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[Objective]Acupuncture has been described to be effective for acute vomiting induced by anti-cancer drugs of chemotherapy. However, the effect of acupuncture for the prolonged acute nausea that continues more than 24 hours from its onset after chemotherapy has not been satisfactorily investigated. In the present study, we report two cases of prolonged acute nausea induced by chemotherapy and effectively treated with acupuncture and moxibustion.<BR>[Case 1] 79-year-old male who had diagnosed as early adenocarcinoma of the lung had chemotherapy by anticancer drug under hospitalization after right lower lung lobectomy. In spite of administration of anti-emetic agents, he complained of mild but persistent nausea that developed within 24 hours after chemotherapy and continued more than 24 hours from onset. Acupuncture at PC6 (Neiguwan) and ST25 (Tianshu) with moxibustion at CV12 (Zhongwan) and ST25 (Tianshu) were performed in addition to anti-emetics. <BR>[Case 2] 64-year-old female who had undergone radiation therapy by gamma knife for metastatic brain tumors of adenocarcinoma of the lung had chemotherapy by anti-cancer drug under hospitalization. Since administration of anti-emetics during the first period of chemotherapy was less effective, moxibustion at ST25 and CV12 in addition to anti-emetics was performed during the second period of chemotherapy. <BR>[Results]In both cases, the prolonged acute nausea was improved showing significant decrease in the VAS immediately after the treatment of acupuncture. <BR>[Discussion]Severe nausea and vomiting might have been suppressed by anti-emetic agents, but mild acute nausea was prolonged and persisted. Prolonged acute nausea caused poor appetite and deterioration of Quality of Life (QOL) of patients in two cases.<BR>Acupuncture with moxibustion and moxibustion could improve prolonged acute nausea and its related symptoms. These results of acupuncture with moxibustion and moxibustion suggest that acupuncture and moxibustion are useful treatment for prolonged acute nausea induced by chemotherapy and can be applied as complementary medicine to patients receiving anti-cancer chemotherapy.
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[Background]Functional abdominal pain syndrome (FAPS) represents a chronic pain disorder localized in the abdomen and the symptoms largely are unrelated to food intake and defecation, which differ from other painful functional gastrointestinal disorders.<BR>We report a case of FAPS whose symptom was successfully improved by acupuncture.<BR>[Case Report]A 75-year-old female had been hospitalized at Meiji University of Integrative Medicine Hospital because of left lower abdominal pain from which she had repeatedly suffered for more than 2 years. Despite strict medication, her symptom had not been improved. After admission to the hospital, according to recommendation by her physician, acupuncture treatment was started. The patient received TCM-based acupuncture treatments five times a week over 13weeks. Primary acupuncture points used for the patient were LV3(Taichong), SP6 (Sanyinjiao), ST36 (Zusanli) and PC6 (Neiguan). Evaluation of the left lower abdominal pain was carried out with a Visual Analogue Scale (VAS). The Gastrointestinal Symptom Rating Scale (GSRS) was used to evaluate QOL related to the digestive symptoms. VAS for the left lower abdominal pain showed a remarkable decrease immediately after the initial acupuncture session. The symptom disappeared within 4 weeks after commencement of the treatment and never appeared during her hospitalization. GSRS was also improved and it was maintained during hospitalization.<BR>[Conclusion]We suggested that acupuncture treatment might be one of the useful, non-pharmacological alternatives for symptoms of FAPS.
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Pneumonia is one of major causes of cough, which sometimes resists medication and remarkably deteriorates QOL of the patient. We report a case of pneumonia in a person suffering from severe cough and pain in the general body accompanied by cough for which conventional medication did not work but was improved by acupuncture treatment. <BR>A 47-year-old woman was diagnosed by her physician with pneumonia on August 2, 200X. Although antibiotics were administered, her symptoms were not improved. She visited Meiji University of Integrative Medicine Hospital and was hospitalized on the same day. Despite strict medication with antibiotics, antitussive agent and expectorant during hospitalization, her severe cough and body pain remained unchanged. <BR>Acupuncture treatment was then started on August 7. The basic meridian points used were LU1 (Zhongfu), LU5 (Chize), BL13(Feishu), LU7 (Leique), LI4 (Hegu), GB20 (Fengchi), GB14 (Danzhui), ST12 (Quepen), ST11 (Qishe), and CV22 (Tiantu). The acupuncture needles were retained for ten minutes at these points in each session. After ten acupuncture treatments for over seven days, the VAS for body pain accompanied by cough showed a remarkable improvement. Also, significant relief in cough was observed every time immediately after treatment. <BR>We suggested that acupuncture treatment might be useful for cough and/or pain in the body accompanied by cough in a patient with pneumonia.
