP for 5 secs ∗ 10 times/point, three courses/day AP: CO1, CO4, CO6, TF4 |
NO AA | Weekly/4 wks | (1) BW∗, BMI∗, BF, WHR (2) Self-efficacy scale∗ |
NR |
|
| ||||||||||
| Schukro et al. (2014) [34] | Austria | Obese female individuals | 7 | 42 | 0 M/42 F | ES with a P-Stim device AP: CO4, CO7, HG |
P-Stim® dummy (no power supply) AP: CO4, CO7, HG |
Weekly/6 wks | BW∗, BMI∗, BF | NR |
|
| ||||||||||
| Yeo et al. (2014) [35] | South Korea | Overweight adults | 6.5 | 58 | 6 M/52 F 38.6 ± 11.8 |
Acupuncture needle on AP1 or AP2 AP1: CO1, CO4, CO6, CO18, HX1; AP2: HG |
Sham AA, removed immediately after insertion; AP: CO1, CO4, CO6, CO18, HX1 | Weekly/8 wks | (1) BW∗, BMI∗, WC∗, BFM∗, BF (2) BP |
NR |
|
| ||||||||||
| Yeh et al. (2015) [36] | Taiwan | Obese adults | 7.5 | 70 | 35 M/35 F 31.3 ± 8.8 |
ES to AP and then apply pressure to each AP with Vaccaria seeds for 1 min ∗ 4 times/day AP: CO4, CO18, HG, TF4 |
ES to sham AP. Apply pressure to each AP with Vaccaria seeds for 1 min ∗ 4 times/day AP: AH3, SF3, SF4, SF6 |
Weekly/10 wks | (1) BMI (2) BP, TCH, TG (3) Adiponectin, leptin |
NR |
|
| ||||||||||
| Hsu (2016) [37] | China | Overweight adults | 3 | 120 | 73 M/47 F 38.7 ± 10.0 |
Vaccaria seeds to AP on each ear alternating every 2 days AP: CO17, CO18, HG, TF4 |
Needle AA to sham AP on body | Every 2 days/12 wks | (1) BW, BMI, BF (2) TCH, TG (3) FINS, HOMA-IR |
NR |
Values are expressed as the mean ± standard deviation. ∗P < 0.05 between treatment and control groups; AA: auricular acupuncture; anti-HSP: anti-heat shock protein; AP: auricular acupoint; BF: body fat percentage; BFM: body fat mass; BMI: body mass index; BP: blood pressure; BW: body weight; ES: electrical stimulation; F: female; FBG: fasting blood glucose; FINS: fasting insulin; HC: hip circumference; HDL-C: high-density lipoprotein cholesterol; HOMA-IR: homeostasis model assessment for insulin resistance; HR: heart rate; hs-CRP: high-sensitivity C-reactive protein; LDL-C: low-density lipoprotein cholesterol; M: male; min: minutes; NR: not reported; sec: second; TCH: total cholesterol; TG: triglycerides; WC: waist circumference; WHR: waist-to-hip ratio; wk: week; acupoints: ankle (AH3), hip (AH5), mouth (CO1), esophagus (CO2), stomach (CO4), small intestine (CO6), large intestine (CO7), spleen (CO13), San Jiao (CO17), endocrine (CO18), hunger point (HG), center of ear (HX1), elbow (SF3), shoulder (SF4), clavicle (SF6), Shen Men (TF4).