Acupuncture treatment for a patient with panic disorder / 全日本鍼灸学会雑誌

[Introduction] We report our experience with a patient with panic disorder (PD) , which suggests the importance of building a trusting relationship between the patient and the acupuncturist.[Case] A 69-year-old woman with PD presented to our acupuncture clinic with anxiety and difficulty breathing. Her symptoms appeared six months prior, and later, she presented to the emergency department of A Hospital with dyspnea and nausea. Shehad a significant medical history of RLS and rheumatoid arthritis. She was diagnosed with PD at the Department of Oriental Medicine of the same hospital. Her symptoms improved with herbal remedies; however, anxiety and difficulty breathing persisted. Her symptoms at the first acupuncture visit were dyspnea, chest tightness, and anxiety regarding seizures that occurred once or twice a week. She also experienced insomnia and nocturnal hot flashes in her legs. She had no panic attacks or prevailing anxiety, and her neurological and cardiovascular parameters were normal. During the treatment period of 91 days, 14 acupuncture and moxibustion treatments were performed once a week. GV20, PC6, HT7, ST36, SP6, LV3, GB20, BL13, BL15, LI4, BL23, and BL33 were used for mood symptoms, and KI9, BL57, and KI3 were used for toe symptoms. After the second visit, BL10, GB21, and SL14 were performed for neck and shoulder symptoms, and Ex-LE10 and plantar nerve acupuncture were performed for coldness in the lower extremities. Moxibustion was applied to SP6, KI3, and LV3.[Course] After the initiation of acupuncture, anxiety and difficulty breathing were almost resolved by the second treatment session; however, insomnia and hot flashes in the lower extremities worsened in the seventh round of treatment. The patient had also hoped for the resolution of the insomnia-related symptoms using acupuncture. However, since acupuncture was ineffective, we explained the need for specialized treatment and referred her case to a psychiatrist. She was diagnosed with restless leg syndrome, and treatment was initiated using pramipexole, which improved hersymptoms.[Discussion] In this case, acupuncture and moxibustion treatment were effective for the symptoms associated with panic disorder. Additionally, the importance of providing opportunities for appropriate medical consultations as needed was demonstrated.

Effect of acupuncture sensation on body sway during one legged stance / 全日本鍼灸学会雑誌

[Objectives]The purpose of this study is to clarify the effect of acupuncture sensation on the body sway during a one-legged stance.[Methods] The study participants were 16 healthy adults (mean age 21.8±1.6 years). The study design was a crossover method, wherein the same individuals participated in the acupuncture stimulation condition and the control condition at intervals of more than one week. Evaluation was performed before and after each intervention by holding a one-legged stance for 40 seconds on a force plate. A total of six items of body sway were measured, including: circumferential area, rectangular area, effective value area, total trajectory length, unit trajectory length, and unit area trajectory length. In addition, Visual analog scale (VAS) was used to evaluate the ease with which the lower leg was subjected to force during measurement. In the acupuncture stimulation condition, single acupuncture was performed on the lower limb muscle group of the measuring leg, and the VAS of the acupuncture sensation was evaluated at the time of stimulation and at the end of measurement. Stainless steel disposable acupuncture needles (length: 50 mm, diameter: 0.20 mm.) were used for stimulation. The stimulation sites were the ST32, ST37, BL37, BL57, and GB37 of the test leg, and acupuncture needles were inserted to the desired depth and removed when sensation was felt. The control condition was the supine position for five minutes. Comparisons were made between the pre- and post-acupuncture stimulation conditions and the pre- and post-control conditions(body sway, lower leg VAS, acupuncture sensation VAS). [Results] There was no significant difference between the two conditions in terms of body sway. However, the VAS of lower limb effort was significantly lower, from 78.0±14.9 mm to 63.1±17.0 mm before and after the intervention (p<0.05). On the other hand, in the control condition, there was no significant difference from 79.5±12.3 mm to 75.2±12.7 mm before and after rest. The VAS of acupuncture sensation was 50.4±14.3 mm during stimulation and 9.8±9.0 mm at the end of measurement, which was significantly lower (p<0.05). [Conclusion] Acupuncture sensation did not affect the body sway before and after acupuncture stimulation. However, the subjective sensation of weakness appeared, suggesting that acupuncture stimulation may cause a transient sensation of weakness.

