Auricular Point Acupressure Therapy: A Safe and Effective Treatment for Postsurgical Abortion Recovery

Summary

This protocol details auricular plaster therapy using Vaccaria seeds on specific acupoints to promote recovery after surgical abortion. As a non-pharmacological adjunct to conventional treatment, it reduces vaginal bleeding duration, alleviates symptoms, and accelerates menstrual cycle restoration, demonstrating both safety and efficacy in clinical application.

Abstract

Infections, vaginal bleeding, and menstrual irregularities are common complications following abortion procedures, which significantly impact the quality of life for patients. Clinical treatments, such as antibiotics to prevent infection and nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief, can alleviate symptoms and reduce the occurrence of complications. Auricular point acupressure therapy involves the application of round, firm, and smooth herbal seeds to specific auricular acupoints (reaction areas), which are then massaged to promote blood circulation, regulate autonomic nervous function and hormone levels, and restore hormonal balance in the body. The proposed approach in this article combines auricular point acupressure with conventional treatments to facilitate post-abortion recovery. Research results indicate that auricular point acupressure therapy effectively improves adverse reactions after abortion, establishes a regular menstrual cycle, and promotes the restoration of reproductive function. Overall, this is a safe, simple, effective, and cost-efficient alternative method that healthcare professionals can easily administer under appropriate guidance, or patients can manage themselves, providing a potential solution for alleviating discomfort following abortion procedures.

Introduction

Surgical abortion is a common remedial measure following contraceptive failure and is one of the primary methods for early termination of pregnancy. Globally, approximately 73 million induced abortions (IA) occur annually, with 61% of unintended pregnancies and 29% of all pregnancies ending through surgical abortion¹. This trend has shown a rising incidence in recent years due to changing reproductive attitudes and social perceptions of fertility².

As an invasive intrauterine procedure, surgical abortion can lead to a variety of short- and long-term complications, including abdominal pain, excessive or prolonged vaginal bleeding, and intrauterine infection, as well as menstrual irregularities, intrauterine adhesions, pelvic inflammatory disease, and infertility. These complications can seriously affect women's physical and psychological health³. Therefore, effective control of postoperative bleeding, prevention of infection, and promotion of reproductive function recovery are essential for improving postoperative outcomes.

Conventional postoperative management typically includes antibiotics for infection prevention, nonsteroidal anti-inflammatory drugs (NSAIDs) for pain control, and hormonal therapy to regulate the menstrual cycle and support uterine recovery⁴. However, these approaches may be associated with adverse effects such as antibiotic resistance, gastrointestinal irritation or renal impairment caused by NSAIDs, and thromboembolic risks resulting from hormonal imbalance^5,6,7. As a result, postoperative patients often face the dual challenges of side effects and treatment-related burden.

Auricular acupressure therapy, a traditional and characteristic modality in Chinese medicine, offers a non-pharmacological, cost-effective, and practical alternative for postoperative recovery. This technique involves applying medicinal seeds -- most commonly Semen Vaccariae (the dried mature seeds of Vaccaria hispanica, a Caryophyllaceae plant) -- to specific auricular acupoints. These seeds are traditionally believed to promote blood circulation, relieve pain, and reduce local swelling. By pressing or massaging the attached seeds, stimulation is transmitted through meridians to regulate the function of internal organs, harmonize the flow of Qi and blood, and alleviate pain^8,9. Treatment usually begins immediately after surgery or on the first postoperative day and continues for five to seven days. Patients are instructed to press the seeds two to three times daily for one to five minutes per session, with the duration adjusted according to recovery progress. However, this therapy is contraindicated in individuals with ear diseases, severe systemic disorders such as cardiac or hepatic-renal dysfunction, serious postoperative complications, or allergies to treatment materials.

Auricular acupressure therapy is often used in combination with other therapeutic modalities and has demonstrated significant efficacy in gynecological disorders such as dysmenorrhea, menstrual irregularities, and perimenopausal syndrome. Building on this foundation, our research team applied auricular acupressure to postoperative care following surgical abortion and observed promising outcomes. This article provides a detailed description of the therapeutic procedure and key considerations to facilitate its standardized clinical application

Protocol

All procedures of this study were conducted in accordance with clinical trial registration and approved by the Ethics Committee of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine (Approval No. 2022SL-015). All patients involved in the study provided informed consent for the use of data, images, and related videos by the researchers during the trial period.

1. Patient selection

1. Inclusion criteria
   1. Confirm early intrauterine pregnancy (gestational age ≤ 10 weeks) and confirm that the patient has undergone surgical abortion.
   2. Ensure the patient has been informed about the study, signed informed consent, and is willing to complete the intervention process.
   3. Confirm the absence of ear infections, trauma, or other auricular diseases that may interfere with therapy.
2. Exclusion criteria
   1. Exclude patients with serious systemic diseases such as severe heart disease, liver or kidney dysfunction, or malignancies.
   2. Exclude patients who experience severe complications after abortion, such as uterine perforation or post-operative infections.
   3. Exclude patients with known allergies to the study's materials or medications.
   4. Exclude patients with severe cognitive or communication disorders.
3. Exclusion, dropout, and termination criteria
   1. Exclude patients who deviate from the treatment protocol, have incomplete data, or receive conflicting treatments during the trial.
   2. Consider as dropouts those lost to follow-up or who voluntarily withdraw after enrollment.
   3. Terminate patients from the study if severe adverse events occur.