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[Objective]The present study investigated the relationship between subjective symptoms of katakori (shoulder stiffness) and shoulder hardness which was examined both with clinical palpation and a mechanical device, as well as the correlation between these two measurements. <BR>[Methods]Subjects were enrolled to the study if they had a stiff shoulder on the day of the visit (katakori group, n = 60) or if they had no experience of katakori in their lifetime (non-katakori group, n = 10). The intensity of the katakori was evaluated with a visual analogue scale (VAS). Shoulder hardness was evaluated at acupoint Jianjing (GB21) and at the point where the subject felt the most intensive symptom by both palpation of experienced acupuncturists who were unaware of the allocation and a hardness meter. The method of acupuncture treatment was decided by acupuncturists who were not an evaluator of the hardness.<BR>[Results and Discussion]There was no significant relationship in the hardness measured with the device and palpation between the katakori group and non-katakori group. Also, the intensity of katakori (VAS) and the changes after treatment showed no significant correlation with the hardness and its changes. These results support the validity of our clinical experience that patients who complain of severe shoulder stiffness do not always have a hard shoulder.
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We have been utilized acupuncture and moxibustion in our department of internal medicine at Meiji University of Integrative Medicine since its investment in 1987. In the department, various kinds of symptoms in the field of internal medicine have been managed with acupuncture and moxibustion. In this article, I would like to introduce our activities regarding acupuncture treatment in the department of internal medicine and some remarkable results of our clinical studies which evaluated effects of acupuncture and moxibustion as well as relationship between acupuncture therapists and the staff of our department. In the field of respiratory disorders such as COPD or bronchial asthma, usefulness of acupuncture have been proved through a controlled clinical trial which involved COPD patients who had not been able to control with standard care. Also, acupuncture was found to be useful in the management of bronchial asthma in a case series study in which acupuncture treatment was repeatedly applied with intervals without acupuncture. We have also demonstrated that acupuncture was useful for gastrointestinal disorders such as irritable bowel syndrome (IBS). Results of a case series with n-of-1 study design showed significant reduction in the symptoms during acupuncture treatment, while those in the period without acupuncture had been aggravated. Data from studies on diabetic complications such as peripheral neuropathy or gastropathy also showed usefulness of acupuncture. We considered that it is valuable to explore unknown usefulness of acupuncture in the field of internal medicine and prove effectiveness of acupuncture with appropriate scientific manner.
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INTRODUCTION:Acupuncture has been reported to be useful for both physical and psychological symptoms. Here we report a case who complained of various physical symptoms due to advanced hepatocellular carcinoma effectively cared for with acupuncture.<BR>Case:A 64-year-old female complained of general fatigue, constipation, and pain in the lower back and leg during her hospitalization for leg edema due to advanced hepatocellular carcinoma. Although the leg edema was improved by the administration of albumin, physical symptoms such as pain in the lower back and leg, constipation, or general fatigue remained. <BR>We applied acupuncture with aiming at relaxing muscles (erector spinae, rectus femoris, right adductor) by a local needling approach, and to improve incomplete defecation by applying moxibustion at the acupoint on the abdomen. <BR>METHOD:Faces Scale was used to evaluate general condition. Evaluation of the pain in the lower back and lower extremities were made with a Numerical Scale where 10 indicates the most painful, while 0 indicates no pain. <BR>RESULT:Both general fatigue and pain in the lower extremities wererelieved after acupuncture treatments (FS for general condition improved from 3to 1, NS for pain decreased from 7 to 4). Also, the feeling of incomplete defecation disappeared.