Survey research on the perceptions and issues of ordinary women regarding cosmetic acupuncture / 全日本鍼灸学会雑誌

[Objective] This study aimed to investigate the awareness and perceptions of cosmetic acupuncture among ordinary women.[Method] A questionnaire method was adopted, with a target population of 1,000 ordinary women living in Shizuoka prefecture, which is considered a suitable location for test marketing in Japan.Questionnaires were distributed through the Chambers of Commerce in the prefecture by age group, according to the population ratio, and responses were obtained. The items included (1) basic information; (2) presence and type of facial cosmetic concerns; (3) experience of acupuncture, awareness of cosmetic acupuncture, the medium through which they learned of it, perception of effects, and experience of cosmetic acupuncture; (4) effects and types of cosmetic acupuncture, presence or absence of adverse effects, current treatment status, desired treatment outcomes and reasons for seeking treatment, wishes from treatment clinics, and wishes from practitioners; and (5) 1 month's investment in beauty.[Result] The response rate was 56.2%, and 91.8% of the participants perceived that they had facial cosmetic concerns; 28.8% had experience with acupuncture, whereas 42.0% had knowledge regarding cosmetic acupuncture. Television (45.3%) was the primary source of information regarding this. The most prevalent perception of the effects of cosmetic acupuncture was lifting (44.8%), and 43.2% of the 521 participants inexperienced with cosmetic acupuncture consented to treatment. Participants mostly reported being somewhat interested in the procedure as their reason for wanting to receive treatment (45.3%). The most common reason for opting out of treatment was due to pain (52.6%). Of those who experienced cosmetic acupuncture, 60.0% said they experienced positive effects, and lifting (62.5%) is the most frequently perceived outcome, which matched the commonly held perception. However, among the participants, 45.0% reported negative effects, while 47.5% received the treatment two or more times in the past but did not continue. Participants mainly wanted clean treatment centers and skilled practitioners. The most common monthly investment in beauty was between 3,000 yen and 5,000 yen (28.5%).[Discussion/Conclusion] The results suggest that many women have cosmetic concerns regarding their faces and expect lifting from cosmetic acupuncture. The low treatment rate among women and their reasons for not seeking re-treatment were elucidated in this study, despite their degree of awareness. Further, the problems associated with the development of cosmetic acupuncture were clarified.

Comparison between conventional acupuncture and press tuck needle acupuncture for physical and psychological fatigue in office workers / 全日本鍼灸学会雑誌

[Aim] We compared the effects of acupuncture and press tuck needle (PTN) acupuncture in office workers with physical and psychological fatigue.[Design] A randomized, open-label, parallel-group, comparison study.[Setting] An acupuncture room in the A Clinic within the Kanto Metropolitan Area.[Patients] Clinic workers. The inclusion criteria were 20-45 years of age and awareness of physical and psychological fatigue. The exclusion criteria were fatigue-related diseases and symptoms, medical abnormalities, and history.[Intervention] The subjects were randomly allocated to either the acupuncture treatment group (ACP group) or PTN acupuncture treatment group (PTN group). The interventions were based on acupoints for fatigue symptoms as per previous reports and individualized treatment for physical symptoms, including neck and lower back pain, among others, and were performed twice a week for one month.[Evaluation methods] The visual analog scale (VAS) scores were the primary method for evaluating for physical and psychological fatigue at four weeks post-treatment. Other forms of measurement used were the VAS scores within groups immediately after treatment and to evaluate physical health, the Health Perceptions Questionnaire, General Health Questionnaire-12, and Short Form-36 responses; and salivary amylase levels were used.[Results] Thirteen of 14 subjects in the ACP group and 13 of 15 in the PTN group were included in the analysis. There was no significant difference between the groups for VAS scores. Evaluation, immediately before and after the intervention showed a significant decrease in VAS scores for physical fatigue in both groups. The ACP group showed a greater immediate change than the PTN group. In a comparison within each group, the VAS of psychological fatigue in the PTN group showed significant decrease after the eighth treatment.[Conclusions] Acupuncture may immediately improve physical fatigue in office workers. Moreover, the frequency of using PTN acupuncture may eventually decrease physical fatigue. Therefore, acupuncture and PTN acupuncture can help office workers' health.

