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.

Relationship between the five viscera symptoms and "depression"or "anger" / 全日本鍼灸学会雑誌

[Introduction]Patients express various symptoms that reflect their physical, mental and psychological conditions. Thus, traditional Chinese medicine (TCM) emphasizes the relationship between physical and mental states. In the clinical practice of acupuncture and moxibustion, however, many patients chiefly cite physical complaints, and are often treated without a full discussion of their mental and psychological conditions. In TCM, feelings are divided into five categories:anger, happiness, concern, sadness, and fear. The relationship between these feelings and symptoms of disease of the five viscera is not clearly defined, so we attempted to clarify the correlations. This report describes the results of a survey on the characteristics and nature of anger and depression in terms of the five viscera.<BR>[Methods]After obtaining informed consent, 102 students from a vocational school and our university (60 men and 42 women, average age 25 ± 8) were recruited for this study. Three survey sheets were used:Oriental Medicine Health Questionnaire 57 (OHQ57) for understanding the condition of the five viscera; 24 of the 34 items of the State-Trait Anger Expression Inventory (STAXI) for understanding the state of anger;and Beck Depression Inventory (BDI) for assessing depression. The survey was conducted from June to July in 2012.<BR>[Results]The average scores in OHQ57 were 5.1 ± 3.1 for kan (liver), 4.6 ± 3.2 for shin (heart), 5.2 ± 3.1 for hi (spleen), 3.8 ± 3.3for hai (lung), and 3.9 ± 2.7 for jin (kidney). The average scores in STAXI were 23.0 ± 5.1 for State of Anger, 18.8 ±.1 for Anger-Expression, 20.8 ± 3.8 for Anger-Suppression, and 18.9 ± 3.5 for Anger Control. The average score in BDI was 12.4 ± 8.0. Significant correlations were found between State of Anger and kan:Anger-Expression and han/shin/hai in STAXI, and between depression and shin/hi in BDI.<BR>[Conclusion]The Suwen ("Basic Questions,"the oldest Chinese medical text) and other TCM literatures report that anger and depression are related to kan, and the results of this study confirmed the relationship between anger and kan. Based on factor analyses, scores of Anger State (intensity of anger) revealed that groups suspected of having diseases of kan tended to get angry easily and Anger-Expression (expression of anger) showed that these groups displayed both aggressive behavior and verbal assertion. On the other hand, latent factors of depression, possibly caused by diseases of kan, were not revealed in factor analyses, although depression was significantly correlated with shin and hi.

A Case of Ulcerative Colitis with Recurrent Attacks of Melena that Required Changing in Prescription during Medical Treatment / 日本東洋医学雑誌

We report the case of a 33-year old man with ulcerative colitis and attacks of melena who responded positively to a change in prescription, in accordance with change in his disease state. His melena developed in May of the year XXXX. He was diagnosed with ulcerative colitis (proctitis) after a thorough evaluation at another medical institution, administration of 5-ASA, steroid suppositories and an antidiarrheal agent had brought no relief, and he consequently sought Kampo treatment at our institution. Saireito (9.0g/day) and kyukikyogaito(9.0g/day) extract granules were initially administered for two weeks in addition to the aforementioned drug therapy, which resulted in improvement of his melena. However, the same Kampo formulations prescribed later, when his attacks recurred, failed to effectively halt rectal bleeding. These recurrent attacks differed from his first, in that blood was seen after the elimination of feces (feces first, blood later), and as “feces-first, blood-later” conditions are described in the Synopsis of the Golden Chamber as “enketsu” indications for odoto decoction, his prescription was changed to odoto. After odoto administration for 2 months, his melena gradually resolved, and active rectal inflammatory change was improved as seen with colonoscopy. His melena then lessened after 1 month's administration, and symptoms of melena had almost completely disappeared after 2 month's administration. Amelioration of active rectal inflammatory change was also confirmed with colonoscopy findings. This was an interesting case where the progression of a clinical condition required a corresponding change in prescription for effective management of symptoms.

Review of an experimental program for fundamental education about kampo herbal medicine / 医学教育

A model core curriculum proposed by the government in 2001 outlined the core structure for undergraduate medical education, in which a kampo medicine educational program was established to teach holistic medicine. Eighty Japanese medical schools have attempted to implement this program. We presented lectures on kampo herbal medicine as part of practical training in kampo focusing on clinical pharmacology and using a team-based format. This experience-based program aims to promote active learning of kampo herbal medicine among students. 1) After 116 4th-year students at Tokai Medical University had listened to 6 units of general lectures on the basic theory of kampo medicine, they received practical training comprising 3 units of kampo medical practice, acupuncture, and kampo herbal medicines in small groups of approximately 13 students (12 students, 3 groups; 13 students, 4 groups; and 14 students, 2 groups).2)For experience-based learning about kampo herbal medicine, each group was divided into 2 teams of students who practiced and worked on assignments so that they could understand herbal medicine from the viewpoints of both physicians and patients.3) By preparing keishito using Cinnamomi Cortex, whose production areas and quality differ, students learned the fundamental mechanism of kampo medicine through team discussions of their subjective sensory assessment of the herbal medicine keishito and the objective analysis of the main ingredients of Cinnamomi Cortex. 4) Group A (40 students, 6 teams) took the examination 2 days after the practice, and group B (76 students, 12 teams) took the exam before the practice. Group A did not show any correlation between examination results and interest levels in kampo herbal medicine, and all students but 1 correctly answered 60% or less of the questions. Group B showed a positive correlation between interest levels and examination results, and 6 students correctly answered less than 60% of the questions.5)The present practice could be effective in motivating students in kampo medicine.