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<b>Background</b><br>Although there are several reports that electroacupuncture (EA) in the abdomen reduces fasting blood glucose and improves insulin sensitivity, the effects under a glucose load or hyperinsulinemic conditions have not yet been studied. In this study, we investigated the effect of EA at Zhongwan (CV12) under the conditions of an intravenous glucose tolerance test (IVGTT) and a hyperinsulinemic euglycemic clamp in normal Sprague-Dawlay (SD) rats.<br><b>Methods</b><br>Male SD rats were anesthetized with pentobarbital (40mg/kg i. p.) and then maintained by continuous infusion through a tail vein. Blood samples were drawn from the ventral tail artery during the fasting stage (baseline and 30min after), and at 2, 5, 10, 20, 30, 45, 60min after a glucose load (0.5g/kg). EA was performed for 30min (EA30, n=8) during the fasting stage and for 90min (EA90, n=8) during both the fasting and IVGTT periods. In the hyperinsulinemic euglycemic clamp experiments, insulin (2mU/kg/min) was infused through the tail vein, followed by infusion of 20% glucose at variable rates to maintain fasting blood glucose levels. EA was performed for 40min after a steady-state was achieved.<br><b>Results</b><br>Significant decreases in fasting blood glucose and increase in plasma insulin concentration were observed during the fasting period in rats in both the EA30 and EA90 groups, whereas rats in the control group (n=8) which did not receive any EA stimulation showed no such changes. Total glucose levels during the IVGTT were lower in the EA30 and EA90 groups compared to controls, with a significantly higher level of relative insulin secretion. During the hyperinsulinemic euglycemic clamp, glucose consumption was increased significantly by EA stimulation with a marked increase in both insulin concentration and sensitivity.<br><b>Conclusion</b><br>EA at CV12 accelerates glucose consumption during IVGTT and hyperinsulinemic conditions probably as a consequence of increased insulin sensitivity and/or increased plasma insulin concentration.
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[Objective] It is necessary to administer anti-cholinergic agents or glucagon during gastroscopy for inhibition of gastric peristalsis. However, application of these drugs are limited in patients with glaucoma, hypertension, benign prostate hyperplasia, heart disease, or diabetes mellitus because of possible adverse events.<BR>Based on the report that acupuncture stimulation at CV 12 (Zhonguan, Chukan) inhibited gastric activity, we studied whether the acupuncture at CV 12 could be applicable as an alternative to these drugs.<BR>[Method] Subjects in the present study were 60 patients who underwent gastroscopy at Meiji University of Oriental Medicine Hospital. They were allocated into two groups; acupuncture group (mean [SD] age, 66 [10]) and drug group (mean [SD] age, 64 [13])<BR>Patients in the acupuncture group were given manual stimulation at CV 12 with an acupuncture needle for 10 minutes before examination and during gastroscopy.<BR>After examination, a gastroscopist evaluated the magnitude of the peristalsis and disturbance during the examination using the visual analogue scale (VAS) and a 4-grade categorical scale.<BR>Patients in the drug group were pre-administered anti-cholinergic drug or glucagon, and evaluated with the same scale.<BR>[Results and Discussion] Inhibition score in the acupuncture group was lower but not statistically significant, as compared with the drug group, and the effect of acupuncture stimulation was acceptable to allow examination of the patients without severe disturbance. <BR>Acupuncture may be a useful non-pharmacologic alternative to anti-cholinergic drugs and glucagon to inhibit gastric movement during gastroscopy, when these drugs could not be administered.
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The present study investigated the effect of moxibustion for 4 weeks on insulin resistance in Otsuka-Long-Evans Tokushima Fatty (OLETF) rats, a model of spontaneous noninsulin-dependent diabetes mellitus (NIDDM). Glucose infusion rate (GIR) in the moxibustion group was higher than that in the control group. This finding suggests that moxibustion may be effective for insulin resistance.
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Chronic obstructive pulmonary disease (COPD) causes severe respiratory dysfunction and severely limits patients' daily activities. We report a case of the patient with COPD whose respiratory symptoms were successfully improved by acupuncture. A 70-year-old man visited Meiji University of Oriental Medicine Hospital complaining of dyspnea during exercise on _??_. Despite strictly controlled medication and a regimen of home oxygen therapy (HOT), his general condition continued to worsen. Then a series of acupuncture treatment was started on _??_. The severity of dyspnea of the patient before acupuncture treatment was determined as level V according to Hugh-Jones classification, and spirometry showed severely disturbed respiratory functions (%VC: 63.5%, FEV<sub>1</sub>%: 29.4%, PEFR: 84.8 1/min in the morning and 93.5 1/min at night). The basic combination of meridian points for the treatment of the case was LU1 (Zhongfu), CV12 (Zhongwan), CV4 (Guanyuan), LU5 (Chize), and BL13 (Feishu). The acupuncture needles were retained for ten minutes in each session. The single-subject research design (A-B-A method) was applied to detect the specific effect of the acupuncture treatment on the respiratory functions or the symptoms of the subject. “A” and “B” mean “treatment period” and “no treatment period” respectively. After 60 acupuncture treatments during a 14-month period, both the respiratory symptoms and the VAS for dyspnea showed improvement, which were specifically observed during the intervention period. Improvement was also reflected in the level of the Hugh-Jones classification and respiratory function test. It was suggested that acupuncture treatment might be effective for advanced cases of COPD.
