Correction rates and safety of acupuncture and moxibustion for treating breech presentation / 全日本鍼灸学会雑誌

[PURPOSE] To evaluate the efficacy and safety of acupuncture and moxibustion treatments in breech presentation, we report correction rates and adverse events for correcting breech presentation in our department.[PARTICIPANTS AND METHODS] Subjects were pregnant women who were diagnosed with breech presentation in our obstetrics and gynecology department and started acupuncture and moxibustion treatment between April 1, 2009 and October 31, 2018. The target patients were retrospectively investigated by medical records. The main items investigated were the status of the pregnant women at the time of acupuncture and moxibustion initiation (presence or absence of threatened preterm labor), treatment position (sitting or lateral position), correction rates and occurrence of adverse events. Successful correction was defined as the rate of head position after acupuncture and moxibustion treatments. Adverse events were defined as "unfavorable medical events occurring during or after treatment, regardless of causation."[RESULTS] There were 371 pregnant women in the study; among them 57 women were diagnosed with threatened preterm labor at the start of acupuncture and moxibustion treatment, including 21 pregnant women who were in the hospital. The sitting position was used for treatment for 45.2% (168 cases) of subjects and lateral position was used for 54.7% (203 cases). The correction rates were 72.2% (268/371). In pregnant women with threatened preterm labor who were hospitalized at the time of acupuncture and moxibustion initiation, the correction rates were 28.6% (6/21 cases), which was significantly lower than that of outpatient pregnant women. There was no significant difference in the rate of correction by treatment position between sitting and lateral position. There were no adverse events of vagal reflexes when the left lateral position was treated. The frequency of adverse events per number of procedures was 1.1% (21/1916) and per number of cases was 5.7% (21/371 cases). There were two cases of rupture of membranes with no apparent causal relationship.[CONCLUSION] The safest position for treatment in pregnant women was considered to be the left lateral position. Most of the adverse events were minor or moderate, but there were two cases of rupture of membranes with no apparent causal relationship. When performing acupuncture and moxibustion for breech presentation, it is necessary to work closely with the patient's obstetrician.

Acupuncture and Moxibustion in Hospitals—How have General Hospitals Changed after Introducing Acupuncture and Moxibustion in Routine Care? / 日本東洋医学雑誌

Although it is not yet common, certified Kampo (traditional Japanese medicine) doctors and acupuncturists are cooperating with each other to provide traditional medical treatment for patients in some general hospitals in Japan. In other hospitals, however, Kampo and acupuncture-moxibustion have not been introduced, and doctors only treat patients using modern Western medicine. Many doctors must already be aware that modern Western medicine is not the only approach for the treatment of patients, but they do not make any efforts to improve the situation by adopting traditional medicine. Here, we give some examples of hospitals in which acupuncture treatments are routinely provided, having a favorable effect on both patients as well as the hospitals themselves. We believe that these examples give us a good opportunity to consider the future of an ideal medical system in which modern Western medicine and traditional Japanese medicine are successfully integrated.

Current status of acupuncture in palliative care of Tonami General Hospital / 全日本鍼灸学会雑誌

[OBJECTIVE] In recent years, acupuncture treatment for cancer patients has spread worldwide. However, in Japan, there are few facilities where acupuncture and moxibustion treatment is being carried out in a hospital, and in introducing acupuncture treatment as part of palliative care is rare. In this study, we investigated the current situation at our hospital where acupuncturists are participating in the palliative care team of the hospital.[PARTICIPANTS AND METHODS] Subjects were patients with cancer in our hospital who were hospitalized to receive the best supportive care for their condition and who had started acupuncture treatment between April 8, 2011 and November 13, 2017. The target patients were retrospectively investigated by medical records. [RESULTS] Of the 75 patients, 72 (96%) were Performance Status 3 and 4. Thirty-seven (49%) had oxygen therapy. Fifty-five patients (73%) had pleural fluid or ascites during acupuncture and moxibustion treatment, and 50 patients (67%) had edema. In the treatment of acupuncture, Contact Needle Therapy was used to avoid the risk of infection and bleeding, and in the moxibustion treatment, scarring moxibustion was not used to avoid the risk of burns and infection. Fifty-nine patients (79%) had a positive opinion of the acupuncture treatment. Forty-five patients (66%) requested acupuncture within two days of their death. There were 3 adverse events, but all were mild and transient, .[CONCLUSION] In the acupuncture treatment at our hospital for patients in the terminal stage of cancer, treatment was performed taking into consideration the risks to the patient, and there were no serious adverse events. There were many positive feedbacks from patients who received acupuncture, suggesting that acupuncture may be useful for alleviating symptoms at the end stage of cancer.

