Evaluation of the Therapeutic Efficacy of Auricular Pellets Combined With Atorvastatin 20mg in Patients With Dyslipidemia and Phlegm-Dampness Syndrome

September 4, 2026 updated by: To Buu Ngoc, University of Medicine and Pharmacy at Ho Chi Minh City

The Potential Efficacy of Auricular Pellets Combined With Atorvastatin 20mg in Managing Blood Lipid Levels and Improving Phlegm-Dampness Symptoms in 80 Patients With Dyslipidemia and Phlegm-Dampness Syndrome: A Randomized Controlled Trial

Dyslipidemia (DL) is a metabolic disorder characterized by abnormal levels of blood lipids and is an important risk factor for cardiovascular disease. Although current management primarily relies on lifestyle modification and lipid-lowering medications, particularly statins, some patients may have an inadequate treatment response, experience adverse effects, or have difficulty maintaining long-term adherence.

Traditional Chinese Medicine therapies are increasingly used as complementary approaches to conventional treatment. Auricular acupuncture, which stimulates specific acupoints on the ear, has been investigated for its potential effects on lipid metabolism. In Traditional Chinese Medicine, Phlegm-Dampness syndrome is considered a common syndrome pattern associated with dyslipidemia. However, clinical evidence regarding the effects of auricular acupuncture on blood lipid parameters and Phlegm-Dampness symptoms in patients with dyslipidemia remains limited, particularly in Vietnam.

This randomized controlled trial evaluates the effects of auricular acupuncture combined with atorvastatin compared with atorvastatin plus sham auricular acupuncture in patients with dyslipidemia presenting with Phlegm-Dampness syndrome. The primary outcome is the change in blood lipid parameters, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), from baseline to the end of the 8-week intervention. Changes in clinical symptoms of Phlegm-Dampness syndrome are also evaluated.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This single-blind, randomized, sham-controlled clinical trial includes 80 outpatients aged 18 years or older with dyslipidemia presenting with Phlegm-Dampness syndrome at Le Van Thinh Hospital, Ho Chi Minh City, Vietnam. Only participants are blinded to group allocation. Participants are randomly assigned to two equal groups. Both groups receive atorvastatin 20 mg once daily after dinner and are advised to follow a lipid-lowering, high-fiber diet.

The intervention group receives Khanh Phong intradermal auricular needles applied to five auricular acupoints: Pi (CO13), Stomach (CO4), Endocrine (CO18), Sympathetic (AH6a), and Shenmen (TF4). The therapeutic points are selected according to traditional medicine treatment principles for Phlegm-Dampness syndrome and the Vietnamese traditional medicine guideline. Participants are instructed to perform self-acupressure four times daily. The control group receives sham auricular acupuncture performed by inserting the same type of intradermal auricular needles used in the intervention group at three predefined auricular points considered theoretically unrelated to the treatment of dyslipidemia and Phlegm-Dampness syndrome: Finger (SF1), Thoracic Spine (AH11), and Knee (AH4). Participants in the control group are not instructed to perform self-acupressure.

The intervention period lasts 8 weeks. In both groups, intradermal auricular needles are applied at the initial treatment session and subsequently replaced every 5 days, for a total of 12 treatment sessions. In the intervention group, the treated ear is alternated between sessions; in the control group, the needles are applied to the left ear. Participants are monitored for 15 minutes after each procedure and are instructed regarding monitoring for potential adverse events, including fainting, localized pain or swelling, ear bleeding, infection, and perichondritis.

Blood lipid parameters, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), are measured at baseline (T0) and after the 8-week intervention (T8). The primary outcome is the change in these blood lipid parameters from baseline to T8. Secondary outcomes include the percentage improvement in the nine-symptom Phlegm-Dampness syndrome score, assessed at baseline and every 15 days during the intervention, and the incidence of treatment-emergent adverse events throughout the 8-week study period.

