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[Objective] The Zang-Fu and the meridians, which are one of the foundations of modern acupuncture and moxibustion medical education, appeared in "Lingshu" in the "Meridian" section. However, the Zang-Fu and the meridians each has a history of independent development in ancient China Before the Common Era. The purpose of this study is to investigate the process by which the meridians came to be associated with the Zang-Fu, drawing from descriptions in "Suwen", which was compiled Before the Common Era.[Method] The source literature of this study is "Revisions and Extensive Notes on the Huangdi Neijing Suwen", with reference to "Acupuncture and Moxibustion Medicine and Classic Research" by MARUYAMA Masao to classify compilations of "Suwen". The research items are the names of the Zang and the Fu, the relationships between the Zang and the Fu, and the piao-li relationships of the Zang-Fu and the three Yin and three Yang of the hands and feet. [Result] The names for the Zang were Liver, Heart, Spleen, Lungs and Kidneys, and for the Fu were Small Intestine, Bladder, Gallbladder, Large Intestine, Stomach, and Sanjiao. The Zang-Fu relationships were Lungs-Large Intestine, Spleen-Stomach, Heart-Small Intestine, Kidney-Bladder, Liver-Gall Bladder, and Chronic Illness-Sanjiao. The piao-li relationships of the Zang-Fu and the three Yin and three Yang of the hands and feet were Foot Thai-Yang and Shao-Yin, Foot Shao-Yang and Chueh-Yin, Foot Yang-Ming and Thai-Yin, Hand Thai-Yang and Shao-Yin, Hand Yang-Ming and Thai-Yin, and Hand Shao-Yang and Heart. The Liver is treated by Foot Chueh-Yin and Shao-Yang, the Heart is treated Hand Shao-Yin and Thai-Yang, the Spleen is treated by Foot Thai-Yin and Yang-Ming, the Lungs are treated by Hand Thai-Yin and Yang-Ming, and the Kidneys are treated by Foot Shao-Ying and Thai-Yang. There was the expression "太陰陽明表裏為脾胃脈也" that Hand-Foot, Yin-Yang and the Zang-Fu were grouped by their Piao-li relationships. And there were the expressions saying "Shao-Yin is the Kidneys" and "Yang-Ming is the Stomach", although these were not in complete form. [Discussion] The Zang-Fu meridians, combining the Zang-Fu and the meridians, started from the Spleen-Stomach. There were other expressions combining the Zang-Fu with the meridians, although these were also not in complete form. While medicine at that time was being organized and integrated with the Yin-Yang and Five Elements theories, the relationships between the Zang-Fu and the meridians were also established. And it is inferred that the process of combining these and developing them into a new medical system existed during this period. [Conclusion] The relationships between the Zang-Fu and the meridians were established in "Suwen", which was compiled Before the Common Era, and the expression combining them started from "太陰陽明表裏為脾胃脈也".
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The Medical Safety Committee has conducted various activities for patient safety in Japanese traditional Kampo medicines. In this study, we conducted a questionnaire survey to promote the prevention of medical accidents and their recurrence. We received responses from 15 of 19 facilities specializing in Kampo medicine and collected a total of 247 incident and accident cases in the field of Kampo medicine. Cases of side effects included interstitial pneumonia caused by Kampo prescriptions containing Scutellariae Radix, aconite poisoning, and licorice-induced pseudoaldosteronism. Furthermore, we also collected decoction-specific cases, which are unique to facilities specializing in Kampo medicine, for the first time. From the results, we included the following seven points for risk management in the field of Kampo medicine : 1) insufficient recognition to the side effects of Kampo medicines, 2) misunderstanding of the dosages of Kampo products, 3) errors due to similarities in Kampo formulas and crude drug names, 4) preconception of frequently used Kampo prescriptions, 5) contamination in the decoctions, 6) errors related to crude drug items and their dosages that are frequently added or subtracted, 7) errors in hospital wards.
