ABSTRACT
There is little common understanding among acupuncturists regarding the poor prognosis for peripheral facial paralysis, evaluation methods, precautions during treatment, including acupuncture and moxibustion treatment. Cooperation among relevant occupations is also a major issue. Currently, the treatment of paralysis is focused on how to minimize sequelae during the recovery process of paralysis in cases with poor prognosis. The goal is to prevent sequelae and improve patient quality of life (QOL). For that purpose, it is important to understand the guidelines for medical treatment of paralysis, and like other medical staff, the acupuncturist should provide appropriate medical examination, treatment, self-care guidance, etc., and cooperate with other medical specialists. We hope that this seminar will provide a common understanding of the pathophysiology and evaluation methods of paralysis, precautions for acupuncture and moxibustion treatment, and a consensus of clinical research and the future possibility of using acupuncture and moxibustion in the treatment of paralysis.
ABSTRACT
[Objective] Peripheral facial paralysis with sequelae (PFPS) reduces the quality of life (QOL) of patients. However, not much information is available on acupuncture treatment (AT) for PFPS. We report a case of a patient with PFPS whose sequelae and QOL were successfully improved by a combination of medication, physical therapy (PT) and AT.[Case] A 42-year-old woman. Her chief complaint was facial tightness, facial asymmetry, and synkinesis.[History of present illness] Left paralysis developed in November X-1, and Bell's palsy was diagnosed. Yanagihara Score (YS) was 6 points. She received intravenous steroid treatment during hospitalization for 9 days after second week after onset. In addition, she was given facial nerve decompression on January 24, X. but there wasno change. Subsequently, she visited the Department of Otolaryngology-Head and Neck Surgery, The University of Tokyo on 24 April. Electroneurography was 4%, YS was16 points and synkinesis was found. AT was started from May 29, X. [Acupuncture treatment] We performed AT on muscle for facial expression for contractural reduction. Also, weinstructed self-care techniques such as massage, open-eyelid exercise, individual muscle strengthening exercise and matters that require attention in everyday life. AT was performed 19 times, once every one to two weeks.[Assessment and Progress] Measurements of YS, synkinesis, synkinetic potential (SP), Facial Clinimetric Evaluation Scale (FS) were evaluated at about 7 and 15 months after onset. YS (point) changed from 24 to 34, synkinesis changed from (++) to (+), SP did not change, FS (point) increased from 41 to 57.[Discussion and Conclusion] Treatment for PFPS is limited and reduces QOL. We added regular acupuncture treatment to medication and PT for PFPS. As a result, we were able to relieve sequelae, contributing to improvement in the quality of life. It is suggested that AT might have efficacy for PFPS.
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The effects of acupuncture and moxibustion on headache in clinical trials were reviewed. First, the effects of Western medicine on headache for patients with primary headache and secondary headache were systematically reviewed based on online data, and possible mechanisms were discussed. Second, the role and potential use of acupuncture and moxibustion on headache were considered based on a review of research literature. Finally, the effectiveness of acupuncture and moxibustion on migraine and tension type headache was systematically examined based on online data. These results suggest that acupuncture and moxibustion may be most effective on recurring headache.
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The effects of acupuncture and moxibustion on lower back pain in clinical trials were reviewed. First, the effects of Western medicine on lower back pain, patients with specific and nonspecific lower back pain, were systematically reviewed based on online data, and possible mechanisms were discussed. Secondly, the role and potential of acupuncture and moxibustion on lower back pain were considered based on a review of research literature. Finally, the effectiveness of acupuncture and moxibustion on several kinds of lower back pain was systematically examined based on online data. These results suggest that acupuncture and moxibustion may be more effective on non-specific lower back pain.
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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.
ABSTRACT
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.
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The goal of this panel discussion<BR>The understanding of lumbago has been changing in recent years.<BR>It has moved from "Trouble of the spine"to recognizing the importance of catching the concept of "Living thing, psychology, and social pain syndrome".<BR>It is a way of thinking that is going to grasp the clinical condition of lumbago along with the invisible dysfunction and provide better viewpoint in order to understand the aberration which we call a disorder of conventional intervertebral disc clinical condition of lumbago.<BR>This view point supports the appropriate technical use of acupuncture and moxibustion.<BR>It is important for the medical man not to begin treatment until the complete condition is understood.<BR>In keeping with this viewpoint, the panel of four will be joined by an orthopedist and a physical therapist, and this panel discussion 1 planned "primary care for lumbago".<BR>Each panelist described how to catch condition of a patient, a way of the correspondence, the advantages and disadvantages of acupuncture and moxibustion, therapeutic method and evaluation method in this method of treating lumbago.
