Acupuncture combined with auriculotherapy as adjunctive therapy for hyperemesis gravidarum: A randomized controlled trial evaluating hospital stay, relapse rate, and quality of life.

OBJECTIVE

To evaluate the efficacy of acupuncture combined with auricular therapy as an adjunct to standard fluid resuscitation in patients with hyperemesis gravidarum (HG).

METHODS

A total of 122 HG patients were randomly assigned to the acupuncture combined (AC) group (n = 61) or standard fluid (SF) group (n = 61). The SF group received conventional fluid replacement alone, while the AC group received acupuncture and auricular therapy in addition to fluid resuscitation. Primary outcomes included the Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) score, the Functional Living Index-Emesis (FLIE) score (total and subscores), serum potassium, length of hospital stay, and recurrence frequency; secondary outcomes included the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores. Within-group changes and between-group differences were analyzed using paired t-tests and analysis of covariance (ANCOVA) or Mann-Whitney U tests, respectively.

RESULTS

Both groups exhibited significant within-group improvements in PUQE, FLIE, nausea, vomiting, SAS and SDS scores (all p < 0.001), with no meaningful change in serum potassium. Post-treatment between-group comparisons, assessed by analysis of covariance adjusted for baseline values, showed significant advantages for adjuvant acupuncture combined with auriculotherapy in total FLIE score (adjusted mean difference -4.11, 95%CI -8.15 to -0.07, p = 0.046), nausea subscore (adjusted mean difference -2.11, 95%CI -4.01 to -0.22, p = 0.029), SAS (adjusted mean difference -1.04, 95%CI -2.07 to -0.01, p = 0.049) and SDS (adjusted mean difference -1.61, 95%CI -3.12 to -0.10, p = 0.037), but no significant differences in PUQE, vomiting subscore or serum potassium. The AC group had a shorter median hospital stay (4 vs 6 days, p = 0.041) and lower recurrence frequency (0.15 ± 0.441 vs 0.39 ± 0.759, p = 0.048). The proportion of participants with recurrence was 11.48% in the AC group and 24.59% in the SF group, with no significant difference (p = 0.068).

CONCLUSION

While standard fluid resuscitation effectively relieves the core symptoms of HG, adjunctive acupuncture combined with auriculotherapy provided additional benefits regarding quality of life, psychological status, hospital stay, and recurrence frequency, although no significant intergroup difference was observed in post-treatment PUQE scores or the proportion of patients experiencing HG recurrence. This combined intervention may serve as a safe and valuable adjunctive strategy for HG management. Further sham-controlled trials are required to distinguish specific treatment effects from non-specific contextual factors.