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The Medical Safety Committee analyzed the case reports of minor incidents from the pharmacies last time as part of an activity to promote patient safety in Japanese traditional Kampo medicine. This time, we analyzed the case reports of medical accidents and minor incidents from the medical institutions. We extracted 626 reports related to Kampo products from the public database, which the Japan Council for Quality Health Care has established based on the collected information related to the medical accidents and minor incidents. The medical accident information includes case reports related to drug-induced liver injury. The minor incident reports include prescribing error due to misinterpretation related to the quantity of one sachet of Kampo extract product, dispensing error due to similarity of product appearance, number or name, and administration error due to judging the medicine only by Kanji characters or product company names without checking the Kampo formula name. Additionally, the minor incidents were often discovered by people belonging to different professions or patients themselves. In order to promote patient safety, knowledge about these incidents should be shared among the people involved in the same or different professions.
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[Objective]To investigate the effects of acupuncture on sports activities of athletes[Methods]A total of 1,804 athletes were targeted. The method used was a collective survey. Questionnaires were administered after obtaining consent from the participants; online questionnaires were also provided. The questionnaire evaluated profile (sex, age); sensation immediately after acupuncture treatment, duration of stimulus sensation, stimulus intensity, stimulus sensation, and therapeutic effect; timing of acupuncture treatment; and questions related to acupuncture as to whether the acupuncture caused any adverse effects on play (movement) or showed any positive effects.[Results]In total, 1,525 (84.5%) valid responses were obtained. The survey analyzed 841 subjects (55.1%) who underwent acupuncture. The most common response after acupuncture treatment was that the subjects felt lighter and were able to move more easily; 43.9% of subjects gave this response. In addition, 10.6% of respondents said that they continued to feel pain similar to the sensation during acupuncture treatment and 7.7% said they felt weak. The most common response at 59.8% was that the sensation felt during acupuncture disappeared quickly after treatment was ended, 58.6% of subjects said that the sensation felt after acupuncture was optimal, and 48.3% responded that the sensation from treatment remained and a positive effect was observed. The most common timing for receiving acupuncture for 21.8% of subjects was after practice or a match: [Discussion and Conclusion]Acupuncture for athletes should be performed according to the guidelines, taking into account the competition schedule and type of competition and the appropriate amount of acupuncture stimulation, thereby preventing problems during competition.
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The Japan society of oriental medicine created a committee of medical safety in 2017. The first activity was to summarize the representative side effects of Kampo medicine and to enlighten members of our society about them. In this report, we documented the knowledge to keep in mind at present on pseudoaldosteronism, drug-induced liver injury, and drug-induced lung injury. Since these three major side effects may cause clinically severe conditions, it is very important to detect them early and take appropriate measures. Therefore, proper examinations at the right time are necessary while taking Kampo medicine.
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[Objective] The purpose of this cross-sectional questionnaire-based study is to investigate the challenges of adverse events during treatment by acupuncture and moxibustion to an athlete. [Methods] In total, 1,804 subjects, including athletes who participated in marathons and university athletes were enrolled in this study. The survey was conducted by distributing the questionnaire or via online questionnaire to the athletes who fit the criteria for the study. The questionnaires were collected after consent was received from the participants; online questionnaires were also collected. The questionnaire was examined for age, sex, and type of competition, purpose of the acupuncture treatment and the actual effects, and treated area, content of adverse event, number of times the subjects received acupuncture, and informed consent, and free description of adverse events.[Results] In total, 1,525 (84.5%) valid responses to the questionnaires were received. The survey analyzed 841 subjects (55.1%) who experienced acupuncture and moxibustion. The following responses about adverse events of acupuncture were obtained: "pain at time of needle insertion"; 17.0%, "subcutaneous-bleeding"; 10.1% and "pain and feeling of heaviness due to the needle": 10.0%, among others. For moxibustion, responses included "burns"; 5.9% and "malaise"; 5.8%, among others. In the free description, there were 17 descriptions of discomfort due to excessive stimulation and difficulty in movement during exercise. Of the questions regarding whether or not they received informed consent, 215 were received orally (25.6%), 34 were received in written form (4.0%), 99 were received both orally and in written form (11.8%).[Discussion and Conclusion] Acupuncture for athletes causes a certain rate of adverse events. It was suggested that guidelines for athletes to receive acupuncture safely and training and education for practitioners are important.