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The skin has a special significance in acupuncture. In acupuncture, the skin is both a site of both examination and treatment while providing an interface for information exchange with the external world. Various findings that appear on the body surface should not simply be understood as dermatologic findings, but considered as a reflection of the internal condition of the body, the external world and the mental condition. From this perspective, although acupuncture treatment use only simple stimuli, such as needles, and stimulate only specific sites on the body surface, they can produce therapeutic effects and regulate physical and mental functions<BR>In this symposium, we reviewed the relationship between skin and acupuncture by examining acupuncture and moxibustion treatments for specific dermatologic diseases and their clinical effects. As a result, we were able to reaffirm the above relationship from the perspective of an acupuncturist.<BR>The methods and clinical effects of acupuncture and moxibustion treatment were introduced for atopic dermatitis (by Egawa), tinea unguium (by Dr. Menjou), and the dermatologic symptoms of connective tissue diseases (by Dr. Kasuya). Moreover, Dr. Kagawa presented his research results related to the effects of acupunctural stimulation on the condition of the skin. Based on these research results, the possible effects of acupuncture treatment were discussed based on extensive application in fields such as dermatology, cosmetics, and anti-ageing. Regarding the significance of the skin (body surface) within the practice of acupuncture, it was reconfirmed that the skin reflects the condition of the organs and the mind, and examination of the skin may elucidate both mental and physical health. In addition, we also discussed the body surface as a site of both examination and treatment, and investigated the efficacy, potential for further development, and significance of acupuncture, which connect the skin with systemic functions.
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Acupuncture and moxibustion were introduced to Japan from China in the 6 th Century. Since then our ancestors adapted these unique techniques and knowledge to our climate and ethnicity, and eventually developed the Japanese system of acupuncture and moxibustion.Whether acupuncture and moxibustion therapy is successful or not depends on the knowledge and skill of the individual acupuncturist. However, in recent years, the role of medical doctors, nurses, physical therapist and other medical professionals working as a team has become particularly important, with some acupuncturist starting to work in university hospitals as part of these teams, and contributing to patient well-being.In this paper, to elucidate the roles of acupuncture and moxibustion in modern medicine, we show how acupuncture and moxibustion are applied in university hospitals, and how acupuncturists evaluate the effectiveness of their acupuncture and moxibustion.
Subject(s)
Acupuncture , Moxibustion , Hospitals, University , HospitalsABSTRACT
Acupuncture and moxibustion were introduced to Japan from China in the 6 th Century. Since then our ancestors adapted these unique techniques and knowledge to our climate and ethnicity, and eventually developed the Japanese system of acupuncture and moxibustion.<br>Whether acupuncture and moxibustion therapy is successful or not depends on the knowledge and skill of the individual acupuncturist. However, in recent years, the role of medical doctors, nurses, physical therapist and other medical professionals working as a team has become particularly important, with some acupuncturist starting to work in university hospitals as part of these teams, and contributing to patient well-being.<br>In this paper, to elucidate the roles of acupuncture and moxibustion in modern medicine, we show how acupuncture and moxibustion are applied in university hospitals, and how acupuncturists evaluate the effectiveness of their acupuncture and moxibustion.
ABSTRACT
[Objective]We report on a hemophilia A patient who was treated at the department of internal medicine of our hospital receiving acupuncture treatment at an acupuncture treatment clinic. It began with iliopsoas muscle hematoma, and remarkably hindered daily life with severe pain.<BR>[Case]The case was a male hemophilia A patient in his twenties. He continuously took clotting factor replacement therapy by self-injection. He received acupuncture treatment in the lower back, and increasingly came to have more pain in the lower back and extremities. He was admitted to our hospital with a fusiform blood tumor in the iliopsoas muscle with MRI.<BR>[Conclusion]In a congenital bleeding disease, it is necessary to check the condition and the severity of symptoms by collecting information through medical examination by interview, visual examination, examination by touch, and manual muscle testing for acupuncture treatment.
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[Introduction] We evaluated the efficacy of treatment and clinical characteristics of a patient with incomplete rotator cuff tear with a clinical presentation similar to that of frozen shoulder. It seems difficult to differentiate incomplete rotator cuff tear from frozen shoulder on physical findings alone since the former lacks the specific characteristics of rotator cuff tear. However, many patients with incomplete rotator cuff tears show a poor response to treatment due to mechanical disorders; thus, differentiation of incomplete rotator cuff tear from frozen shoulder may be demonstrated during the patient's clinical course.<BR>[Patient] In this patient, the joint range of motion improved in all directions, and the pain score also improved from 10 to 5, showing reduction of pain. However, the symptoms did not resolve smoothly; frequent remis-sions and exacerbations of symptoms were observed.<BR>[Discussion] We frequently encounter disorders diagnosed as periarthritis scapulohumeralis in daily clinical practice, and patients with such disorders usually respond well to treatment. However, we should realize that a variety of clinical conditions are involved in the disorders, and the clinical courses of patients should be followed closely during treatment.