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To investigate the effect of electro-acupuncture stimulation (EAS) on insulin sensitivity in rats, we performed several stimulations on Otsuka Long Evans Tokushima Fatty (OLETF) rats, during euglycemic clamp. We divided OLETF rats into five groups according to the kind of the stimulation: EAS at vagal innervated region of the auricle (AVA), EAS at non-vagal innervated region of the auricle (ANVA), EAS on the back of the body (AB), pinching on the back of the body (PB), and no stimulation on the body (NS). These procedures were also applied on Long Evans Tokushima Otsuka (LETO) rats as a control study.<br>Furthermore, we performed long-term stimulation (from six to 24 weeks of age) on OLETF rats to assess the preventive effect of those stimulations on the formation of the insulin resistance. EAS of pulse duration 300ms, 1.5V, 1Hz was applied for 10 or 15minutes. As a result, the glucose infusion rate (GIR) showed significantly higher levels during stimulation of PB group in LETO rats. On the other hand, the GIR of AVA group in LETO rats and PB group in OLETF rats were decreased by stimulation. The GIR in AVA group and AB group after long-term stimulation were significantly higher than those of NS group in OLETF rats. These results suggested that EAS at the auricle and the back is useful for the prevention of the formation of insulin resistance when it's applied before onset of the symptoms in OLETF rats.
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We report the succesful treatment for improvement of orthostatic hypotension of a case of Shy-Drager syndrome (SDS).<br>CASE REPORT<br>A 56 year-old man diagnosed with SDS was admitted to our hospital on July 8, 1988 because of orthostatic hypotension. He had been suffering from dizziness, dysuria and muscular rigidity for 2 years. He had been treated with drug-therapy, but these sympton had progressed. Physical examination on admission revealed severe orthostatic hypotension due to disorders of autonomic nervous system, so he could not stand still.<br>For the treatment, we performed Yushi and punctured its points (Geshu. Hachiyu, Danshu, Pishu, Weishu) or 3 points (Sanyinjiao, Taixi, Taichong) that is located on legs. Acupuncuture therapy was applied from July 13, 1988 to December 10, 1988, every day except on holiday. We estimated the effect of acupuncture therapy with transition of blood pressure and orthostatic hypotension. Transition of acupuncture therapy were as follows.<br>(1) Yushi were performed alone.<br>(2) 3 points of legs (Sanyinjiao, Taixi, Taichong) were punctured alone.<br>(3) Yushi were performed, and 3 points of legs were punctured.<br>(4) Geshu, Genshu, Pishu and 3 points of legs were punctured.<br>(5) Subcutaneous needle at Yushi points.<br>(6) Punctured depth of 1cm to Yushi points.<br>Symptomatical respons was observed at about 70th treatment, and blood pressure was stabilized constantly and activity of daily life was improved.<br>Kinoshita et al. reported that Yushi act to sympathetic nervous system inhibitory, so serve to treat for hypertension. But in this case, its act was accelerate. It is speculated that Yushi act to autonomic nervous system homeostatically.
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We examined the effects of acupuncture stimulation (ACP-S) to the bilateral Quchi points (Q-P) on insulin secretion with or without electric stimulation (E-S) after an oral glucose load of 75g. This study was performed for 9 healthy volunteers classified into 5 group, a group of ACP-S to Q-P without E-S, a group of ACP-S to Q-P with E-S, a group of ACP-S to the bilateral points 1.5cm laterally apart from Q-P (P apart from Q) without E-S, a group of ACP-S to P apart from Q-P with E-S and a group of no ACP-S. Values of blood suger and serum insulin were determined before and 30min, 60min and 120min after an oral glucose administration. The value of serum insulin at 30min after oral glucose load and the total insulin values during the oral glucose tolerance test were significantly higher in a group of ACP-S to Q-P without E-S compared with those in the other group. These results suggested that acupuncture stimulation to Quchi points might increase insulin secretion.
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We examined relation between mucosal findings of tongue and gastric mucosal lesion by comparison photographic findings of tongue with gastroendoscopic findings of stomach. Subjects of this study were 115 cases undergoing gastroendoscopic examination in our hospital. The state of tongue surface was evaluated by thickness and color of tongue coating and tongue fissure. Especially, the tongue area was divided into 9 sections in order to investigate distribution of coating and fissure. The cases showing thick coating at the lateral sections of tongue were significantly numerous in patients who had gastric ulcer, compared with the cases in those who had no gastric ulcer. From these results, it was suggested that inspection of tongue mucosa could become one of the useful examination of oriental medicine for gastrointestinal disease.