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The number of acupuncturists and moxibustion therapists has rapidly increased since around 2000. If they can be regarded as new healthcare resource investments, it is of great significance to evaluate their social impact. Here, we conducted a regional correlation study in different prefectures by using the extension of average life expectancy as an evaluation index. The results revealed an increase in “acupuncturists (human healthcare resources)” and in “facilities for performing acupuncture and moxibustion therapy (physical healthcare resources)” to show a weak but statistically significant positive correlation with the extension of average life expectancy for elderly men. Due to methodological limitations, however, this study cannot confirm a causal relationship between them. The author strongly hopes that public service corporations involved in the provision of acupuncture and moxibustion will henceforth serve as a bridge to allow researchers, acupuncturists, and moxibustion therapists to collaborate and conduct multicenter joint studies, in order to create an even greater social impact of acupuncture and moxibustion.
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Sports Acupuncture is used for alleviating physical disorders of athletes and it helps them to keep up the quality of their performance. Acupuncture has been used for sports injuries to relieve the pain, and lately, is also applied for preventing injuries, conditioning, or health maintenance. However, the definition of "Sports Acupuncture"is still unclear and there is no guideline to apply acupuncture for athletes.<BR>As Tokyo Olympic and Paralympic will be held in Tokyo in 2020, we decided to review past researches related with sports acupuncture. These researches examine the effects of acupuncture for muscle pain, muscle fatigue, muscle atrophy, and sports injuries. Moreover, we invite one former athlete and she speaks how she used acupuncture when she was a player. After this panel discussion we will be able to make a step to next level, so that we re-create "Sports Acupuncture"on athletes'demand.
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[Objective]To investigate the effectiveness of acupuncture in the control of lower back pain of sailors that participated in the National Sports Festival of Japan to assess whether or not acupuncture can be used as a pre and post race treatment.<BR>[Methods]The study was conducted at the National Sports Festival of Japan sailing games. The focus was on sailor's complaints of lower back pain. Acupuncture treatment for lower back pain was executed pre and/or post race, and the respective therapeutic effect was evaluated. Acupuncture was executed by several techniques and on several points of the lower back. <BR>The depth of insertion was the most critical criteria and must be shallow. The insertion depth of the study was approximately 5 mm. <BR>Acupuncture points were chosen by the therapist. The insertion point was selected based on characteristics such as tenderness and induration of tissue. As needed, the dermis was stimulated continuously utilizing the acupuncture needle. The effect of acupuncture treatment was evaluated using the Visual Analog Scale (VAS).<BR>[Results]Lower back pain in sailors was alleviated by acupuncture and decreased by a VAS value (p < 0.01). The result was the same in pre and/or post race patients. Organic disease was confirmed in 19.0%of the patients. Both lumbar disc herniation and isthmic spondylolisthesis were diagnosed. There were no adverse events.<BR>[Conclusion]Acupuncture was an effective treatment method and as such can be used as a method of treatment of sailors at pre or post race. However, to attain the maximum efficacy, the depth of the needle insertion must be shallow.