2. Preparation before treatment

1. Prepare the materials (see Figure 1 and Table of Materials). Gather a metal probe, forceps, sterile cotton swabs, 75% alcohol, and auricular point adhesive (Vaccaria segetalis seeds on 0.5 cm × 0.5 cm medical tape).
2. Prepare the patient. Seat the patient comfortably in a relaxed position with ears fully exposed.
3. Ensure the practitioner disinfects hands and inspects the patient's auricular skin. Proceed only if no redness, swelling, or ulceration is observed.
   NOTE: If allergic to adhesive tape, use an alternative. Do not initiate treatment if auricular abnormalities are present.

3. Experimental procedures

1. Auricular acupoint operation
   1. Select six acupoints: Liver (CO12), Spleen (CO13), Kidney (CO10), Uterus (TF2), Ovary (AT4), and Endocrine (CO18) (see Figure 2).
   2. Massage both front and back of the auricle 3-5x, from earlobe to apex (front), and apex to earlobe (back), until both ears are reddened (Figure 3).
      NOTE: Massage promotes Qi and blood flow in auricular points.
   3. Locate sensitive acupoints. Pull the auricle upward and backward to expose the selected acupoint zones. Use the probe to detect sensitive points and mark them (Figure 3).
      NOTE: Sensitive points elicit more pain or tenderness and are therapeutically preferable. If none found, use standard point locations.
2. Auricular point acupressure treatment
   1. Disinfect the auricle with a sterile cotton swab dipped in 75% alcohol to clean the treatment area (Figure 3). Wait until dry.
      NOTE: Alcohol enhances adhesion by removing skin oils. Use iodine tincture if allergic.
   2. Expose the treatment area. Ensure the auricle is fully visible and clean (Figure 3).
   3. Use forceps to place the Vaccaria seed adhesive precisely at the marked acupoint. Confirm placement with the patient (Figure 3).
   4. Press and knead the seed adhesive between the thumb and index finger from both sides of the auricle (Figure 3). Maintain a steady rhythm until the patient feels soreness, numbness, fullness, pain, or warmth.
      NOTE: These sensations indicate "De Qi," which reflects effective stimulation. Monitor patient comfort.
   5. Ask the patient to press each acupoint for 1-2 min, 3x daily (morning, afternoon, evening) for 5 consecutive days.
3. Postoperative care and adverse reaction management
   1. Keep the ear clean and dry. Replace the adhesive if it detaches.
      NOTE: The adhesive does not interfere with activities like bathing.
   2. Offer emotional support to reduce anxiety.
   3. If pain occurs, advise reducing pressure. Remove the adhesive if pain is severe.
   4. If redness, itching, or exudation appears, remove the adhesive and apply topical antihistamine if needed.
   5. If the patient experiences dizziness, chest tightness, or sweating, stop treatment immediately, monitor vitals, and administer appropriate care.
4. Observation indicators and evaluation criteria
   1. Record the duration and volume of postoperative vaginal bleeding.
   2. Assess menstrual status by tracking the time to first menses, duration, and volume. Criteria are >50% change from baseline volume defines increase/decrease.
   3. Evaluate TCM symptoms and signs, and monitor dizziness, fatigue, palpitations, sweating, abdominal/lumbar discomfort, and assess complexion, tongue, pulse.
   4. Record complications. Track infections, need for repeat curettage, or other adverse events.
      NOTE: Use the PBAC chart to assess menstrual and bleeding volume.
5. Data processing
   1. Data collection: Conduct all assessments by trained researchers using a double-entry method to ensure data accuracy.
   2. Statistical analysis
      1. For normally distributed continuous data, express results as mean ± standard deviation (SD) and perform paired t-tests for within-group comparisons and independent sample t-tests for between-group comparisons. If variances are unequal, apply the t′ test for between-group comparisons.
      2. For non-normally distributed continuous data, express results as median (P25, P75) and use the Wilcoxon rank-sum test for between-group comparisons.
      3. For categorical data, present results as frequencies and percentages and perform chi-square tests for between-group comparisons.
      4. Use paired t-tests for pretreatment and posttreatment comparisons. Apply two-tailed hypothesis testing and consider differences statistically significant at P < 0.05.

Results

In this clinical study, routine B-ultrasound was performed preoperatively to determine the gestational age and the location of the pregnancy sac. Electrocardiogram (ECG), blood and urine routine tests, and vaginal discharge examinations were conducted, and if no abnormalities were detected, the patients proceeded with the surgical abortion. A total of 216 subjects were enrolled in the study.

The patients had been randomly divided into a control group and a treatment group, with 108 patients in...

Discussion

Abortion is an effective method for terminating an unintended pregnancy, encompassing both medical and surgical options. Among these, vacuum aspiration (VA) is the most commonly used and recommended surgical procedure for early pregnancy termination. This method involves the insertion of a rigid or flexible plastic cannula through the cervix to evacuate the uterine contents under negative pressure¹¹. VA includes two approaches: manual vacuum aspiration (MVA) and electric vacuum aspiration (EVA). A...

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
alcohol (75%)	Sichuan Jianwei Medical & Health Supplies Co., Ltd.	Sichuan (Deyang) Health and Disinfection Approval No. [2014]00005
cefdinir capsules, oral	Chengdu Beite Pharmaceutical Co., Ltd., National Drug Approval No. H20203295
metal probe	Hengshui Dezheng Co., Ltd	Auricular Probe
SPSS version 26.0		statistical analysis software
sterile cotton swabs	Hebei Kangji Pharmaceutical & Medical Device Co., Ltd.	Medical Device Registration No. 20192140022
tweezers	Beiruo Wei Medical Co., Ltd.	Su Su Medical Device Registration No. 20239043
vaccaria seeds	China Herb Co.	VH-2025