Effects of manual acupuncture on motor evoked potentials induced by transcranial magnetic stimulation in human / 全日本鍼灸学会雑誌

[Objective]The purpose of this study was to investigate the effects of manual acupuncture stimulation (MA) on motor evoked potential (MEP) induced by transcranial magnetic stimulation (TMS).<BR>[Methods]The subjects were 10 healthy volunteers who gave oral and written informed consent. Experiment 1. MEPs were induced from the right abductor digiti minimi muscle (rADM) by TMS with a circular coil to the left cortex motor area and were measured before and after MA to the right LI4 (right Hoku point), left LI4 (left Hoku point), right LR3(right Taichong point) or left LR3(left Taichong point). A sparrow pecking technique (1 Hz for 1 minute) with a stainless steel needle (40 mm long, 0.18 mm in diameter, Seirin co., Inc, Shizuoka) was used for MA. The subjects received the same experiments four times with MA to different acupoints on a different day. Experiment 2. MEPs were measured during imaging of rADM and lADM contraction and immediately after noxious pinch stimulation to the skin on the right LI4 and left LI4 and right LR3and left LR3respectively. Repeated measure two-way ANOVA was used for statistical analysis to compare between all groups. Repeated measure one-way ANOVA and multiple comparison (Dunnett's test) were applied to time point data in each group.<BR>[Results]MA to the left LI4 or right LR3was significantly decreased MEP (P < 0.01, respectively). In the right LI4, there was a tendency to decrease of MEP, but not significantly (P = 0.26). Most subjects answered feeling severe or strong acupuncture needle sensation. MEPs were significantly increased by imaging of contraction and noxious stimulation (P < 0.001 and P < 0.01, respectively).<BR>[Conclusion]These results suggested a possibility that distant acupuncture stimulation would suppress motor activity via several roots and that an acupuncture inhibited effect was compensated by facilitation arising from the concentration to the stimulated hand.

Present state of infection control in acupuncture and moxibustionpart 2-Questionnaire survey for practicing acupuncturists in the Chubu region- / 全日本鍼灸学会雑誌

[Objective]To survey the current situation of infection control in clinical practice of acupuncture and to discuss the problems and strategy.<BR>[Methods]The subjects were 1,000 acupuncture clinics enrolled in iTownPage in the Chubu region. The questionnaire was sent to them by mail in November 2008. The questions were the following; 1) Profile of respondent, 2) Hand hygiene, 3) Preparation of needling sites, 4) Sterilization and storage of needles and equipment and disposable products, 5) Disposable needle, 6) Hand-pressing (Oshi-de), 7) Infectious waste, 8) Awareness, efforts and self-evaluation of practitioner for infection control, and 9) Comments of this survey.<BR>[Results]The collection rate was 22.2%. Washing time for less than 30 sec was 31.1%, Usage rate of a cloth towel was 67.7%, Hand antisepsis by the basin method was 18.9%, Usage rate of 50 %isopropyl alcohol was 19.8%, etc. 26.6%of all respondents answered that the possibility of infection in acupuncture and moxibustion therapy was very low and 50.9%of those responded that it was low. However, only 27.0%of the responders answered that infection control in their own clinics was appropriate. In addition, 72.5%of the responders belonged to the Japan Acupuncture and Moxibustion Association (JAMA) or the Japan Society of Acupuncture and Moxibustion (JSAM).<BR>[Conclusion]Although some infection controls have been improved, many problems became clear. These problems are suggested to be caused by poor acknowledge, previous experience and wishful thinking of practitioners. It is necessary to continue activities to raise practitioner's awareness for infection control.

Present state of infection control in acupuncture and moxibustion -A questionnaire survey for practicing acupuncturists in the Kinki region- / 全日本鍼灸学会雑誌

