Association of auricular reflective points and the status of lower urinary tract symptoms in aging males

Figures & data

Figure 1. Selected auricular acupoints associated with lower urinary tract symptoms.

Table 1. Socio-demographic data and LUTS-related conditions of participants.

	LUTS +ve (n = 69)	LUTS –ve (n = 44)	Test statistics
Age (years)	74.36 (7.59)	70.93 (6.43)	Mann–Whitney U-test p < 0.05*
Comorbid Illness			X^2 = 0.84
No	20	12	df = 1
Yes	49	32	p > 0.05
International Prostate Symptoms Score (IPSS)
Incomplete emptying
0 = Not at all	19	34	p < 0.001*
1 = Less than 1 time in 5	12	5
2 = Less than half the time	7	0
3 = About half the time	6	2
4 = More than half the time	3	2
5 = Almost always	22	1
Frequency
0 = Not at all	13	38	p < 0.001*
1 = Less than 1 time in 5	8	4
2 = Less than half the time	2	0
3 = About half the time	10	1
4 = More than half the time	5	1
5 = Almost always	31	0
Intermittency
0 = Not at all	40	40	p < 0.001*
1 = Less than 1 time in 5	10	6
2 = Less than half the time	7	0
3 = About half the time	5	0
4 = More than half the time	7	0
5 = Almost always	18	2
Urgency
0 = Not at all	39	36	p < 0.001*
1 = Less than 1 time in 5	8	3
2 = Less than half the time	3	1
3 = About half the time	3	0
4 = More than half the time	2	1
5 = Almost always	14	3
Weak stream
0 = Not at all	34	38	p < 0.001*
1 = Less than 1 time in 5	7	3
2 = Less than half the time	5	2
3 = About half the time	3	0
4 = More than half the time	4	0
5 = Almost always	16	1
Straining
0 = Not at all	48	43	p<0.001*
1 = Less than 1 time in 5	7	1
2 = Less than half the time	4	0
3 = About half the time	4	0
4 = More than half the time	1	0
5 = Almost always	5	0
Nocturia
0 = Not at all	2	10	p < 0.001*
1 = Less than 1 time in 5	6	21
2 = Less than half the time	25	7
3 = About half the time	18	4
4 = More than half the time	14	2
5 = Almost always	4	0
Overall IPSS score (cases were 8 or above)	14.64 (5.93)	3.09 (2.84)	p < 0.001*
Maximum urinary flow rate (Qmax)
(cases were <15 mL/second)	8.40 (3.45)	17.94 (14.77)	p < 0.001*
Quality of life (7 levels)
0 = Delighted	0	6	p < 0.001*
1 = Pleased	3	3
2 = Mostly satisfied	10	24
3 = Mixed	30	9
4 = Mostly dissatisfied	16	2
5 = Unhappy	7	0
6 = Terrible	3	0

Fisher's exact test was used if the expected values in any of the cells of a contingency table are below 5, or below 10 when there is only one degree of freedom.

*Statistically significant.

Table 2. Auricular signals between cases and controls assessed by electrical skin resistance measurement (conductivity) and tenderness testing.