Psychological and Physical Characteristics of Neck Pain in University Students / 日本温泉気候物理医学会雑誌

<b>Objective</b>: Neck pain is a very common complaint in the general population. However, little is known about the characteristics of this complaint. The aim of this study was to clarify the psychological and physical characteristics of neck pain.<BR><b>Method</b>: The subjects were 13 adult men with complaints of neck pain (NP group, mean age 20.2±0.7 years) and 10 healthy volunteers (CON group, mean age 21.2±1.5 years). This study used findings of neck tenderness and muscle stiffness for evaluation of neck pain, and employed the visual analog scale (VAS) to record the subjects’ assessment of their pain. State-Trait Anxiety Inventory (STAI), MOS 36-Item Short-Form Health Survey (SF-36), VAS for evaluation of perceived stress, and measurements of salivary cortisol density levels were utilized to measure stress. The salivary cortisol density was measured by the enzyme immunity method of measurement (the ELISA method). In addition, saliva samples were collected between 9 AM to 10 AM.<BR><b>Results</b>: The mean VAS score for neck pain in the NP group was 56.9±17.3. There was no significant difference in muscle stiffness between the groups. Tenderness of the upper trapezius fibers and right splenius capitis muscle were significantly higher in the NP group (p<0.05). The VAS score of perceived stress and the state anxiety of STAI were significantly higher in the NP group (p<0.05). The SF-36 score was significantly lower in the CON group (p<0.05). The trait anxiety of STAI and the salivary cortisol density were not significantly different.<BR><b>Conclusion</b>: There was no significant difference in the salivary cortisol density levels between the two groups. The degrees of perceived stress and uneasiness were reported as higher in the NP group, while the degrees of psychological and physical health were lower. These findings suggest the role of psychosociological factors in neck pain.

Psychological and Physical Characteristics of Neck Pain in University Students / 日本温泉気候物理医学会雑誌

Objective: Neck pain is a very common complaint in the general population. However, little is known about the characteristics of this complaint. The aim of this study was to clarify the psychological and physical characteristics of neck pain. Method: The subjects were 13 adult men with complaints of neck pain (NP group, mean age 20.2±0.7 years) and 10 healthy volunteers (CON group, mean age 21.2±1.5 years). This study used findings of neck tenderness and muscle stiffness for evaluation of neck pain, and employed the visual analog scale (VAS) to record the subjects’ assessment of their pain. State-Trait Anxiety Inventory (STAI), MOS 36-Item Short-Form Health Survey (SF-36), VAS for evaluation of perceived stress, and measurements of salivary cortisol density levels were utilized to measure stress. The salivary cortisol density was measured by the enzyme immunity method of measurement (the ELISA method). In addition, saliva samples were collected between 9 AM to 10 AM. Results: The mean VAS score for neck pain in the NP group was 56.9±17.3. There was no significant difference in muscle stiffness between the groups. Tenderness of the upper trapezius fibers and right splenius capitis muscle were significantly higher in the NP group (p<0.05). The VAS score of perceived stress and the state anxiety of STAI were significantly higher in the NP group (p<0.05). The SF-36 score was significantly lower in the CON group (p<0.05). The trait anxiety of STAI and the salivary cortisol density were not significantly different. Conclusion: There was no significant difference in the salivary cortisol density levels between the two groups. The degrees of perceived stress and uneasiness were reported as higher in the NP group, while the degrees of psychological and physical health were lower. These findings suggest the role of psychosociological factors in neck pain.