We have been utilized acupuncture and moxibustion in our department of internal medicine at Meiji University of Integrative Medicine since its investment in 1987. In the department, various kinds of symptoms in the field of internal medicine have been managed with acupuncture and moxibustion. In this article, I would like to introduce our activities regarding acupuncture treatment in the department of internal medicine and some remarkable results of our clinical studies which evaluated effects of acupuncture and moxibustion as well as relationship between acupuncture therapists and the staff of our department. In the field of respiratory disorders such as COPD or bronchial asthma, usefulness of acupuncture have been proved through a controlled clinical trial which involved COPD patients who had not been able to control with standard care. Also, acupuncture was found to be useful in the management of bronchial asthma in a case series study in which acupuncture treatment was repeatedly applied with intervals without acupuncture. We have also demonstrated that acupuncture was useful for gastrointestinal disorders such as irritable bowel syndrome (IBS). Results of a case series with n-of-1 study design showed significant reduction in the symptoms during acupuncture treatment, while those in the period without acupuncture had been aggravated. Data from studies on diabetic complications such as peripheral neuropathy or gastropathy also showed usefulness of acupuncture. We considered that it is valuable to explore unknown usefulness of acupuncture in the field of internal medicine and prove effectiveness of acupuncture with appropriate scientific manner.

Third Molar Extraction under Acupuncture Anesthesia in a Dental Patient Hypersensitive to Local Anesthetics / 全日本鍼灸学会雑誌

Acupuncture anesthesia is not often used in dental practices because its efficacy depends on various conditions. However, pain-relieving methods, which use no medication, are necessary for those rare patients who are hypersensitive to local anesthetics or for whom local anesthetics are difficult to use because of diseases of the internal organs of the nervous system. In a patient hypersensitive to local anesthetics, we recently attempted to relieve the pain during extraction of an impacted lower third molar by applying acupuncture anesthesia, after relaxing the patient both physically and mentally with acupoint stimulation. By these methods, pain control for this patient was successful during and after surgery, without medication.

The Treatment of Temporomandibular Joint(TMJ) Arthrosis by Acupuncture / 全日本鍼灸学会雑誌

Temporomandibular arthrosis, whose major symptoms are trismus, pain of the temporomandibular joint and articular noise, has recently been increasing, primarily in younger people. This condition is often accompanied by unexplained complaints (e. g., headache and stiffness of the neck and/or shoulder) which are indications for the application of acupuncture therapy. To deepen the recognition of temporomandibular arthrosis by clinicians, we recently prepared a video tape showing detailed procedures of acupuncture therapy for this disease. The first half of this video tape consists of an explanation of the anatomical features of the temporomandibular joint, the pathophysiology and classification of temporomandibular arthrosis, and magnetic resonance images of the temporomandibular joint. The latter half consists of the diagnostic and therapeutic procedures for this disease, including the acupoints often stimulated for its treatment and the techniques of acupuncture therapy.

Acupunctural Stimulation of The Pudendal Nerve for Treatment of Urinary Disturbances / 全日本鍼灸学会雑誌

An educational video describing the acupunctural stimulation of the pudendal nerve for treatment of urinary disturbances was produced. Treatment points on the meridian were selected within the limits of the top 1/2 to 3/5 of the line that connects the superior posterior iliac spine and the inner lower edge of the ischiatic tuberosity. Since the pudendal nerve is situated between the sacrospinous ligament in this region, it could be readily stimulated from the body surface. A 90mm (#24) acupuncture needle was used for the treatments. When the needle was inserted to a depth of 50-80mm from the body surface, the pudendal nerve was reached. Echo sensation in the penis indicated that the acupuncture needle had contacted the pudendal nerve.<br>Either the sparrow-pecking, needle-twisting, or the low frequency acupunctural techniques were used to delver stimulation to the pudendal nerve. In conclusion, acupunctural stimulation of the pudendal nerve was clinically useful for treatment of urinary disturbances, such as uncoordination of the detrusor muscles in neurogenic bladder and urinary incontinence.

Review of Practices at the Pain Clinic of Osaka Medical University Department of Anesthesiology Over the Past 23 Years / 全日本鍼灸学会雑誌

During the 23 years since this pain clinic was founded, 29, 458 patients have been treated here (about 385, 000 patient visits in total). In the earlier days, patients with whiplash injury (posttraumatic neck syndrome) were predominant. More males than females visited our clinic in those earlier days. Several years after this clinic opened, the percentage of female patients became higher (55% or more) than the percentage of male patients. Reflecting the social trend of an increase in the percentage of elderly people in the total population, the percentage of patients between 60 and 80 years of age has been increasing. Patients who visit this clinic live primarily in Osaka Prefecture. However, it is not uncommon that patients living in other prefectures of the Kinki district visit this clinic. Although patients visit our clinic because of various complaints, they often suffer from chronic, intractable complaints, such as low back pain, combined pain of the lower back and legs, and postherapuetic neuralgia. They often visit our clinic as a last resort for healing, after having consulted many other institutions. The duration of sickness among patients who visit our clinic is long (often over 5 years). Although the methods of treatment and the patients' responses vary, depending on their diseases, the combination of nerve block with acupuncture seems to be more effective on pain. We have utilized various techniques of acupuncture, including the in situ needle acupuncture, low-frequency therapy, SSP therapy, laser therapy and hyperthermia.