Sixteen Cases Effectively Treated with Tokishakuyakusan with Jio (Tokishakuyakusan and Shimotsuto) / 日本東洋医学雑誌

We present 16 cases effectively treated using the traditional Japanese herbal formulation tokishakuyakusan with the crude extract jio (tokishakuyakusan and shimotsuto). All patients were women with a median age of 35.5 years (range : 22-62 years). Cases included infertility (n = 5), dermatological disease (n = 5), gynecological disease (n = 2), excessive sensitivity to cold (n = 2), mental nerve paresthesia (n = 1), and general fatigue (n = 1). All patients had sho for tokishakuyakusan and high degree of ketsu deficiency. All patients with infertility became pregnant within one year. The symptom severity of other patients decreased to less than half compared with their initial visit. Cases of palmoplantar pustulosis and chronic eczema improved without topical corticosteroids. Our results suggest that tokishakuyakusan with jio is a suitable treatment for patients who have sho for tokishakuyakusan and high degree of ketsu deficiency.

<b>How Much Chilly Pain do You F</b><b>eel?</b> / 日本東洋医学雑誌

<p><b>PURPOSE </b>: To create a receiver operating characteristic curve (ROC curve) to screen for excessive sensitivity to cold (ESC).<br><b>PARTICIPANTS AND METHODS </b>: Subjects were 99 women who visited a specialty outpatient clinic for ESC. The controls were 371 female nurses. A numerical rating scale (NRS ; from 0 indicating someone is asymptomatic to 10 indicating profound discomfort) was used to determine the extent of chills in both groups. ROC curves were created to distinguish ESC based on their score on the NRS. An ROC curve was created for each premenopausal and postmenopausal woman.<br><b>RESULTS </b>: The ESC group had a mean score on the NRS of 7.3 (95% confidence interval [CI] : 6.9 to 7.6) while normal subjects had a mean score of 4.0 (CI : 3.7 to 4.3). The ESC group had a significantly higher mean score on the NRS. When the cut-off point for the NRS was set at ≥5, it had 98% sensitivity and 54% specificity for distinguishing premenopausal ESC. Similarly, that cut-off point had 96% sensitivity and 67% specificity for distinguishing postmenopausal ESC.<br><b>CONCLUSION </b>: If an individual with chills has an NRS score of ≥5, that individual may be experiencing discomfort sufficient to warrant being seen by a medical facility. Using an NRS to assess chills should help to screen for ESC.</p>

<b>Effectiveness of Contact Needle Therapy for Peripheral Facial Paralysis.</b> / 日本東洋医学雑誌

<b>PURPOSE</b> : To examine the therapeutic efficacy of contact needle therapy (CNT) for peripheral facial paralysis<br><b>STUDY DESIGN</b> : Case series study<br><b>METHODS</b> : A total of 15 patients (Bell's palsy, 13 cases ; Ramsay Hunt syndrome) with peripheral facial paralysis who first visited between April 1, 2008 and March 31, 2013 and received CNT were examined in this study. Using the Yanagihara paralysis score, complete recovery was defined as a score improved to 36 within about 6 months of paralysis onset, and without moderate or worsened residual morbid synergic movements.<br><b>RESULTS</b> : In all cases, the patient had received standard otological treatment. Median age was 65 years (range, 23-84 years). Median interval from onset of paralysis to first acupuncture treatment was 13 days (range, 4-105 days). Eight patients had an electroneurography (ENoG) value of < 10%. Eight patients achieved complete recovery. Two of the 8 patients with complete recovery had an ENoG value of < 10%.<br><b>CONCLUSION</b> : Not only in-situ acupuncture and electroacupuncture treatments, but also CNT may represent effective acupuncture treatments for peripheral facial paralysis.

Risk Factors for Excessive Sensitivity to Cold and Physical Characteristics:A Prospective Cohort Study / 日本東洋医学雑誌

PURPOSE : To determine risk factors for excessive sensitivity to cold (ESC) in relation to physical features.DESIGN : A prospective cohort study carried out between July 7 and November 14,2008.PARTICIPANTS AND METHODS : Seventy female junior college students with no ESC at baseline, and a median age of 20 years, participated. We used a numerical rating scale (NRS) to classify each ESC sensation over the five days in this July-November period.To confirm physical symptoms, we used Terasawa's diagnostic scores for ki, ketsu, and sui. We defined ESC as mean NRSgeq ≥ 5.RESULTS : We documented 17 participants with ESC in November. The multivariate adjusted odds ratio for ESC was11.6 (95% CI 1.9 to 97.5) for the physical characteristic “edema”. Participants with ESC were shorter in stature than participants without ESC (-5.9cm ; 95% CI -8.6 to -3.1).CONCLUSION : Participants with edema and short stature have a high risk for ESC.