	LUTS +ve (n = 69)	LUTS –ve (n = 44)	Test statistics (chi-square test or Fisher's exact test)†
Electrical skin resistance measurement (conductivity)
Right ear
Angle of superior concha
positive	18	25	p < 0.01*
negative	51	19
Urinary bladder
positive	20	22	p < 0.05*
negative	49	22
Ureter
positive	23	24	p < 0.05*
negative	46	20
Kidney
positive	24	30	p < 0.001*
negative	45	14
Urethra
positive	28	24	p>0.05
negative	41	20
Internal genitalis
positive	28	28	p < 0.05*
negative	41	16
Left ear
Angle of superior concha
positive	21	26	p < 0.01*
negative	48	18
Urinary bladder
positive	25	25	p < 0.05*
negative	44	19
Ureter
positive	30	27	p>0.05
negative	39	17
Kidney
positive	26	26	p < 0.05*
negative	43	18
Urethra
positive	26	24	p>0.05
negative	43	20
Internal genitalis
positive	26	28	p < 0.05*
negative	43	16
Tenderness testing
Right ear
Angle of superior concha
positive	33	30	p>0.05
negative	32	11
Equal	4	3
Urinary bladder
positive	34	25	p>0.05
negative	31	14
Equal	4	5
Ureter
positive	32	22	p < 0.01*
negative	34	19
Equal	3	3
Kidney
positive	35	21	p < 0.001*
negative	27	22
Equal	7	1
Urethra
positive	35	22	p < 0.05*
negative	30	19
Equal	4	3
Internal genitalis
positive	36	17	p < 0.001*
negative	30	25
Equal	3	2
Left ear
Angle of superior concha
positive	28	26	p < 0.001*
negative	38	16
Equal	3	2
Urinary bladder
positive	29	22	p < 0.05*
negative	23	19
Equal	7	3
Ureter
positive	34	20	p < 0.05*
negative	31	19
Equal	4	5
Kidney
positive	34	19	p < 0.05*
negative	32	20
Equal	3	5
Urethra
positive	38	15	p < 0.001*
negative	31	24
Equal	0	5
Internal genitalis
positive	31	19	p < 0.001*
negative	35	22
Equal	3	3

*Statistically significant.

†Fisher's exact test was used if the expected values in any of the cells of a contingency table are below 5, or below 10 when there is only one degree of freedom.

Table 3. Predictive power of various acupoints on the risk of LUTS assessed by electrical skin resistance measurement (conductivity) and tenderness testing.

	Sensitivity (%)	Specificity (%)	Positive predictive value (%)	Negative predictive value (%)
Electrical skin resistance measurement (conductivity)
Right ear
Angle of superior concha	0.74	0.57	0.73	0.58
Urinary bladder	0.71	0.50	0.69	0.52
Ureter	0.67	0.55	0.70	0.51
Kidney	0.65	0.68	0.76	0.56
Urethra	0.59	0.55	0.67	0.46
Internal genitalis	0.59	0.64	0.72	0.50
Left ear
Angle of superior concha	0.70	0.59	0.73	0.55
Urinary bladder	0.64	0.57	0.70	0.50
Ureter	0.57	0.61	0.70	0.47
Kidney	0.62	0.59	0.70	0.50
Urethra	0.62	0.55	0.68	0.48
Internal genitalis	0.62	0.64	0.73	0.40
Tenderness testing
Right ear
Angle of superior concha	0.49	0.73	0.74	0.48
Urinary bladder	0.48	0.64	0.69	0.42
Ureter	0.52	0.54	0.64	0.41
Kidney	0.52	0.49	0.55	0.46
Urethra	0.46	0.54	0.61	0.39
Internal genitalis	0.45	0.40	0.55	0.32
Left ear
Angle of superior concha	0.58	0.62	0.70	0.48
Urinary bladder	0.44	0.54	0.55	0.43
Ureter	0.48	0.51	0.62	0.37
Kidney	0.48	0.49	0.62	0.36
Urethra	0.45	0.38	0.56	0.28
Internal genitalis	0.53	0.46	0.61	0.38

Figures in bold indicate the highest among the acupoints under testing on each side of ear.

Sensitivity (true positive) = number of true positives/number of true positives + number of false negatives.

Specificity (true negative) = number of true negatives/number of true negatives + number of false positives.

Positive predictive value = number of true positives/number of true positives + number of false positives.

Negative predictive value = number of true negatives/number of true negatives + number of false negatives.

Table 4. Multivariate analyses.

Variable	Adjusted Odds ratios	95% CI	p value of Wald statistic
Tenderness of “Angle of superior concha” (Left)†
Present	3.174	1.211–8.319	0.019*
Absent	1.000
Electrical conductivity of “Angle of superior concha” (Left)†
Present	3.029	1.107–8.288	0.031*
Absent	1.000
Electrical conductivity of “Kidney” (Right) †
Present	2.719	1.045–7.077	0.040*
Absent	1.000
Age	1.102	1.028–1.181	0.006*

CI = confidence interval.

*Statistically significant; †Compared with reference point “Shenmen”.