Effectiveness of Low Frequency In Situ Needle Acupuncture Combined with Body Sonic Pad Therapy / 全日本鍼灸学会雑誌

A new therapy was recently developed by combining low frequency in situ needle acupuncture with Body Sonic Pad therapy. With this therapy, the patient lies on a bed fitted with Body Sonic Pads which vibrate slightly, in synchrony with the low-pitched sounds of the music which is played during the therapy. The patient listens to music and can feel the music-synchronized vibration of the pads while receiving in situ needle acupuncture. We recently assessed the effectiveness of this combined therapy.<br>The subjects were 30 patients with chronic shoulder stiffness who visited our department of anesthesiology. These patients received each of the following 5 treatments at different times in random order: (1) Method M (listening to music without any other therapy), (2) Method B (Body Sonic Pad therapy without listening to music), (3) Method MB (Body Sonic Pad therapy while listening to music), (4) Method L (conventional continuous low-frequency (3Hz) in situ needle acupuncture), and (5) Method MBL (continuous low-frequency (3Hz) in situ needle acupuncture combined with Body Sonic Pad therapy while listening to music). The direct therapeutic effect and the degree of comfort during treatment were compared among these five methods. The acupuncture therapy for shoulder stiffness consisted of stimulating the standard points in the shoulder and neck region with 30mm acupuncture needles (No. 20). The electrical stimulation lasted for 20 minutes. The music used for Body Sonic Pad therapy was primarily classical music selected according to the desire of the patients. The effectiveness was rated by the patients on a 4-point scale (markedly effective, effective, slightly effective and ineffective). Effective or markedly effective cases were regarded as responding to the therapy. The level of comfort during treatment was rated on an 11-point scale.<br>The number of patients who responded to the therapy was 7 (23%) for Method M, 6 (20%) for Method B, 10 (34%) for Method MB, 18 (60%) for Method L and 23 (77%) in Method MBL. The response rate was significantly higher for Method MBL when compared to Method M or MB. The mean level of comfort during treatment (rated on a visual analog scale; 0=most uncomfortable; 10=most comfortable) was 6.3±2.1 for Method M, 6.0±2.1 for Method B, 7.0±1.6 for Method MB, 7.2±1.9 for Method L and 8.3±1.6 for Method MBL. Thus, low frequency in situ needle acupuncture combined with Body sonic Pad therapy was slightly superior to the other therapies.

A Case with Distinct Propagated Sensation along the Meridian(PSM). IV. The Variation of PSM according to Stimulation Methods, the Propagating Speed of PSM, and the Blocking Effect of Mechanical Pressure / 全日本鍼灸学会雑誌

Various acupuncture stimulations were given to a 60 year-old housewife with a distinct meridian phenomenon to observe subsequent PSM. Clear PSM was induced either by finger pressure, press needle or low frequency press needle stimulation of Guanchong (terminal point). Scarless moxibustion applied to a source point induced clearer PSM than that to a terminal point. Comparing the propagating speeds of the PSM induced by press needle stimulations of the terminal points of the twelve meridians, those of liver, kidney and spleeen were the fastest (about 70cm/sec) and those of heart and large intestine were the slowest (1cm/sec). The propagation of PSM was blocked by 50-60mmHg of manchette pressure or by about 400g/cm local pressure using a pressure meter.

Therapeutic effect of the cordless mini TENS on shoulder stiffness and painful diseases / 全日本鍼灸学会雑誌

The therapeutic effect of a cordless mini TENS on shoulder stiffness and painful diseases and patients' favorite intensity of stimulation were studied. Effect of this apparatus on peripheral circulation was also examind using a laser Doppler measuring instrument. The 114 cases with shoulder stiffness used the TENS only once (SS group), and the 53 cases continuasly (SC group). The 65 cases with painful diseases used the TENS only once (PS group) and the 53 cases continuasly (PC group). A great majority of the patients prefered stimulation with moderate frequency and high intensity. Effectiveness was seen in 76% of SS group and 87% of SC group, and in 75% of PS group and 91% of PC group. Peripheral circulation was significantly increased after the stimulation of the apparatus.