Characteristics of Shoulder Periarthritis Patients Developing Articular Contracture during Acupuncture Therapy / 日本温泉気候物理医学会雑誌

 Forty-one patients with periarthritis with no evident articular contracture at the start of acupuncture (at the first presentation) were divided into 13 subjects who developed articular contracture during acupuncture (transition group) and 28 subjects who did not (non-transition group), and the clinical characteristics of the two groups were compared.<br> The following results were obtained. (1) The mean age of the subjects was significantly higher in the transition group than in the non-transition group (58.5±6.8 years vs. 52.1±9.6 years). (2) The percentage of subjects in the transition group was significantly higher in the subjects not clearly diagnosed as having no contracture at the first presentation than clearly diagnosed as no contracture (57% vs. 19%). (3) The percentage of subjects in the transition group was significantly higher in the subjects in whom the lesion site was enlarged or could not be identified than independent (50% vs. 17%). (4) The percentage of subjects in the transition group was significantly higher in the subjects with nocturnal pain than without (64% vs. 15%). (5) The transition group was unlikely to show improvement of pain or restriction of the range of motion with acupuncture as compared to the non-transition group.<br> The possibility of developing articular contracture should be considered while providing treatment by acupuncture and guidance to patients showing the above tendencies.

Characteristics of Shoulder Periarthritis Patients Developing Articular Contracture during Acupuncture Therapy / 日本温泉気候物理医学会雑誌

 Forty-one patients with periarthritis with no evident articular contracture at the start of acupuncture (at the first presentation) were divided into 13 subjects who developed articular contracture during acupuncture (transition group) and 28 subjects who did not (non-transition group), and the clinical characteristics of the two groups were compared.  The following results were obtained. (1) The mean age of the subjects was significantly higher in the transition group than in the non-transition group (58.5±6.8 years vs. 52.1±9.6 years). (2) The percentage of subjects in the transition group was significantly higher in the subjects not clearly diagnosed as having no contracture at the first presentation than clearly diagnosed as no contracture (57% vs. 19%). (3) The percentage of subjects in the transition group was significantly higher in the subjects in whom the lesion site was enlarged or could not be identified than independent (50% vs. 17%). (4) The percentage of subjects in the transition group was significantly higher in the subjects with nocturnal pain than without (64% vs. 15%). (5) The transition group was unlikely to show improvement of pain or restriction of the range of motion with acupuncture as compared to the non-transition group.  The possibility of developing articular contracture should be considered while providing treatment by acupuncture and guidance to patients showing the above tendencies.

The Effect of Acupuncture Therapy on Arteriosclerosis Obliterans (ASO) / 日本温泉気候物理医学会雑誌

We evaluated the clinical effect of acupuncture treatment on 21 patients with Arteriosclerosis Obliterans (ASO). Severity of ASO was grade I in one case, II in 17 cases, III in two cases, and IV in one case (Fontaine classification). Mainly low-frequency electroacupuncture was applied to inpatients two to four times per week and to outpatients, once or twice a week. Effects on claudication distance (ICD), pain, coldness, and Ankle Brachial Pressure Index (ABPI) were assessed on inpatients by comparing the status before starting treatment with that before the acupuncture treatment at the 17th visit. We also assessed the thermograph and plasma calcitonin gene-related peptide (CGRP) of the lower extremities.<br>Improved warmth, increased intermittent limping distance, and relief of pain during walking were observed in patients of grade I and II (Fontaine classification of severity). No improvement of symptoms was observed in patients of grade III and IV. No change in ABPI was observed in any patient. Surface temperatures in the peripheral extremities were significantly elevated from 15 minutes after insertion of the needles until 15 minutes after removal. A significant increase in plasma CGRP was observed immediately after the treatment.<br>These findings suggest that acupuncture treatment may be effective for some symptoms of grade I and II ASO and that improvement of peripheral circulation via vascular dilatation may be involved in the mechanism of action.