Study Type

Interventional

Enrollment (Actual)

80

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Vietnam
      • Hồ Chí Minh, Vietnam
        • Bệnh viện Lê Văn Thịnh

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Diagnosis: Dyslipidemia (DL), untreated or discontinued treatment for at least 1 month, and not taking drugs that induce DL.
  • Laboratory Criteria: LDL-c levels between 2.6 and 4.9 mmol/L.
  • TCM Criteria:

Diagnosed with Phlegm-Dampness syndrome in patients with DL according to the "Guiding Principles for Clinical Research on Combined Traditional Chinese and Western Medicine":

Primary symptoms: Obesity, heavy sensation in the head, chest tightness, nausea/phlegm expectoration, numbness in limbs.

Secondary symptoms: Palpitations, insomnia, bland taste in the mouth, poor appetite.

Tongue manifestations: Enlarged/flabby tongue, greasy/slippery tongue coating. Pulse: String-taut and slippery pulse (Wiry-Slippery pulse). Diagnostic threshold: Confirmed when presenting >= 50% of TCM Phlegm-Dampness syndrome symptoms in patients with DL.

Exclusion Criteria:

  • Participants are non-compliant with the treatment protocol.
  • Participants decline to continue study participation for any reason (Withdrawal of consent).
  • Participants experience health events during the study and do not wish to continue participation.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental Group
Participants in the experimental group receive atorvastatin 20 mg orally once daily after dinner and lifestyle guidance consisting of a lipid-lowering, high-fiber diet. In addition, Khanh Phong intradermal auricular needles are applied to five auricular points: Pi (CO13), Stomach (CO4), Endocrine (CO18), Sympathetic (AH6a), and Shenmen (TF4). The needles are applied to one ear at each treatment session, with the treated side alternated between sessions. Participants are instructed to press each retained needle for 60 seconds, four times daily at 4-hour intervals. The needles are replaced every 5 days, for a total of 12 treatment sessions during the 8-week intervention.
Drug: Atorvastatin
Participants in both groups are prescribed Atorvastatin 20mg to be taken orally at a dose of 1 tablet per day. The medication must be administered consistently every day after dinner. This pharmacological treatment is maintained continuously throughout the 8-week study period to manage and monitor its effects on blood lipid levels.
Behavioral: Diet and exercise regimen
Participants are instructed to strictly follow a therapeutic lifestyle change regimen throughout the 8-week study period. The dietary component focuses on a lipid-lowering, high-fiber diet, which includes reducing saturated fat intake, limiting dietary cholesterol to less than 300 mg/day, and increasing the consumption of vegetables and fiber-rich foods. The exercise component requires participants to maintain a consistent daily physical activity routine tailored to their health status. Adherence to both diet and exercise guidelines is monitored regularly by the research team.
Other Names:
  • Standard Care
  • Routine Dyslipidemia Management
Procedure: Auricular Acupressure
In this study, active semi-permanent auricular needles (auricular pellets) will be applied to 5 therapeutic acupoints: Spleen (CO13), Stomach (CO4), Endocrine (CO18), Sympathetic (AH6), and Auricular Shenmen (TF4) on the left ear. Needles will be retained for 5 days to provide continuous stimulation, with the patches replaced on the 6th day. Participants will be prompted to perform self-acupressure on the points 4 times daily (60 seconds per acupoint). The entire procedure totals 12 sessions over an 8-week period, performed by a licensed traditional medicine physician following standardized protocols.
Other Names:
  • Ear Acupressure
  • Auricular Therapy
  • Auricular Pellets
Sham Comparator: Sham Comparator Group
Participants in the sham comparator group receive atorvastatin 20 mg orally once daily after dinner and the same lifestyle guidance as the experimental group. In addition, sham auricular acupuncture is performed using the same type of intradermal auricular needles used in the experimental group. The needles are inserted at three predefined auricular points considered theoretically unrelated to the treatment of dyslipidemia and Phlegm-Dampness syndrome: Finger (SF1), Thoracic Spine (AH11), and Knee (AH4). The needles are applied to the left ear and replaced every 5 days, for a total of 12 treatment sessions during the 8-week intervention. Participants are not instructed to perform self-acupressure.
Drug: Atorvastatin
Participants in both groups are prescribed Atorvastatin 20mg to be taken orally at a dose of 1 tablet per day. The medication must be administered consistently every day after dinner. This pharmacological treatment is maintained continuously throughout the 8-week study period to manage and monitor its effects on blood lipid levels.
Behavioral: Diet and exercise regimen
Participants are instructed to strictly follow a therapeutic lifestyle change regimen throughout the 8-week study period. The dietary component focuses on a lipid-lowering, high-fiber diet, which includes reducing saturated fat intake, limiting dietary cholesterol to less than 300 mg/day, and increasing the consumption of vegetables and fiber-rich foods. The exercise component requires participants to maintain a consistent daily physical activity routine tailored to their health status. Adherence to both diet and exercise guidelines is monitored regularly by the research team.
Other Names:
  • Standard Care
  • Routine Dyslipidemia Management
Procedure: Sham Auricular Acupressure
Sham auricular acupressure will be performed using auricular pellet patches with the needles completely removed, applied to 3 non-therapeutic ear points: Finger (SF1), Thoracic Spine (AH11), and Knee (AH4) on the left ear. The patches will be replaced on the 6th day, totaling 10 sessions over an 8-week period with alternating ears. The procedure duration and appearance will be identical to the active intervention to maintain blinding, but participants are strictly instructed NOT to perform any self-acupressure.
Other Names:
  • Sham Ear Acupressure
  • Placebo Auricular Acupressure