The evaluation of the effect of low energy laser irradiation stimulation on shoulder stiffness / 全日本鍼灸学会雑誌

In the previous paper, we reported a clinical study on laser irradiation stimulation for pain diseases. In the present study, we examined the effect of laser irradiation stimulation on peripheral blood circulation and its clinical effectiveness in the treatment of shoulder stiffness.<br>[METHOP] Five healthy adults were irradiated with low energy semiconductor laser (Ga-Al-As, 70mw, 830nm) at the Jianjing (VF21) for ten minutes. Skin blood flow near the stimulated point was measured using Laser-Doppler method before and after (for 20min.) irradiation.<br>Clinical effectiveness was examined for 50 patients with clonic shoulder stiffness who visited Anesthesiological Department of Osaka Medical College Hospital. The patients were randomly devided into two groups: laser irradiation group (L group) and Non-irradiation group (C group). To the C group, the apparatus was set but no laser was irradiated. Stimulation points were Tianzhu (VU10), Jianjing (VF21), Jianwaishu (IT14) and other points commonly used for shoulder stiffness. According to the numerical scale of subjective symptom reported by the patients immediately after the stimulation, therapeutic effictiveness was rated into four grades: “marked improvement” “improvement” “slightJimprovement” and “no change”. “Marked improvement” and “improvement” were regarded as effective cases.<br>[RESULTS] After laser stimulation, blood flow increased several times heigher than the original level but it tended to decrease back to the original level within the measuring period. The incedence of effective cases was 58% for L group and 40% for C group.<br>[CONCLUSION] Laser irradiation stimulation has been reported to have same effect as acupuncture, and gathering attention as stimulation method with less adverse effects. Our study demonstrated that laser stimulation induced transient improvement of local blood circulation.

An evaluation of music-rhythm low-frequency electro-acupuncture / 全日本鍼灸学会雑誌

We have been studying the optimal condition of low-frequency electro-acupuncture. In the present paper, clinical effect of music-rhythm low-frequency electro-acupuncture on shoulder stiffness was evaluated. In this therapy, musical rhythms was directly converted to pulse waves.<br>Subjects were fifty patients with chronic shoulder stiffness who visited the anesthesical department of Osaka Medical College and assented to be a subject of this experiment. Each patient underwent the following three methods in random order: conventional 3Hz continuous-wave low-frequency electro-acupuncture (C method), music-rhythm low-frequency electro-acupuncture without music sound (S method), music-rhythm low-frequency electro-acupuncture with music sound (M method). The acupoints such as “Tianzhu” and “Jianjing”, which were reported by the Acupoint Committee of Japan Acupuncturists' Association as frequently used ones, were selected as basic points. Music-rhythm low-frequency electro-acupuncture was carried out using a special signal discriminating apparatus which output alternating square waves (1-100Hz) sychronizing with a music tape. Electrical stimulation was given for 15 minutes. The music was from an album of Japanese popular songs called Enka. No. 20 needles of 30mm in length were used. The effect of each method was evaluated by the patient immediately after the treatment using a numerical scale. The numerical evaluation was classed into four grades (“remarkably effective”, “effective”, “slightly effective”, “not effective”), and “Remarkably effective” and “effective” cases were counted as effective ones. Comfortableness was rated using a visual analog scale with 11 grade {-5 (discomfort): 0: +5 (comfort)}.<br>As to the immediate effect, “effective” was seen in 60% cases of C method (30/50), 58% of S method (29/50) and 76% of M method (38/50). M method showed 20% higher effectiveness than C and S method. This was statistically significant. Averaged comfortableness was 2.1 in C method, 1.9 in S method and 2.7 in M method.<br>We demonstrated the effectiveness of music-rhythm low-frequency electro-acupuncture on shoulder stiffness. To give music sound simaltaneously is necessary to get better physical and psychological results.