Educational Problems Associated with Kampo Medicine Lectures as an Elective at Tokai University School of Medicine / 日本東洋医学雑誌

Kampo medicine lectures at Tokai University School of Medicine are an elective subject this year. In order to evaluate student acceptance of this elective, we performed a questionnaire investigation prior to lectures for all fourth-year medical students (n=96). Among the 76 students who provided effective answers, 47 considered attending the Kampo medicine lectures, and 35 of these did attend them. Ten could not attend though they had wanted to. Three could not attend because applicant numbers surpassed class quotas, and 6 reported that other elective subjects were of greater interest to them. Regarding a new model core curriculum for medical education, 6 students (8%) knew that questions about Kampo medicine might be included in a medical state examination, and only 3 (4%) knew that Kampo medicine was included as a specific behavioral objective (SBO). Regarding attitudes toward Kampo medicine, 64 students (84%) were interested in it, while 47 (57%) had a good image of it. However, about two-thirds of students had skeptical or negative images of Kampo medicine citing phrases such as “lack of evidence, ” “mysterious, ” “unscientific, ” “difficult to understand, ” “doubtful” and “works slowly.” These findings suggest that a minimal knowledge of Kampo medicine should be taught to all medical students as a required subject. Furthermore, establishment of advanced programs should be considered as well, since medical students have great interest in, and expectations of Kampo medicine.

A Trial of Moxibustion with Warming Acupuncture Based on Evidence of Oriental Medicine in a Palliative Care Unit / 全日本鍼灸学会雑誌

[Introduction] We consider that the missions of acupuncture medicine are : 1) cooperation with other departments, 2) treatments of subclinical diseases, and 3) palliative care, and we have been actively persuing all of the above. We conducted an acupuncture trial in the Palliative Care Unit (PCU) in Kawasaki General Care Center.<BR>[Subjects] We studied 74 cancer patients who were hospitalized in PCU between June 1999 and March 2001. There were 36 male patients and 38 female patients, and their average age was 63.9 ± 11.8 years old.<BR>[Methods] We treated the patients using appliance moxibustion with warming acupuncture (CS-2000). Nurses in charge treated the patients according to an association of points chosen with differentiation of syndromes.<BR>[Results] Of 74 cases, 51.4% received effective palliation. Among 58 cases who complained of pains, 55.2% received effective palliation. Treatments were most effective for patients who complained of “dull persistent pain”, “severe dull pain”, “heavy throbbing pain”, “bulging pain” and “penetrating pain” in order of effectiveness.<BR>[Discussion] Appliance Moxibustion with warming acupuncture is expected to relieve 1) pain not controllable with painkiller, 2) cancer pain (pain originating from cancer) or pain from combatting the disease, and 3) pain unrelated to cancer. Such pain is considered to be dull pain (indescribable pain).<BR>This is not based on data, but we were also able to play the following roles. One is spiritual care resulting from sharing common time and space with patients, and the other is providing nurses and doctors with meaningful information obtained from close communication with patients. (This is a part in teamwork medicine.) : <BR>[Conclusion] By participating in palliative care, we found out that we were able to contribute to caring to remove physical pain (and other symptoms) which is part of holistic pain. Especially, we found out that our care is meaningfully effective in removing pain.

Combined Treatment using Acupuncture, Moxibustion and Internal Remedies ("Toeki") for Leg Edema after Radical Operative Hysterectomy and Radiotherapy / 日本東洋医学雑誌

At the request of the gynecology deparment, ten patients who were suffering from edema of the legs after undergoing radical operative hysterectomy and radiotherapy were treated with a combination of Oriental medical therapies, namely acupuncture, moxibustion and ‘Toeki’ (a form of internal treatment more commonly known as Kampo formulas, or decoctions of combinations of crude drugs). The average patient age was 54±3.7 years of age and the average morbid period was 180 days.<br>Although this therapy did not appear to produce any remarkable change in the leg diameter (measured at the thigh, largest diameter of the crus and leg joints), relief from subjective symptoms such as pain associated with the swelling (swelling pain), muscle stiffness and improved bowel function were evident.<br>These findings indicate that Oriental medical treatment has therapeutic value for alleviating the patients' discomfort and improving the quality of life.

Acupuncture Treatment of Intractable Atopic Dermatitis / 全日本鍼灸学会雑誌

We did Oriental medical treatment to intractable atopic dermatitis patients. The number of cases is twenty. We divided them into two groups, namely the group of the combined treatment of acupuncture and “Toeki” (internal remedy), the “Toeki” treatment group, and compared the effective rates of the two. The combined treatment of acupuncture and “Toeki” is effective in seven cases out of eirht, and the effective rate is 88%, while the “Toeki” treatment is effective in eight out of twelve, and the effective rate is 67%. We think that both of the combined treatment of acupuncture and “Toeki” and “Toeki” treatment are both effective, but that the former is more effective than the latter.