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[Purpose]The purpose of this paper is to examine whether or not the Press Tack Needle (PTN) treatment enhances the recovery process from muscle fatigue which assists in the therapeutic exercise rehabilitation process. By using the PTN, this paper investigates the recovery effect of the fatigued muscle. Randomized controlled trials were used to compare outcomes. <BR>[Method]Twenty-nine healthy male adults were chosen as subjects. However, crossover study was used to compare the PTN group and the sham group. After two sets of arm curl exercises with isotonic contraction at 10%weight of maximum voluntary contraction, the decrease percentage of exercise repetition was calculated. A PTN or sham was inserted at the posterior cervical region using the double masking method. After the intervention of the PTN or sham needle, the subjects were asked which intervention was inserted into them. A Kappa statistics value was used to evaluate the validity of the sham group and a Visual Analog Scale (VAS) was used to determine the upper arm fatigue. <BR>[Result]The Kappa statistic value was 0.17. The decrease percentage of the exercise repetition of the PTN group was 35.4±20.1%, and of the sham group was 45.1±11.1%. The PTN group indicated a significantly smaller percentage than the sham group (p<0.01). Both groups showed no difference in Upper arm fatigue. <BR>[Conclusion]The PTN seems to help in recovery from muscle fatigue. It is thought that by inserting the PTN, somato-automomic reflex was induced to promote the increase of blood flow in to the muscle. Faster recovery of physical function of the patient can be possible as well as the improvement of QOL. In conclusion, this investigation showed that the PTN treatment method can be useful in assisting in therapeutic exercise rehabilitation.
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Continued from the previous year's theme of our workshop, we collected various information and ideas for safer acupuncture practice. Subjects and presentations of the present workshop were as follows:<BR>1. Literature review of papers on adverse events published between 2003and 2006<BR> 1) Papers in domestic journals (by Ishizaki and Egawa)<BR> 2) Papers in foreign journals (by Yamashita and Umeda)<BR>2. Debate on wearing sterilized fingerstall or glove<BR> 1) Present status of the use of fingerstall in acupuncture practice (by Katai and Minowa)<BR> 2) Practical side of clinical education of acupuncture using fingerstall (by Hatakeyama and Furuya)<BR> 3) Problem of using individual fingerstalls in acupuncture practice (by Handa and Miyamoto)<BR>We will continue to provide information and discuss solutions in order to reach a common understanding and specific methods for safer acupuncture practice.
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Lately, many people from children to elderly people are playing sports. Society is in need of safer and more comfortable sporting environment, not only for competitive sports, but also for recreational sports. The themes of acupuncture and moxibustion of the field of sports are treatments of sports injuries, keeping the physical condition of the athlete, preventing life-style related diseases and competition performance improvement of the athletes. At this symposium, we reported the present conditions of the study of sports acupuncture and moxibustion. It is summarized as follows:<BR> 1) Press tack needles relieve muscle fatigue that occurs during a long-term training camp,<BR> 2) Acupuncture inhibits the fall of the immune function resulting from high extreme exercise,<BR> 3) Electroacupuncture can relieve disused muscle atrophy of mice,<BR> 4) Press tack needles are effective in acute muscle fatigue and delayed onset muscle soreness, and<BR> 5) The M-Test is effective in estimating performance improvement and preventing sports injuries.
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[Purpose] This report examines the immediate effect of acupuncture treatment for subjective symptoms in competitive sailors.<BR>[Method] The investigation was performed in the conditioning room at the national sports festival. Acupuncture treatment was performed for lumbago (n=108), dorsal pain (n=72). Acupuncture treatment was performed only on the area where players complained of pain. The variety of chief complaints, number of chief com-plaints, and visual analog scale (VAS) score were used for the investigation. Significance of differences in VAS score was compared by t-test.<BR>[Result] There were numerous chief complaints involving lumbago, followed in orderby dorsal pain, and othercomplaints. Acupuncture treatment decreased the VAS score fbr lumbago (n=108) from 52.3±215mm to 21. 5±16.4mm. Dorsal pain (n=72) was also decreased from 48.0±18.7mm to 18.5±15.2mm. These values were both significantly different at p<0.01.<BR>[Discussion] Acupuncture treatment was effective for lumbago, and dorsal pain of competitive sailors. As a result, it was suggested that the acupuncture treatment is an effective condition adjustment methods.