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We evaluated the efficacy, usefulness and safety of acupuncture and moxibustion treatment in rheumatoid arthritis, by the randomized, parallel-group, multi-center study with the drug-treated outpatient group as the control. The endpoints, important in the clinical assessment of acupuncture treatment, included the improvement criteria in ACR core set variables and the Japanese version of the Arthritis Impact Measurement Scales Version 2 (AIMS-2), a system of evaluation of the QOL of patients with RA.<br>Regarding intervention (therapy), a therapy chart for each stage of disease was drawn up to give local and systemic treatment in consideration of the patient's activity and disability in each stage of rheumatoid arthritis, so that generally consistent therapy adapted to the patient's condition would be provided. Result 1. Patients eligible for analysis were 80 patients of A-group (drug therapy group) (80 females, 2 males, 2dropped) and 90 patients of B-group (drug plus acupuncture and moxibustion group), total 170 patients. 2. Patients who satisfied the improvement criteria in ACR core set variables (improved patients) were 8 of 80 patients in A-group and 20 of 90 patients in B-group. The improvement rate was significantly higher for B-group treated by drug plus acupuncture and moxibustion versus A-group, with P=0.04 in 2×2 table chi square test. 3. In QOL change investigated by AIMS-2 questionnaire, the improvement occurred significantly more frequently in the drug plus acupuncture and moxibustion group, with difference between groups at 12 months after the initiation of clinical study at P=0.001. 4. Changes in the subjects included in AIMS-2 questionnaire: Improvement was significantly more frequent in the drug plus acupuncture and moxibustion group versus drug therapy group in respect to the ability to walk, finger function, housework, sociableness, pain, mood, and the degree of subjective improvement. In the present randomized, parallel-group, multicenter study, a significant improvement was detected in the drug plus acupuncture and moxibustion group versus the drug therapy group in the aforesaid respect, which suggested that the use of acupuncture and moxibustion combined with the conventional therapy would prevent deterioration of physical functions, improve blood circulation, stabilize mental status, and thereby contribute to the improvement of QOL in patients with rheumatoid arthritis.
ABSTRACT
We evaluated the efficacy, usefulness and safety of acupuncture and moxibustion treatment in rheumatoid arthritis (RA), by the randomized, parallel-group, multi-center study with the drug-treated outpatient group as the control. The endpoints, important in the clinical assessment of acupuncture treatment, included the improvement criteria in ACR core set variables and the Japanese version of the Arthritis Impact Measurement Scales Version 2 (AIMS-2), a system of evaluation of the quality of life (QOL) of patients with RA.<BR>Regarding intervention (therapy), a therapy chart for each stage of disease was drawn up to give local and systemic treatment in consideration of the patient's activity and disability in each stage of RA, so that generally consistent therapy adapted to the patient's condition would be provided. Result 1. Patients eligible for analysis were 80 patients of A-group (drug therapy group) (80 females, 2 males) and 90 patients of B-group (drug plus acupuncture and moxibustion group), total 170 patients. 2. Patients who satisfied the improvement criteria in ACR core set variables (improved patients) were 8 of 80 patients in A-group and 20 of 90 patients in B-group. The improvement rate was significantly higher for B-group treated by drug plus acupuncture and moxibustion versus A-group, with P=0.04 in 2 (2 table chi square test. 3. In QOL change investigated by AIMS-2 questionnaire, the improvement occurred significantly more frequently in the drug plus acupuncture and moxibustion group, with difference between groups at 12 months after the initiation of clinical study at P=0.001. 4. Changes in the subjects included in AIMS-2 questionnaire : Improvement was significantly more frequent in the drug plus acupuncture and moxibustion group versus drug therapy group in respect to the ability to walk, finger function, housework, sociableness, pain, mood, and the degree of subjective improvement. In the present randomized, parallel-group, multicenter study, a significant improvement was detected in the drug plus acupuncture and moxibustion group versus the drug therapy group in the aforesaid respect, which suggested that the use of acupuncture and moxibustion combined with the conventional therapy would prevent deterioration of physical functions, improve blood circulation, stabilize mental status, and thereby contribute to the improvement of QOL in patients with rheumatoid arthritis.