Three Cases of Recurrent Respiratory Tract Infections in Tube-feeding Elderly Patients Treated with Acupuncture / 日本東洋医学雑誌

Case1was a 91-year old man diagnosed with multiple cerebral infarctions. He had undergone percutaneous endoscopic gastrostomy in the same year. One year later, we initiated acupuncture treatment because of recurrent respiratory tract infections. The acupuncture points selected were LU 5, Chize and KI 13, Taixi. Before acupuncture, the frequencies of antibiotics-use and feverish days were 6.3 days and 2.7 days per month on average. During acupuncture therapy, these frequencies were reduced to 1.2 days and 0.6 days per month, respectively.Case 2 was an 81-year old man diagnosed with right thalamic hemorrhage. He underwent percutaneous endoscopic gastrostomy in the same year. After 6 months, we began acupuncture treatment, also because of recurrent respiratory tract infections. The acupuncture points were the same as in Case 1.Prior to acupuncture, antibiotics-use and feverish days were 8 days and 4.5 days per month, which were then reduced to1and 0.6 days per month, respectively.Case 3 was a 93-year old man diagnosed with dementia. He was being fed via nasoenteric tubes. After 3 months, again because of recurrent respiratory tract infections, acupuncture treatment was begun. The acupuncture points were the same as in Cases 1 and 2.His use of antibiotics and feverish condition were 9 days and 10 days per month on average before acupuncture, but with acupuncture therapy these were improved to 2 days and 1.3 days per month.Based on this experience, it is suggested that acupuncture be considered for the treatment of recurrent respiratory tract infections in elderly, tube-fed patients.

Three Case Reports of Dysesthesia Successfully Treated with Ougikeishi-gomotsu-to / 日本東洋医学雑誌

We report three cases of dysesthesia that showed improvement after treatment with Ougikeishi-gomotsu-to. Case 1 was a 70-year-old woman diagnosed with post-herpetic neuralgia in 1998 (left trigeminal nerve level). She visited our department with left facial dysesthesia and pain on ****, 2002. We initiated the treatment by Ougikeishi-gomotsu-to. She judged the dysesthesia to have disappeared by about 50% after 4 weeks, and by about 10-20% after 6 weeks. We used Rokumi-gan with Ougikeishi-gomotsu-to on ********. She felt a little dysesthesia and pain on *****.<br>Case 2 was a 55-year-old woman diagnosed with carpal tunnel syndrome in March 2002. She had felt dysesthesia in both hands since 1999. She visited our department for the first time in April 2002. We initiated the treatment by Ougikeishi-gomotsu-to. After 1 week, she felt dysesthesia in only the fingertips. Now, we are using Boui-ougi-to, acupuncture and moxibustion in combination with Ougikeishi-gomotsu-to. She feels only a little dysesthesia.<br>Case 3 was a 72-year-old woman diagnosed with post-herpetic neuralgia on ********, 2002 (Th 12 and L 1 level). She was treated at the anesthesiology department on *****. But her pain and dysesthesia hardly improved. She visited our department on ****. We initiated the treatment by Ougikeishi-gomotsu-to. She judged her dysesthesia and pain to have disappeared by about 40% after 23 days, and by about 20% after 6 weeks.

A Case Report of Sciatica Successfully Treated with Gorei-san-ryo / 日本東洋医学雑誌

We report a case of sciatica showing improvement by treatment with Gorei-san-ryo. The patient, a 66-year-old woman with right gonarthrosis, had been receiving treatment at the orthopaedic surgery department since May 19, 2000. She felt left hip pain and left leg numbness on May 10, 2002. She was diagnosed with left-side sciatica on May 15, 2002. She was treated with loxoprofen, eperisone, and epidural steroids at the orthopaedic surgery, but her symptoms hardly improved. She visited our department on August 7, and treatment wiht Busi-to was begun. After four weeks, her symptoms had not improved. Busi-to was stopped and Gorei-san-ryo was begun on September 4. After two weeks, her hip pain had improved. Keishi-bukuryo-gan was administered in addition to Gorei-san-ryo on September 18. On December 25, her sciatica as evaluated by visual analogue scale, had decreased from 100 to 35 since first visiting our department. Based on this experience, it is suggested that Gorei-san-ryo be considered in the treatment of sciatica.

A Case Report of Rheumatoid Arthritis Successfully Treated with Dai-seiryu-to-ka-daio / 日本東洋医学雑誌

We report a case of rheumatoid arthritis (RA) that showed improvement after treatment with Daiseiryu-to-kadaiou. The patient was a 77-year-old woman diagnosed with RA in 1988. She had been visiting our department regularly since 1994. Oral steroids were used for two weeks in May 1994, but were discontinued due to a bacterial infection of the artificial femoral head. Thereafter, treatment was continued with bucillamine, nonsteroidal anti-inflammatory drugs, and various Kampo medicines. Joint pain worsened in November 2001. She was hospitalized on **********, as the CRP level had elevated to 15.2mg/dl. She had been taking bucillamine for seven years, but it had already been assessed as ineffective. It was discontinued upon hospitalization, and treatment with Daiseiryu-to-kadaiou was immediately begun. By ******, the patient judged the pain in both knees to have improved by about 50 percent. Moreover, the CRP level decreased to 2.4mg/dl by *******. The Lansbury index also improved from 100 percent to 69 percent during her hospitalization, and she was discharged on *******. Based on this experience, it is suggested that the prescription of Daiseiryu-to-kadaiou be considered in the treatment of RA patients.