As a preparatory study for treating diabetic neuropathy by acupuncture, we investigated the effect of electroacupuncture on the sciatic blood flow in rats. Nerve blood flow was measured with a laser doppler flowmeter. Different treatments were applied to three groups of rats as follows:
1) those stimulated with low-frequency (1Hz, 5Hz) electroacupuncture,
2) those stimulated with high-frequency (20Hz, 100Hz) electroacupuncture and
3) those stimulated by pinching in the tails.
In the electroacupuncture groups, stimulation was applied to the plantae. While little change was observed in the rats stimulated with low-frequency electroacupuncture, temporary increases in both blood flow and blood pressure were observed in the rats stimulated with high-frequency electroacupuncture and in the rats subjected to pinch stimulation.
These reactions were all inhibited by the administration of phentolamine (α receptor blocker).
These results suggest that the increase in sciatic blood flow induced by high-frequency electroacupuncture and pinch simulation are dependent on the blood pressure.

We investigated whether TEAS affected intellect in the elderly, prevented the decline of daily activity and/or improved HDS-R and elderly activity valuation scale in 93 aged patients over 70.
As a result, HDS-R and the elderly activity valuation scale increased after 8 weeks, in the physical exercise group that also received TEAS treatment, indicating a tendency to improve. Improved intellect was measured by asking subject to guess the time and date, recollect some words, and remember five items in HDS-R. All items on the elderly activity valuation scale were improved except for hearing and appetite. Many patients showed increased scores in combination with TEAS. Before treatment, patients in both groups were divided into 4 subgroups by HDS-R score and change in HDS-R was investigated after treatment for 8 weeks. Those scoring 16 points or more on the initial test tended to show an increased score in both groups, those showing 11-15 points initially demonstrated an increased score only in exercise in the combined group, and those showing 10 points or less did not demonstrate any change in either group.
Based on these results, physical therapy combined with TEAS appeared to accelerate daily activity and promote intellect and cognition in the elderly.

Recently, the importance of patient satisfaction emerged in the context of providing high-quality health care. However, the level of patient satisfaction with acupuncture treatment and the factors that influence satisfaction have not been investigated. We conducted a cross-sectional survey on the satisfaction of patients who consult acupuncture clinics and investigated factors that have a certain influence on the level of satisfaction using multivariate analysis.
Subjects in the present study consisted of 2210 patients who consulted acupuncture clinics that were randomly selected from the alumni association of Meiji University of Oriental Medicine. The survey was conducted between July 10 through July 23, 2000 using our original questionnaire which consists of questions about health state and basic information about the patient, environment of the clinic, assessment of the practitioner by the patient and overall patient satisfaction with the clinic. Sampling of the subject was made using stratified random sampling method and the questionnaires were returned directly from the patient by mail.
Of 2210 patients given the questionnaire, 1, 319 (59.7%) responded. Mean (SD) level of the total satisfaction with the clinic evaluated using 100 mm visual analogue scale (VAS) was 81.4 (13.8). Simple linear regression analysis showed that the degree of explanation given by the practitioner was significantly related to patient satisfaction, while multiple regression analysis showed that the effect of treatment, treatment skill of the practitioner, patient's reliance on the practitioner, clean environment of the consultation room, depth of the practitioner's understanding of the patient and willingness of the practitioner to answer questions were factors significantly related with the patient's satisfaction.
In the present study, there was high overall satisfaction among patients consulting acupuncture clinics and the factors influencing satisfaction could be classified into three kinds : factors relating to the quality of treatment, communication factors between the patient and practitioner, and environmental factors related to the clinic.

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.
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.
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.
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.
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.

[Introduction]This symposium was organized for the adoption of the Tokyo Declaration for Japanese Acupuncture and Moxibustion at the final meeting of the congress and was composed of three subjects that were supposed to become a framework for the declaration draft.
[Subjects] 1. History of acupuncture in Japan 2. Analysis of the present circumstances 3. Tasks for the future
The first subject was an explanation of important matters in acupuncture development in Japan, based on the key note lecture given prior to this symposium. The second subject was analysis from both aspects of research studies and clinical situations. The third subject was to be suggestions for further development of acupuncture after revealing present problems.
There are more or less many issues in the acupuncture field;clinical practice, education, research and clinical training, but these issues may not have been approached either systematically or generally before. Whereas, in the light of opinions gathered from many others, many future issues came apparent through the three subjects of this symposium. In conclusion, the goal was to find a strategy that would make Japanese acupuncture become a prevailing therapy in the future more than what it is today.

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.
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.

Cancer is the leading cause of death in Japan, which boasts one of the longest life expectancies in the world. Some types of cancer cause excruciating pain. Measures are actively being taken to establish palliative care units as specialized facilities to mitigate pain and set up palliative care teams in core hospitals for cancer care. In accordance with the guidelines of the WHO, a method using narcotic drugs as a means of pain relief has been established in Japan, but for patients at the middle to late stages of cancer, sufficient pain control cannot be ensured for many cases. Although various alternative therapies, including acupuncture, moxibustion, and haut care (hand and foot massages) are used to alleviate pain, the effectiveness of these methods is still unclear. Accordingly, we examined the actual conditions of palliative care together with evidence of acupuncture and moxibustion therapies and haut care as a means of pain relief.

[Objective]In recent years, communication skills have been recognized as an essential competence for acupuncturists. This study proposes to develop a scale for measuring the medical communication skills of acupuncturists.
[Materials and Methods]A questionnaire of 20 items was used to measure medical communication skills. These items were adopted from a concept analysis conducted in a previous study.
Cronbach's alpha was used to examine the scale's reliability. The scale's validity was examined by correlation analysis and multiple regression analysis comparisons with normal communication skills subscale scores (ENDCOREs, Encode, Decode, Control, Regulate) and a Japanese version of characteristic trait anxiety scores (STAI, State-Trait Anxiety Inventory).
[Results]Factor analysis, using a principal extraction method and promax rotation, was conducted on responses from 443students and therapists. As a result, the original 20 items were reduced to 16, and the following three factors were extracted:I. Acceptance of patients and self-control;II. Appropriate explanation to patients;and III. Understanding of patient's feelings. These three factors had high degrees of internal consistency (Cronbach's alpha =.872 -.892).
The scores of the three factors correlated significantly with the scores of the six factors of ENDCORE, and with the anxiety scores. Although the results of multiple regression analysis showed that each factor of ENDCORE explained the three factors, the anxiety scores did not influence medical communication skills. The scores for the three factors correlated significantly with self-evaluation scores of medical interview skill. In addition, these three factors were affected by the degree of clinical experience.
[Conclusion]These results suggest that this scale may be a reliable instrument for assessing medical communication skills among Japanese acupuncturists.