title: Efficacy of auriculotherapy for constipation in adults: a systematic review and meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  To assess the clinical evidence of auriculotherapy for constipation treatment and to identify the efficacy of groups using Semen vaccariae or magnetic pellets as taped objects in managing constipation.
  
  
  METHODS
  Databases were searched, including five English-language databases (the Cochrane Library, PubMed, Embase, CINAHL, and AMED) and four Chinese medical databases. Only randomized controlled trials were included in the review process. Critical appraisal was conducted using the Cochrane risk of bias tool.
  
  
  RESULTS
  Seventeen randomized, controlled trials (RCTs) met the inclusion criteria, of which 2 had low risk of bias. The primary outcome measures were the improvement rate and total effective rate. A meta-analysis of 15 RCTs showed a moderate, significant effect of auriculotherapy in managing constipation compared with controls (relative risk [RR], 2.06; 95% confidence interval [CI], 1.52- 2.79; p<0.00001). The 15 RCTs also showed a moderate, significant effect of auriculotherapy in relieving constipation (RR, 1.28; 95% CI, 1.13-1.44; p<0.0001). For other symptoms associated with constipation, such as abdominal distension or anorexia, results of the meta-analyses showed no statistical significance. Subgroup analysis revealed that use of S. vaccariae and use of magnetic pellets were both statistically favored over the control in relieving constipation.
  
  
  CONCLUSIONS
  Current evidence illustrated that auriculotherapy, a relatively safe strategy, is probably beneficial in managing constipation. However, most of the eligible RCTs had a high risk of bias, and all were conducted in China. No definitive conclusion can be made because of cultural and geographic differences. Further rigorous RCTs from around the world are warranted to confirm the effect and safety of auriculotherapy for constipation.
authors.affiliation: 1 Department of Oncology, Hospital Affiliated to Nanjing University of Traditional Chinese Medicine , Nanjing, China .
authors.forename: Li-Hua
authors.initials: LH
authors.lastname: Yang
authors.forename: Pei-Bei
authors.initials: PB
authors.lastname: Duan
authors.forename: Shi-Zheng
authors.initials: SZ
authors.lastname: Du
authors.forename: Jin-Fang
authors.initials: JF
authors.lastname: Sun
authors.forename: Si-Juan
authors.initials: SJ
authors.lastname: Mei
authors.forename: Xiao-Qing
authors.initials: XQ
authors.lastname: Wang
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055097:Auriculotherapy; D003248:Constipation / Q000628:therapy*; D005260:Female; D006801:Humans; D055909:Magnetic Field Therapy; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult