ABSTRACT
We report a 74-year-old woman who developed right-sided Hunt syndrome on July 3, XXXX, and who received stellate ganglion block and an infusion of aciclovir while hospitalized. Steroids were not used due to her diabetes. After discharge, she continued taking vitamin B<sub>12</sub>, and received stellate ganglion block three times a week, but the paralysis did not show a tendency toward recovery. Following a combination of acupuncture and rehabilitation starting on October 6 (post-onset day 95), the paralysis score, which was 4 points on day 95, showed a tendency toward recovery : 32 points on day 186, and 36 points or more (within the normal range) on day 246. No apparent synkinesis was seen one year after the onset. Although Hunt syndrome appeared to be refractory due to her advanced age, presence of diabetes, unused steroids, complete paralysis with a paralysis score of 8 points or less, and no tendency to recover for three months or more, the results suggested that she responded to the combination of acupuncture and rehabilitation.
ABSTRACT
We retrospectively investigated the effects of acupuncture on refractory peripheral facial paralysis. Among patients with Bell's palsy or Ramsay Hunt syndrome (type II) who underwent acupuncture between August 1996 and June 2004, were 29 patients with a minimum electroneuronography (ENoG) percent response of 0%, and NET scale-out (14 patients with Bell's palsy, 15 with Ramsay Hunt syndrome). Demographically, they 21 males and 8 females, with a mean age of 44.3±12.8 years. Their disease duration, and paralysis score assessed using the 40-point method (Yanagihara's method) were 43.2±23.9 days and 10.2±2.7 points, respectively. To evaluate treatment response, we employed the paralysis score, and a sequela score assessed using a modification of the sequela evaluation method designed by Nishimoto and Murata et al. The paralysis score exceeded 36 points within 6 months after onset. Five patients (17.2%) without sequelae were regarded as having achieved complete recovery, and 24 (82.8%) as having achieved incomplete recovery. When the minimum ENoG is 0%, recovery within 6 months beyond onset is considered impossible. The results suggest, however, the efficacy of acupuncture.
Subject(s)
Paralysis , AcupunctureABSTRACT
We retrospectively compared the treatment effects of electro-acupuncture against <i>in situ</i> acupuncture, in 15 Hunt's Syndrome patients who underwent acupuncture therapy in our institution between August 1996, and June 2004, and who had fulfilled 3 electroneurography (ENoG) criteria with a value of 0% within 90 days after onset, had a paralysis score of <20, and could be followed up for 6 months after onset. Electroacupuncture therapy was performed on the paralysis side of the faces of 8 patients (the electro-acupuncture group), while <i>in situ</i> acupuncture therapy was performed on the remaining 7 (the <i>in situ</i> acupuncture group). No significant differences were observed in the background factors between the two groups. Treatment results were evaluated using the 40-point paralysis score described by Yanagihara, as well as a sequela score, which was a modified method of the sequela assessment developed by Nishimoto and Murata et al. Changes in paralysis scores from first acupuncture therapy, out to 6 months post-onset were compared using repeated ANOVA measures, and Mann-Whitney U tests respectively. Recovery of paralysis scores did not significantly differ between the two groups (p=0.0507), although slightly better recovery was observed in the electroacupuncture group, as compared with the <i>in situ</i> acupuncture group. Additionally, sequelae scores did not significantly differ between the two groups (p=0.51). In recent years, many have been of the opinion that lowfrequency stimulation is contraindicated. In this study, however, the incidence of sequelae did not differ significantly between the electro-acupuncture therapy and the <i>in situ</i> acupuncture therapy groups, although slightly better paralysis recovery was observed in the former.
ABSTRACT
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.