Changes in peripheral lymphocyte subpopulations after direct moxibustion.

We measured peripheral lymphocyte subpopulations after direct moxibustion using moxa cones the size of a half-rice grain. In humans at 2 hrs after the direct moxibustion, NK cell percentage decreased and CD4/CD8 ratio increased significantly. Although the same trends were observed in the control session, those changes were not statistically significant. In rabbits at 3 and 12 hrs after direct moxibustion, CD4/CD8 ratio significantly increased, and recovered at between 24 and 72 hrs after treatment. Similarly, the CD4/CD8 ratio significantly increased in the control session, but they seemed to have a shorter duration. Although it is not yet clear whether the effects are beneficial, we found that direct moxibustion influences the immune system at least transiently.

Systematic review of adverse events following acupuncture: the Japanese literature.

CONTEXT: Many Japanese cases of adverse events after acupuncture are not listed in medical databases such as Medline. Therefore, they are not easily accessible to researchers outside Japan. OBJECTIVE: To complement existing reviews of adverse events after acupuncture in the West and to provide more detailed discussion and analysis. DATA SOURCES: Literature search using 'Igaku Chuo Zasshi (Japana Centra Revuo Medicina) CD-ROM version' covering the period of 1987-1999. STUDY SELECTION: Case reports of adverse events, which were suspected to be due to acupuncture treatment, were included. Experimental studies, surveys, and news articles were excluded. DATA EXTRACTION: Two independent reviewers extracted data from located articles in a pre-defined structured way, and assessed likelihood of causality in each individual case. DATA SYNTHESIS: 89 articles which reported 124 cases were located. The most frequent adverse events were: pneumothorax (25 cases), spinal cord injury (18 cases), acute hepatitis B (11 cases), and localized argyria (10 cases). There were two fatalities from infections. Forty-eight events were caused by needle breakage including 26 cases of intentionally embedded needle and 16 cases of accidental breakage. There were also 10 cases of injury from self-treatment. CONCLUSION: Although it has already been demonstrated that severe adverse events seem to be uncommon in standard practice, many serious cases of negligence have been found in the present review, suggesting that training system for acupuncturists (including medical doctors) should be improved and that unsupervised self-treatment should be discouraged.

Incidence of adverse reactions associated with acupuncture.

OBJECTIVES: To determine the type, severity, and incidence of acupuncture adverse reactions that are observed in standard practice. DESIGN: A survey based on observation and interview by the therapists. SETTING: Tsukuba College of Technology Clinic in Japan. SUBJECTS: All patients who underwent acupuncture treatment during a period of 4 months from April to July 1998. OUTCOME MEASURES: Type, severity, and incidence of acupuncture adverse reactions. RESULTS: A total of 391 patients were treated in 1,441 sessions, involving a total of 30,338 needle insertions. The incidence of recorded systemic reactions in individual patients was: tiredness (8.2%); drowsiness (2.8%); aggravation of preexisting symptoms (2.8%); itching in the punctured regions (1.0%); dizziness or vertigo (0.8%); feeling of faintness or nausea during treatment (0.8%); headache (0.5%); and chest pain (0.3%). The incidence of recorded local reactions, expressed as a percentage of needle insertions, was: minor bleeding on withdrawal of the needle (2.6%); pain on insertion of the needle (0.7%); petechia or ecchymosis (0.3%); pain or ache in the punctured region after the treatment (0.1%); subcutaneous haematoma (0.1%); and pain or discomfort in the punctured region during the needle retention (0.03%). CONCLUSION: Although some adverse reactions associated with acupuncture were common even in standard practice, they were transient and mild compared to cases such as pneumothorax, cardiac injury, infection, or spinal lesions reported in other studies.

Adverse events in acupuncture and moxibustion treatment: a six-year survey at a national clinic in Japan.

OBJECTIVES: Many of the frequently reported adverse effects of acupuncture are serious or severe such as pneumothorax, infection, spinal cord injury, or cardiac injury. However, reviewing published case reports does not provide enough information to assess the safety of acupuncture and moxibustion. In order to investigate adverse events of acupuncture, we reviewed all the relevant cases reported by the therapists at our clinic. SETTING: Over a 6 year period, in the national Tsukuba College of Technology Clinic in Japan, all the acupuncture and moxibustion therapists were required to report the cases of adverse events immediately upon recognition. RESULTS: A total of 84 therapists (13 preceptors and 71 interns) participated in the treatments. The total number of treatments was 65,482. Ninety four (0.14%) adverse events were reported. There were fourteen categories: failure to remove needles (27 cases), ecchymosis or hematoma without pain (9 cases), ecchymosis or hematoma accompanied by pain (8 cases), burn injury (7 cases), discomfort (7 cases), dizziness (6 cases), nausea or vomiting (6 cases), pain in the punctured region (6 cases), minor hemorrhage (4 cases), aggravation of complaint (4 cases), malaise (3 cases), suspected contact dermatitis (3 cases), fever (3 cases) and numbness in the upper extremities (1 case). CONCLUSION: No serious or severe cases such as pneumothorax, infection, or spinal cord injury were reported by the college preceptors and interns. The results indicate that serious or severe adverse events are rare in standard practice. We suggest that most severe or serious cases of adverse events caused by acupuncture reported in journals are actually cases of negligence. In the future, negligence should be discussed from the point of view of medical education and technical instruction for the therapists, and adverse reactions should be discussed from the point of view of incidence and prevention based on the result of further investigation.