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One of the complications in patients on long-term hemodialysis is spondyloarthropathy resulting from amyloidosis due to abnormal accumulation of β2-microglobulin. With deposition of β2-microglobulin in soft tissues, such as ligaments and joints, destruction of bones and cartilages begins at the site of ligament attachment and proceeds with the accompanying inflammatory reaction, fibrosis and ligament thickening. The soft tissue proliferative lesion and destruction of bones and cartilages produce spinal canal stenosis and, ultimately, compression of the spinal cord and cauda equina, to give rise to various clinical symptoms.<br>We tried acupuncture treatment on two patients with lumbar spinal canal stenosis due to hemodialysis-related spondyloarthropathy who presented with neurogenic intermittent claudication, and evaluated its effects. Acupuncture treatment involved placement of acupuncture needles chiefly in the stenotic region, once weekly, for about three months. Marked improvement was obtained regarding claudication distance and JOA score in patient number one, who had radicular type intermittent claudication. Slight improvement of claudication distance and improvement of JOA score (particularly relief of pain) were obtained in patient number two, who had mixed type intermittent claudication. These results suggest that acupuncture treatment might be effective for dialysis patients with lumbar spinal canal stenosis associated with hemodialysis-induced spondyloarthropathy.
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The effect of acupuncture treatment on ending peripheral facial nerve paralysis was examined using standard set by the Japan Society of Facial Nerve Treatment. A comparison was made of how recovery was affected by acupuncture treatment alone, drug treatment alone, and a combination of drugs (steroids) and acupuncture.<BR>As a result we found that 1) in groups having an ENoG of 41% or more, the acupuncture-only group showed less recovery than did the group that received oral steroids. 2) Among the groups having an ENoG of 21% or more, there was no significant difference between the group given oral steroids and the group given both steroids and acupuncture treatment. 3) For groups having an ENoG of 1%-20%, there was no difference in recovery between the group given large doses of injected steroids and the group given large doses of injected steroids concommitant with acupuncture. But the group that was given both oral steroids and acupuncture did not recover as well as the other groups. 4) A comparison of the groups receiving only medication and receiving medication with acupuncture showed there was no special hastening of recovery seen with the administration of acupuncture; in fact, the acupuncture may have even delayed recovery.<BR>The above results indicate that the administration of steroids is more important than the use acupuncture in the treatment of peripheral facial nerve paralysis, and that a suitable treatment should commence within 7 days after the occurrence of symptoms.
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[Objective] To compare the effectiveness of electro-acupuncture with that of transcutaneous electrical nerve stimulation (TENS) in the treatment of lower back pain and to investigate problems with conducting rigorous trials in Japan. [Design] A multi-center, randomized, observer-blinded, controlled trial with two parallel arms. [Setting] Four medical facilities affiliated with universities or colleges in Japan. [Subjects and methods] Low back pain patients without sciatica suffering for at least two weeks were randomly assigned to either an acupuncture with electro stimulation group (Group A) or a TENS group (Group T). Plans called to recruit 80 patients in the protocol. Patients in both groups were treated twice a week for 2 weeks with 1 Hz electro-stimulation for 15 minutes. Visual analogue scale (VAS) of pain relief and the scores recommended by the Japanese Orthopaedic Association (JOA Score) were measured. Primary endpoint was improvement of pain that was assessed from the changes in VAS. [Results] Three patients were withdrawn after one-week run-in period and one patient was withdrawn from Group A during treatment the period. Consequently, 31 in group A and 33 in group T completed the trials and were available for evaluation. There was no difference between the groups in primary endpoint and JOA scores. [Discussion] Problem of patient recruitment should be resolved by strategically selecting facilities or by advertising for participants. Future investigation with attentive trials using adequate intervention is required to conclude whether or not acupuncture exceeds TENS in efficacy. [Conclusion] There was no statistical difference between electro-acupuncture and TENS for lumbago in this study.
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We executed an acupuncture therapy to 62 lumbar spinal canal stenosis cases who were diagnosed by CT, MRI photo state and clinical symptom and examined the result.<br>The 36 men and 26 women in this study had a mean age of 67.3 years.<br>An acupuncture was executed by aiming to give an effect to the soft tissues and a blood circulation around the area where the stenosis was recognized then pierced facet joint closely and deeply and gave an electric acupuncture stimulus.<br>14 cases were very good and 17 cases had good results according to the JOA score. No cases worsened.<br>We concluded an acupuncture treatment was effective for treating lumbar spinal canal stenosis.
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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.