Effect of acupuncture on dysurea after radical operation for cervical carcinoma / 全日本鍼灸学会雑誌

Acupuncture treatment was undertaken for 153 cases with dysurea after radical operation for carcinama of uterine cervix. Eighty-four percent of the patients were forties, fifties or sixties. Seventy percent of them underwent acupuncture treatment within two weeks after the operation. The treatment consisted of one or combination of the following methods: direct current acupuncture, in situ acupuncture, low-frequency electro-acupuncture and SSP. Acupoints considered to facilitate metabolism in the pelvic cavity and to be related to diurea were selected. The treatment group (fifty cases) had 19.7 days on which average residual urine was less than 50ml, whereas the control group 24.6 days. “Remarkable effect” and “effect” were obtained with SSP in seventy-seven percent of the cases, and with low-frequency electro-acupuncture in seventy-three percent. With the latter, “no effect” was obtained in only two percent of the cases. SSP therapy was effective and gained patients' favor because it gave no anxiety.

Study of oversensitivity to cold according to ryodoraku autonomic nervous system therapy(neurometry) / 全日本鍼灸学会雑誌

It is presumed that oversensitivity to cold is derived from the imbalance of the autonomic nervous system. As a result of the cold condition, the patient may complain of various other problems as well. According to oriental medicine, the main origin of oversensitivity to cold is the invasion of cold, an external evil. In neurometry, this symptom is depicted by low measurement values. Before each treatment session we performed neurometry to assess the patient's condition. Then we performed general Ryodoraku regulation therapy, using a 60mm length, 0.24mm diameter needle as a 200μA (12V) negative electrode for 7 seconds. withI the objective of tonifying and warming the body. In addition, we performed half-rice grain size moxibustion 7 flashing moxas on the special effective extraordinary meridian points. Hanfeng, Lisanli, and main meridian points Fengmen, Zhishi. Neurometry revealed that oversensitivity to cold is related to values of the F, Ryodoraku which are lower than the normal physiological range. The treatment indicated by neurometry proved to be successful in increasing the F, Ryodoraku values.

A case with obvious meridian phenomenon. (III) / 全日本鍼灸学会雑誌

The direction of echo sensation of each acupoint was examined on the patients who showed obvious meridian phenomenon.<br>The heart meridian and large intestine meridian were chosen. Echo sensation propagating both directions, i. e. afferently and efferently, was seen most often, then afferently only and efferent only followed.<br>The direction of echo sensation did not neccesarilycoincide with that of meridian stream.

A comparative study on the changes in pain threshold resulting from "exercise" work load and acupuncture anaesthesia / 全日本鍼灸学会雑誌

In this research we conducted a comparative study on the pain threshold elevation resulting from “exercise” work loads, ie. running and cycling, and acupuncture anaesthesia. 10 subjects participated throughout our research; whereas, additional subjects only participated in selected experiments. It was found that the pain threshold increased for both exercise work load and acupuncture anaesthesia; however, no significant correlation was found between the pain threshold elevation percentages resulting from exercise work load and acupuncture anaesthesia.<br>Therefore we propose, although it has been ascertained that the elevation of pain threshold involves the endomorphin mechanism, that there must be other important mechanisms involved as well.

The analgesic effect of laser-puncture on painful diseases / 全日本鍼灸学会雑誌

A statistical study on effects of laser-puncture was carried out. In addition, an attempt was made to compare between the effect of acupuncture and this method. The treatments were under-taken for various chronic and acute cases with pain. In the laser-puncture treatment, two types of laser (<i>i, e.</i> low energy 10mW laser and 70mW sharp laser) were used. Laser-beam was given to 20-30 points which were located in painful areas, innervating nerve areas and remote areas for 40 sec for each.<br>In the open study, 10mW laser-puncture was effective (including ‘rather effective’) in 64% of the cases, and 70mW laser-puncture 73%. In the blind test, ‘the day’ evaluation showed that the laser-punctures were more effective than placebo treatment: 10mW laser-puncture was effective in 80% of the cases, and placebo in 67%. 70mW laser-puncture was effective in 87% of them, and placebo in 80%. <i>In situ</i> acupuncture was effective in 97%, and no effect was seen in 7%.<br>Only ‘the day’ evaluation in the open study showed that 70mW laser-puncture was more effective than 10mW one. In the blind best, 10mW and 70mW laser-puncture were more effective than placebo, and in situ acupuncture was more effective than the laser-punctures, but there were no significant differences among the three treatmets.