Modulation of human basophil growth in vitro by xiao-qing-long-tang (syo-seiryu-to), chai-pu-tang (saiboku-to), qing-fei-tang (seihai-to), baicalein and ketotifen.

Our previous study showed the inhibitory effect of Qing-Fei-Tang (Q.F.T.) and baicalein on the leukotriene (LT)B4 synthesis of human alveolar macrophages. It has recently been demonstrated that LTs support various cell growth, and basophil and its precursor numbers increase in atopic patients. Therefore, we examined the effect of anti-allergic drugs, including Q.F.T., Xiao-Qing-Long-Tang (X.Q.L.T.), Chai-Pu-Tang (C.P.T.), baicalein and ketotifen which have been used for treatment of bronchial asthma, on human basophil growth in vitro using cord blood mononuclear cells as a basophil precursor source and conditioned medium of T cell leukemia cell line Mo as a growth factor. Two-week cultured basophil numbers identified by alcian blue-safranin staining and those histamine contents assayed fluorometrically were inhibited by Q.F.T. (1.0 mg/ml), X.Q.L.T. (0.01-1.0 mg/ml), C.P.T. (0.01-1.0 mg/ml), baicalein (1-100 microM) or ketotifen (1-100 microM) in a dose-dependent manner while low dose (0.01-0.1 mg/ml) of Q.F.T. showed an enhancing effect on the basophil growth and the histamine content. However, LTB4 or LTC4 failed in restoring the basophil growth reduced by 1 mg/ml of C.P.T. or 100 microM of ketotifen. These results suggest that anti-allergic drugs may modulate basophil growth and differentiation in vitro and/or in vivo and therefore be useful and reasonable for controlling allergic diseases including bronchial asthma.

Effects of qing-fei-tang (seihai-to) and baicalein, its main component flavonoid, on lucigenin-dependent chemiluminescence and leukotriene B4 synthesis of human alveolar macrophages.

A traditional Chinese remedy, Qing-Fei-Tang (Seihai-to, T90), has been used for treatment of chronic respiratory diseases with long-lasting cough and sputum, e.g. chronic bronchitis. We examined the effect of T90 and its main component flavonoid, baicalein, on the lucigenin-dependent chemiluminescence (CL) and leukotriene B4 (LTB4) synthesis of human alveolar macrophages (AM). AM were obtained by bronchoalveolar lavage from patients with various respiratory diseases, including sarcoidosis, idiopathic pulmonary fibrosis, bronchial asthma, chronic bronchitis and lung cancer. CL were observed by stimulating 1 x 10(5) AM with phorbol myristate acetate in the presence of lucigenin. LTB4 were generated by incubating 1 x 10(6)/ml AM with Ca ionophore A23187 for 30 min and determined by reverse phase high performance liquid chromatography and radioimmunoassay. T90 (0.2-2.0 mg/ml) and baicalein (0.1-100 microM) inhibited both CL and LTB4 production of AM in a dose-dependent fashion. These inhibitory effects were not due to cytotoxic effects of the procedure because neither 2 mg/ml T90 nor 100 M baicalein affected the viability of AM nor lactate dehydrogenase release from AM. These results suggest that T90 exerts its effect on inflammatory lung diseases through the anti-inflammatory action, i.e. inhibiting the oxidative and arachidonate metabolism of local inflammatory lung cells.

Iron-containing proteins augment responses of human lymphocytes to phytohemagglutinin and pokeweek mitogen in serum-free medium.

The effects of various iron-containing compounds on the responses of human peripheral lymphocytes to phytohemagglutinin (PHA) and pokeweed mitogen (PWM) were studied in serum-free medium supplemented with bovine serum albumin. Hemoglobin, transferrin and ferritin enhanced the incorporation of 3H-thymidine into DNA after PHA-stimulation of lymphocytes, while hemin, iron metal powder, ferrous sulfate, chromium powder, and zinc sulfate have little effect. The response to PWM, measured by plaque formation, was enhanced only by transferrin. Desferrioxamine, a chelating agent specific for ferric iron, completely removed these augmentative effects. The results indicate that iron-containing proteins influenced the responses of lymphocytes to stimulation by PHA and PWM in serum-free medium.