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We encountered two patients complaining of hiccups following the resection of subaural tumor or subarachnoid hemorrhage. In one patient, we measured the autunomic nerves of Ryodoraku, and placed grains of silver on Ryodoraku points which showed abnormal values. We also used the in situ needle technique on acupoints which were considered to be closely related to the phrenic nerve. Furthermore, we inserted round-head subcutaneous needles in auricular acupoints such as “Kaku”, “Shinmon”, “Hishitsuka”, and “Jichu”. After repeating the above treatment twice, the hiccups disappeared completely. In the other patient who had difficulty even taking off clothes, a subcutaneous needle was inserted into “Kaku”, which was repeated twice a week. After five months, the hiccups disappeared completely.<br>Based on our experience with the two patients above, we had the impression that auricular acupuncture is particularly effective. “Kaku” was the main acupoint used, which is believed to influence the diaphragm. We believe that this technique can therefore be used clinically in the future.
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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.
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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.
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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.
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In the present paper, we examined differences in therapeutic effectivenesses of venous methods of acupuncture, ranging from filiform needle to EAP, LFEA, laser and SSP, in cases with shoulder stiffness. The immediate and delayed effect of each method, comfortableness during treatment session, changes in temperature, blood flow, and the oxygen density at the Jianjing and Hegu point were examined.<br>Significant improvement was seen in every therapeutic method. Electrical acupuncture using direct current was most effective. No difference were evident among SSP, low-frequencey electro-acupuncture and filiform needle. There was a correlation between confortableness and the improvement rate in electrical acupuncture using direct current and laser acupuncture. Deep temperature, blood flow and the degree of oxygen saturation of the stimulated part tended to increasd in each case.
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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.
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The authors have been studied the effects of low energy semiconductor laser on capillary blood flow of the skin. In the present paper, we report a comparative study of acupuncture, low energy He-Ne laser and semiconductor laser.<br>[SUBJECT & METHOD] Subjects were five healthy adults. Two types of laser irradiation and in situ acupuncture using No. 20 needle, 30mm in legth, were separately applied to the right Hegu (IC4) for 10minutes. Two laser types were low energy He-Ne (632.8nm, 8.5mW) and low energy semiconductor MR-180Is (830nm, 30mW). Capillary blood flow of the skin was measured at the palmar center of right index fingertip before, during and 30 minutes after stimulation using a laser doppler blood flow velocity meter (LDV, ALF2100). Measurement was carried out after 20-minute rest in a room maintained at the temperature of 25±0.5°C.<br>[Result] After the acupuncture stimulation, blood flow rose to 140% of the original level and it was retained throughout the measurement period. By He-Ne or semiconductor laser irradiation, blood flow rose to 111% and 107%, respectively, but it showed tendency to decrease and reached below the original level 30 minutes later.<br>[CONCLUSION] Acupuncture stimulation demonstrated heigher effect in improving the peripheral blood circulation than He-Ne laser or semiconductor laser irradiation.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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The effect of acupuncture-moxibustion treatment in the control of malignant neoplasm pain was examined in 157 (36%) of 434 cases in our clinic over a 16 year period (1966-1981).<br>In these cases, gastric cancer (36 of 157 cases: 23%) was the largest in number, followed by uterine cancer, and lung cancer. Many of the patients treated also complained of mental changes such as sleeplessness or anxiety.<br>Several kinds of acupuncture and moxibustion were applied to these cases, and marked improvement was found in 14-26% of them. These treatments were more effective in the cases after radical operations than in those cases deemed inoperable due to metastasis.<br>10 cases (6%) were aggravated by acupuncture, though none were severe.<br>The side effects by acupuncture such as slight aggravation of the pain were observe in 10 cases (6%), though none were severe.
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In China, for years they have been studying the PSC to investigate scientifically the substance of traditional meridians. As we had been to there, we learned how to investigate it. According to their method we did it in Japan.<br>Objects were 340 healthy youths. The stimulated points were the well points in each meridian. The low frequency electroacupuncture (5-20Hz) was given to these points 30 minutes. Objects showed us their sensation or orally or by gesture.<br>We divided the result into 4 stages according to the chinese method;<br>salient…5 (1.5%)<br>comparatively salient…3 (0.9%)<br>slightly salient…7 (2.0%)<br>Non-salient…325 (95.6%)<br>In China, by the way, objects were 1, 000 people and it was 1.3%, 1.8%, 15.2% and 81.7%.<br>In this study, though it showed a low incidence of about 4.4% (about 18% in China), it was found that there was a phenomenon of the PSC.
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Introduction<br>It is said that D-phenylalanine improves the pain relief effect of acupuncture on pain disease. We applied it to different kinds of pain disease as preadministration and studies the clinical effectiveness.<br>Method<br>Subjects were 24 patients suffering from such comparatively chronic pain diseases as prosopalgia (2), a pain in the posterior region of neck (5), frozen shoulder (4), coxalgia with melosalgia (10) and gonalgia (3).<br>A. The low frequency electrical acupuncture (3Hz, sub-successive wave, 20 minutes) was applied to them on the most frequently used points by the JSA Committee of Acupoints.<br>B. 0.5g of DPA was administered to each patient as preadministration and acupuncture was given.<br>C. Lactose was administered to all of the same patients as a placebo and acupuncture was given.<br>D. The therapy was repeated two times.<br>E. We evaluated the just after effect of the therapy on both groups with the double blind experiment.<br>Effect<br>The preadministration of DPA improved the effectiveness of acupuncture against such pain disease. From our study, it was clarified that the effectiveness of DPA rose by 30% in comparison with the placebo.
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Purpose:<br>We previously reported that using D-phenylalanine (D-PA) as a pre-medication increasingly enhanced acupuncture aneshesia effects occur. In order to investigate this effect clinically, we performed tooth extractions under acupuncture anesthesia using D-PA as a premed.<br>Method:<br>We divided the patients in the oral surgery department of our hospital for whom acupuncture-moxibustion was determined indicated, into 2 groups, a test group (9cases) to which D-PA (4.0g) was administered 30minutes prior to acupuncture anestesia, and an acupuncture anesthesia only group (about 31cases), and comparitively examined results.<br>The points used were: LI-4 on both sides in all cases, and indicated local points selected from among JOKAN, ST-7, GV-26, ST-2, LI-20, CV-24, ST-6, SI-18 and ST-5. Needles were inserted (in some cases a point surface electrode was used) and the acupuncture sensation aroused, following which low frequency current at 3-15Hz was administered.<br>The tooth extractions were begun about 30minutes later. The standard for determining results was a score of 1=absolutely no pain, 2=slight pain, 3=very painful, 4=a small amount of local anesthesia administered, as supplement, 5=attempt to use acupuncture anesthesia abandoned.<br>Results:<br>In the control group effective results (score 1 or 2) were obtained in about 30% of the cases while in the test group there was almost no need for supplementary local anesthesia and generally effective results were obtained in most cases.<br>Summary:<br>The results were more excellent in the group in which D-PA was used as a pre-med for tooth extractions with acupuncture anesthesia than in the group in which it was not used.