Clinical Study of Electro-Acupuncture Therapy -(EAT)-Examination of muscle-EAT and nerve-EAT- / 日本温泉気候物理医学会雑誌

We investigated the difference between muscle-EAT and nerve-EAT basically and clinically. A basic study was performed on healthy adult males. The skin blood flow, deep-tissue temperature, deep hemodynamics, heart rate, and deep-pain threshold were adopted as indexes, and they were compared for a total of three groups: the muscle stimulation-EA group, nerve stimulation-EA group and control group (no stimulation). An acupuncture needle was inserted into the gastrocnemius muscle for muscle stimulation-EA and another needle into the tibial nerve in the femoral region for nerve stimulation-EA. Electric current was then applied at 1Hz for 15 minutes after the flexibility of the foot joint was conformed. Each index was measured after it became stable and was recorded from 10 minutes before starting stimulation until 20 minutes after ending stimulation.<br>A clinical study was performed on 41 patients with cervical radiculopathy. Muscle-EAT was applied to the patients as the first choice. Cases graded five points or less in pain score (10-point method) after one month were included in the muscle-EAT group. Cases graded six points or more were subjected to nerve-EAT and were included in the nerve-EAT group. The therapeutic results in these two groups were examined for a period of three months at intervals of one month based on the pain score and the evaluation criteria for the results of treatment of cervical radiculopathy.<br>As a result, we found that the skin blood flow significantly increased on the stimulated side in both the muscle stimulation-EA and nerve stimulation-EA group. The increase was greater in the nerve stimulation group than in the muscle stimulation group. The deep-tissue temperature rose significantly on the stimulated side in the nerve stimulation-EA group. Regarding the deep hemodynamics, deoxy Hb decreased significantly in the nerve stimulation-EA group. No difference was found in heart rate between the two groups. The deep-pain threshold was significantly raised by nerve stimulation.<br>Patients with cervical radiculopathy who did not respond to continuous muscle-EAT for one month were subjected to nerve-EAT. After three months (two months after changing to nerve-EAT), similar improvements were found in both groups. Significant improvement of paresthesia was obtained with nerve-EAT.<br>These results suggested that the nerve-EAT influences the peripheral circulation and the deep pain threshold more effectively, enhancing the clinical efficacy.

The Effects of Electroacupuncture Stimulation on Circulation in Human Ocular Fundus / 日本温泉気候物理医学会雑誌

The effect of electroacupuncture (EA) stimulation on tissue circulation in the human ocular fundus (choroidal blood flow) was studied in 11 adult healthy volunteers (6 males and 5 females, age 31.5±5.7y) who had no physical or ocular disease. Using the laser speckle method, normalized blur (NB) values, a quantitative index for tissue blood flow, were measured over an area of choroid between the macula and the optic nerve papilla with no discrete visible vessel. The EA stimulation was applied between BL 10 and GB 20 and between GB 21 and SI 13 on the right side for 15 minutes at 1Hz with an intensity which cause slight muscle contraction. The NB value and intraocular pressure (IOP) in both side eyes, blood pressure (BP) and pulse rate (PR) were measured at baseline time, immediately after EA, and every 5 minutes after EA up to 15 minutes. These procedures were repeated on the same subjects as a control trial on another day. The NB value of choroid on the stimulated side significantly increased following EA stimulation compared with the control value, while that in the unstimulated side showed no significant change. No significant change was observed in BP, IOP or ocular perfusion pressure throughout the experimental period.

The Effects of Acupuncture on Shoulder-Hand Syndrome (SHS) as a Complication of Hemiplegia / 日本温泉気候物理医学会雑誌

