School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong).
Alice Lee Centre for Nursing Studies, Yoog Loo Lin School of Medicine, National University of Singapore, Singapore.
JMIR Mhealth Uhealth. 2019 May 29;7(5):e14386. doi: 10.2196/14386.
Obesity is a common global health problem and increases the risk of many chronic illnesses. Given the adverse effects of antiobesity agents and bariatric surgeries, the exploration of noninvasive and nonpharmacological complementary methods for weight reduction is warranted.
The study aimed to determine whether self-administered auricular acupressure (AA) integrated with a smartphone app was more effective than using AA alone or the controls for weight reduction.
This study is a 3-arm randomized waitlist-controlled feasibility trial. A total of 59 eligible participants were randomly divided into either group 1 (AA group, n=19), group 2 (AA plus smartphone app, n=19), or group 3 (waitlist control, n=21). A total of 6 reflective zones or acupoints for weight reduction were chosen. The smartphone app could send out daily messages to the subjects to remind them to perform self-pressing on the 6 ear acupoints. A "date picker" of the 8-week treatment course was used to enable the users to input the compliance of pressing and the number of bowel movement daily instead of using the booklet for recordings. The app also served as a reminder for the subjects regarding the dates for returning to the center for acupoint changing and assessments. Treatment was delivered 2 times a week, for 8 weeks. Generalized estimating equations were used to examine the interactions among the groups before and after intervention.
Subjects in group 2 expressed that the smartphone app was useful (7.41 out of 10). The most popular features were the daily reminders for performing self-pressing (88%), the ear diagram indicating the locations and functions of the 6 ear points (71%), and ear pressing method demonstrated in the video scripts (47%). Nearly 90% of the participants completed the 8-week intervention, with a high satisfaction toward the overall arrangement (8.37 out of 10). The subjects in group 1 and 2 achieved better therapeutic effects in terms of body weight, body mass index (BMI), waist circumference, and hip circumference and perceived more fullness before meals than the waitlist controls. Although no significant differences in the pairwise comparisons between the 2 groups were detected (P>.05), the decrease in body weight, BMI, body fat, visceral fat rating and leptin level, and increase in adiponectin level were notable in group 2 before and after the intervention.
The high compliance rate and high satisfaction toward the trial arrangement indicate that AA can be used to achieve weight reduction and applied in future large-scale studies. AA integrated with the smartphone app has a more notable effect than using AA alone for weight reduction. Larger sample size should be considered in future trials to determine the causal relationship between treatment and effect.
ClinicalTrials.gov NCT03442712; https://clinicaltrials.gov/ct2/show/NCT03442712 (Archived by WebCite at http://www.webcitation.org/78L2tO8Ql).
肥胖是一个普遍的全球健康问题，增加了许多慢性疾病的风险。鉴于抗肥胖药物和减肥手术的不良反应，有必要探索非侵入性和非药物性的减肥方法。
本研究旨在确定自我实施耳压（AA）与智能手机应用程序相结合是否比单独使用 AA 或对照组更有效减肥。
这是一项 3 臂随机候补对照可行性试验。共有 59 名符合条件的参与者被随机分为 3 组：第 1 组（AA 组，n=19）、第 2 组（AA 加智能手机应用程序组，n=19）或第 3 组（候补对照组，n=21）。共选择了 6 个用于减肥的反射区或穴位。智能手机应用程序可以每天向受试者发送消息，提醒他们按压 6 个耳部穴位。使用“日期选择器”设置 8 周治疗疗程，以便用户输入按压的依从性和每日排便次数，而不是使用小册子进行记录。该应用程序还可以提醒受试者关于返回中心更换穴位和评估的日期。每周治疗 2 次，持续 8 周。使用广义估计方程检验干预前后组间的相互作用。
第 2 组的受试者表示智能手机应用程序很有用（10 分制得 7.41 分）。最受欢迎的功能是每日自我按压提醒（88%）、6 个耳部穴位位置和功能的耳部示意图（71%）以及视频脚本中演示的耳部按压方法（47%）。近 90%的参与者完成了 8 周的干预，对整体安排的满意度很高（10 分制得 8.37 分）。第 1 组和第 2 组的受试者在体重、体重指数（BMI）、腰围和臀围方面的治疗效果更好，并且在饭前感觉更饱。尽管在组间比较中未发现显著差异（P>.05），但在干预前后，第 2 组的体重、BMI、体脂肪、内脏脂肪评分和瘦素水平降低，脂联素水平升高。
高依从率和对试验安排的高满意度表明，AA 可用于减肥，并可应用于未来的大规模研究。与单独使用 AA 相比，AA 与智能手机应用程序相结合对减肥有更显著的效果。在未来的试验中，应考虑更大的样本量来确定治疗与效果之间的因果关系。
ClinicalTrials.gov NCT03442712；https://clinicaltrials.gov/ct2/show/NCT03442712（由 WebCite 存档；http://www.webcitation.org/78L2tO8Ql）。