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[Objective] To examine the effect of press tack needle (PTN) treatment on muscle soreness after triathlon race in a placebo (P) -controlled study.<BR>[Method] Subjects were 149 healthy triathletes randomly divided into 2 groups, PTN group and P group. PTN and P were placed on the L 3 to S 2 dermatome area (BL23, BL24, BL25, BL26 and BL32) only during the race. The visual analog scale (VAS) was used to measure muscle soreness at 6 points (Quads, Hamstrings, Calves, Tibialis anteriors, Glutes and lower back). Measurements were obtained before the race (PRE), after the race (POST1), and on the day after the race (POST2) to evaluate the effect of PTN treatment.<BR>[Results] Each VAS score was increased on POST1 compared to that on PRE (p<0.01) for both groups. With PTN treatment, VAS scores were decreased on POST2 compared to those on POST1 except for Glutes (p<0.01, p<0.05), and had recovered to the PRE-race condition. In the P group, VAS score of the hamstrings was decreased on POST2 compared to that on POST1, while VAS scores were significantly higher than those on PRE for Quad, Hamstrings, and Calves.<BR>[Conclusion] It is suggested that PTN stimulation during triathlon race suppresses delayed-onset muscle sore-ness.
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[Objective] This study examined the effect of press tack needle (PTN) treatment onshoulder stiffness.<BR>[Method] A total of 53 volunteers with shoulder stiffness were randomly divided into 2 groups, the press tack needlegroup and placebo (P) group. The points stimulated by PTN or P were a maximum of 4 tender points around the shoulder treated for 3 days. Evaluation of the effect was based on the consciousness of shoulder stiffness and visual analog scale (VAS) estimating the grade of the shoulder stiffness. The evaluations were done in prior to treatment (Pr), immediately after treatment (Post 1), and 3 days after treatment (Post 2).<BR>[Result] As a result, the number of the volunteers reporting awareness of stiff shoulder after 3 days decreased to 12 of28 persons in the PTN group, 23 of 25 in the P group. There was a significant difference between the 2 groups (p<0.01). The VAS value decreased in the PTN group from 52.5±20.7 (Pr) to 40.5±22.4 (Post1), to 342±19.7 (Post2), while in the P group from 55.2±17.5 (Pr) to 46.5±19.7 (Post1) to 45.9±21.7 (Post2). There were significant differences between Pr and Post1 (p<0.05), and between Pr and Post2 (p<0.01) in PTN group.<BR>[Conclusion] It was suggested that PTN stimulation on the tender points improved shoulder stiffness.
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Effects of multiple moxibustion on platelet aggregation, blood coagulation and fibrinolytic activity in mice have been studied. Male ddY mice (5 weeks old) were used as experimental animals. 15mg of moxa was divided into 6 cones and mice were treated by each 3 cones at right and left LV-14. The experimental schedules of multiple moxibustions were 5, 10 and 15 treatments of twice a week. The electronic aggregometer was suitable for measuring platelet aggregation using whole blood. However, no significant changes on platelet counts, platelet aggregation and ATP release induced by collagen (final concentration: 2μg/ml) and ADP (final concentration: 20μM) were found after multiple moxibustions. 15 treatments of moxibustion induced the increase in fibrinogen contents and the decrease tendency of factor XIII activity. While 10 treatments of moxibustion showed the increase in PLG content and α2 PI activity. These results suggested that multiple moxibustions induce the reasonable reaction to keep a good homeostasis on blood coagulation and fibrinolytic system in mice.
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In our previous studies, blood coagulation and fibrinolytic activity after single moxibustion were found to change within the range of physiological variability in mice. In this paper, the effect of multiple moxibustion on the activity of blood coagulation was examined by using male ddY mice (6 weeks old). 15mg of moxa was divided into 6 cones and mice were treated by each 3 cones at right and left LV-14. The multiple moxibustion schedule was a total of 5, 10 and 15 treatments. There was no effect of multiple moxibustion on body weight and Ht. 5 treatments of moxibustion showed a significant decrease in PT (p<0.05) and 10 treatments showed an increase in the ma value of TEG and in HPT activity. No significant change in PTT nor ATIII activity was found following multiple treatments of moxibustion.<br>These results showed that the enhancement of blood coagulation did not continue during multiple moxibustion even though single moxibustion stimulated the activity of blood coagulation at 1 and 3hrs. In addition, the increase in HPT activity induced by 10 treatments of moxibustion may have shown an effect of mildly stimulating liver function.