Clinical study on enhanced analgesic effect by DPA according to the different ways of administration. I / 全日本鍼灸学会雑誌

In previous papers, we experimentally demonstrated the enhancing effect of D-phenylalanine (DPA) administration on the analgesic effect of acupuncture by the increase of pain threshold. In the present study, we examined the effect of administration manners in the patients with chronic lumbago who visited our anaesthesiological department. We conducted a double-blind study with two different administration manners: “previous-day” and “just-before”.<br>METHODS<br>Fifty-six patients suffering from chronic low back pain for more than three months were devided into two groups. DPA or placebo was orally administered intwo different manners prior to low-frequency electro-acupuncture treatment. Group I patients (26 cases), took 0.5g three times (i. e. a total of 1.5g): after the evening meal and before go to bed on the day before, and after the beakfast on the day of acupuncture (“previous-day” administration). Group II patients (30 cases), took 4.5g 30 minutes before acupuncture treatment “just-before” administration. The treatment was undertaken twice with DPA administration and twice with placebo administration for each group. “Direct effect” was determined by the number scale method and a comparison between the two groups was made. In the additional experiment, three volunteers were orally given 4.0g or 1.5g DPA, and blood phenylalanine level was determined two hours, four hours and one month later.<br>RESULTS<br>In the group I (previous-day administration), “DPA+acupuncture” produced the following result: excellent 7.8%, good 69.2%, moderate 19.2%, (significantly different from placebo administration). In the group II (just-before administration), “DPA+acupuncture” produced the following result: excellent 23%, good 37%, moderate 20%, and no-effect 20% (significantly different from placebo administration). Comparing group I with group II, the percentage of the “excellent” or “good” cases in the former was larger than that of the latter (+17%). Blood phenylalanine level showed its high value 2-4 hours after administration of 4g DPA, whereas 2 hours after that of 1.5g DPA.<br>Conducting a clinical investigation into the effectual administration (timing and doses) of DPA, we found that previous-day administration is more effective than “just-before” administration in enhancing effect of acupuncture analgesia. Although there is room for further studies with a larger number of cases, considering that DPA has a “slow onset long acting” effect (Ehrenpreis), we can conclude that the series administration of DPA on the day before acupuncture treatment is advisable.

A statistical study on propagated sensation along the channels (PSC) of outpatients / 全日本鍼灸学会雑誌

The term, propagated sensation along the channels (PSC) means the peculiar sensation expeerienced by some people along thier meridians when given acupunctural stimulation of acupoints.<br>In the present study, the incidence of PSC in outpatients who were undergoing acupuncture treatment was investigated.<br>Low frequency electrical stimulation was performed through press needles at twenty-six points: the twelve terminal points of the twelve regular meridians and the Inner-Zhiyin points of both sides. PSC was assessed on a four-grade basis after the manner carried out in China.<br>The incidence of PSC was significantly high among the outpatients compared with that among healthy youth. Patients with hypertension or posttraumatic neck syndrome showed higher incidence of PSC than the other patients.

The Effect of Acupuncture Treatment for the Low Back Pain Patients with D-Phenylalanin (DPA) Preadministration (II) / 全日本鍼灸学会雑誌

We have been studying the effect of preadministration of D-phenylalanin (DPA) on acupuncture analgesia for various types of pain. DPA is thought to suppress the activity of carboxypeptidase, which discomposes endorphins. In this double-blind placebo-controled study, clinical effectiveness of acupuncture with DPA preadministration in relieving chronic low back pain was examined.<br>DPA (4g) or placebo (lactose: 4g) was orally administered to thirty out patients with chronic low back or lower extremity pain 30 minutes before acupuncture treatment. A half of the patients were given placebo in the first session and DPA in the second one, and the other half were given DPA firstly and placebo secondly.<br>The patients were asked to rate their pain after treatment in comparison with pre-treatment condition. Successful pain relief was obtained in 60% of the patients given DPA prior to acupuncture and in 33.4% of those given placebo. Although it is said that there is a great individual variation in response to acupuncture therapy, this result demonstrates that preadministration of D-phenylalanin enhances analgesic effect of acupuncture therapy.