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Mean Change From Baseline in Total Cholesterol at Week 8
Time Frame: Baseline and Week 8
Serum total cholesterol (TC) is measured in mg/dL at baseline and at Week 8. Change from baseline is calculated as the Week 8 value minus the baseline value (Week 8 - baseline). A negative change indicates a reduction in serum total cholesterol concentration.
Baseline and Week 8

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Incidence of treatment-emergent adverse events
Time Frame: Throughout the 8-week study period
To evaluate the safety of the auricular acupressure procedure by recording adverse events (if any).
Throughout the 8-week study period
Percentage Improvement in Phlegm-Dampness Syndrome Clinical Symptom Score
Time Frame: Baseline, Day 15, Day 30, Day 45, and Day 60 (Week 8)
Phlegm-Dampness syndrome clinical symptoms are assessed using a 9-item symptom score based on the Guidelines for Clinical Research on New Chinese Medicine Drugs (Zhongyao Xinyao Linchuang Yanjiu Zhidao Yuanze, 2002), published by the Ministry of Health of the People's Republic of China. The scale assesses nine symptoms: obesity/overweight, heavy sensation in the head, chest tightness, nausea/expectoration of phlegm, numbness of the limbs, palpitations, bland taste in the mouth, reduced appetite, and insomnia. Each item is scored from 0 (absent) to 3 (severe), resulting in a total score ranging from 0 to 27. Higher total scores indicate greater symptom severity and therefore a worse outcome; lower total scores indicate less severe symptoms and therefore a better outcome. The percentage improvement is calculated based on the reduction in the total symptom score from baseline at each assessment time point.
Baseline, Day 15, Day 30, Day 45, and Day 60 (Week 8)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Medicine and Pharmacy at Ho Chi Minh City

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 10, 2026

Primary Completion (Actual)

June 10, 2026

Study Completion (Actual)

June 10, 2026

Study Registration Dates

First Submitted

May 28, 2026

First Submitted That Met QC Criteria

May 28, 2026

First Posted (Actual)

June 3, 2026

Study Record Updates

Last Update Posted (Actual)

September 10, 2026

Last Update Submitted That Met QC Criteria

September 4, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 496/HDDD-DHYD

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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