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In our previous studies, it was suggested that single moxibustion stimulation activated blood coagulation and fibrinolytic activities within normal range in mice at 1 and 3hrs.<br>In order to further investigate the mechanism of moxibustion, we have examined the antithrombin III (AT III) and fibrinolytic activities after single moxibustion.<br>Male ddy mice (6 weeks old) were used as experimental animals. Each mouse was treated with 15mg of moxa divided into 6 cones, 3 each on the right and left LV-14.<br>We obtained the following results. The plasminogen (PLG) activities and the values of plasma total protein decreased at 1hr after single moxibustion.<br>The activities of plasma AT III, α2 plasmin inhibitor (α2 PI) and factor XIII, and plasma fibrinogen level remained unchanged at 1 and 3hrs.<br>The blood coagulation and fibrinolytic activities changed, but they were almost within the range of physiological variability.<br>These results suggest that blood coagulation and fibrinolysis were activated as part of its defence mechanism while keeping homeostatic balance.
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Effects of moxibustion on liver injury induced by CCl<sub>4</sub> and ethionine in mice were investigated in the reticuloendothelial system. The phagocytic activity was determined by the carbon clearance method and the activity of lysosomal enzyme (acid phosphatase and β-glucuronidase) in peritoneal exudate cells was measured.<br>Male ddY and ICR mice (5 weeks old) were used as experimental animals.<br>Liver injury was produced by the administration of carbon tetrachloride (CCl<sub>4</sub>) in a dose of 0.04ml/body in olive oil, p. o., or single administration of ethionine in a dose 1g/kg, i. p.<br>15mg of moxa was divided into 6 cones and they were treated by each 3 cones on right and left LV-14.<br>We obtained the following results. After 15 times administration of CCl<sub>4</sub> (3 times a week), the rise of serum transaminase (GOT, GPT), the decrease of K index and α index which meant phagocytic activity and the increase in liver/body (L/B) and spleen/body (S/B) weight ratio were recognized. For CCl<sub>4</sub> induced liver injury, α index and S/B weight ratio were improved by 10 times moxibustion (2 times a week). After 15 times moxibustion (3 times a week), the tendency to increase in K index and to decrease of α index was seen and, at the same time, an increase in L/B weight ratio was seen.<br>On the other hand, an increase in K index was induced after single administration of ethionine and simultaneous single moxibustion showed the tendency to decrease of K index.<br>It was suggested that moxibustion play an important role to regulate the mechanism of reticuloendothelial system on CCl<sub>4</sub> or ethionine induced liver injury.
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Morphological changes of sciatic and tivial nerves have been observed microscopically and cholinesterase activities of anterior tibial, gastrocnemius and soleus muscles have been examined by the biochemical determination and histochemical method. 25mg of moxa/body (3 times a week, x6) were treated on the acupuncture point, B-18, B-25 and G-34 in acrylamide neuropathy rats.<br>After 400p.p.m. acrylamide treatment, the degeneration of peripheral nerves with myelin ovoids and foldes, and shrunken myelinated axons were observed. These lesions were advanced in the tibial nerve than in the sciatic nerve. In B-25 and B-18 moxibustion rats, good results were obtained to decrease myelin degeneration in peripheral nerves, but the lesions were advanced in G-34 rats than in acrylamide ones.<br>In the acrylamide rats, no change of muscle cholinesterase activity was found except the increase in the enzyme activity in the homogenate of anterior tibial muscle. In the gastrocnemius muscle of moxibustion treated rats, the microsomal fraction which contained much more sarcoplasmic reticulum showed high cholinesterse activity. And the activity per muscle protein showed various changes.<br>It showed that the stimulation of moxibustion had a mild effect to recover the experimental peripheral neuropathy induced by 400p.p.m. acrylamide because of morphological changes of sciatic and tibial nerves and weight of skeletal muscles.