Hemiplegia after a cerebrovascular event is a complication that causes problems in daily life such as difficulty of walking and may lead to social disadvantages. Furthermore, various subsequent health issues that accompany hemiplegia tend to hinder rehabilitation. In particular, Shoulder-Hand Syndrome (SHS) is an intractably painful disease with primary symptoms of pain and swelling in the upper limbs of patients. We investigated the effect of the acupuncture treatment on those patients with hemiplegia after a cerebrovascular event who are suspected to have SHS because of such symptoms as pain, swelling, and paresthesia in the upper limb of the affected side by measuring the changes in the numerical scale (NS), Gibbons' RSD score, and range of motion (ROM) in upper extremities.<br>The present study consisted of 13 hemiplegic subjects (eight males, five females) with pain, swelling, and paresthesia in the upper limbs. Acupuncture treatment was applied twice a week for over two months. Specifically electrical acupuncture and/or the retaining needle technique was applied to the upper extremities for 20 minutes in each session. Of 13 participants, 10 showed a significant decrease in NS (reduced by five or more points), eight showed improvement of the swelling in the upper limbs, and nine showed reduction in paresthesia.<br>From these results, we concluded that the acupuncture treatment was effective for SHS that accompanies hemiplegia after a cerebrovascular event and that the improvement of the peripheral blood flow might play an important role in generating treatment effects.

Relations of Stiff Shoulders with Deep Hemodynamics Values / 日本温泉気候物理医学会雑誌

Poor circulation is considered to be a cause of stiff shoulders, but there have been no studies on deep hemodynamics and the subjective estimation/palpation of stiff shoulders. We evaluated the relationship between deep hemodynamics and the degree of the subjective estimation/palpation of stiff shoulders by near-infrared spectrophotometry.<br>The subjects were 146 patients who visited our center and 23 healthy volunteers. Deep hemodynamics (tissue oxygen saturation: StO₂, total hemoglobin concentration: total Hb) was measured in the scapular region of the bilateral shoulders using a deep hemodynamics measurement system (PSA-IIIN, Biomedical Science), and its relationship with the severity of the subjective estimation of stiff shoulders (5-grade rating) and that of palpation (4-grade rating) was evaluated. Deep hemodynamic values were affected by the body mass index (BMI) that is highly correlated with subcutaneous fat thickness. Therefore, analysis was performed in 70 patients and 8 healthy volunteers with BMI of 20-24 that does not affect hemodynamic values. Compared with the healthy volunteers, patients who reported marked shoulder stiffness showed a significant decrease in total Hb, and that who reported shoulder stiffness showed a significant decrease in StO₂. On the other hand, compared with the healthy volunteers, patients with marked shoulder stiffness observed by palpation showed significant decreases in both StO₂ and total Hb; the decreases were more marked with more marked stiffness. These results suggested that deep hemodynamics is a diagnostic parameter of stiff shoulders.

Effects of Acupuncture Therapy on Periarthritis Scapulohumeralis / 日本温泉気候物理医学会雑誌

We examined the effects of acupuncture therapy on 41 patients with various levels of periarthritis scapulohumeralis. These patients were classified into two groups: one consisting of 20 patients having no contracture, those of freezing type (age 61.0±9.0; suffering period 3.0±5.1 months) and the other consisting of 21 patients having contracture, those of frozen type (age 53.8±7.3; suffering period 5.8±7.8 months).<br>As a result, we found that acupuncture therapy relieved pain more effectively in patients having no spontaneous pain than in those having spontaneous pain regardless of the presence or absence of contracture. We next investigated the effects of this therapy by the patient types. In the group of 20 freezing-type patients, which includes only six patients having spontaneous pain, pain relief was relatively easily obtained as indicated by the pain score after the therapy of 3.6±1.8. In the group of 21 frozen-type patients, which includes 13 patients having spontaneous pain, however, it was difficult to obtain sufficient pain relief as indicated by the pain score of 5.7±2.8. There was a statistically significant difference (P<0.002) between these scores. This shows that acupuncture therapy is more effective on freezing-type patients than on frozen-type patients.<br>Therapy also improved the range of motion. In many freezing-type patients, the range of motion was expanded due to pain relief. The abduction ROM expanded from 151.8±39.0° before therapy to 163.8±25.0° after acupuncture therapy. In frozen-type patients, however, the range of motion did not expanded significantly (87.6±24.1° before to 94.8±21.1° after therapy). The above results suggest that acupuncture therapy is effective for relieving the pain of periarthritis scapulohumeralis and that this therapy is particularly effective when applied to those patients having no spontaneous pain before they enter into the frozen phase.