Kampo medicine and acupuncture have traditionally been compared to "two wheels of one cart". Both Kampo medicine and acupuncture have the main aim of eliciting the healing ability of human nature and treat the disease state grasped as "physical/mental distortion"to correct the distortion. Kampo medicine and acupuncture have a lot in common. For example, both respect the subjective symptoms, place an emphasis on removal of complaints and are based on individual care. By utilizing such common points and common direction of care, the combination therapy with Kampo medicine and acupuncture can contribute to alleviation of complaints and QOL (Quality of Life) improvement more effectively than each monotherapy alone. Furthermore, Kampo medicine and acupuncture increase the therapeutic effect of each other and a synergistic effect rather than the additive effect can be expected.
On the other hand, Kampo medicine is basically taken by oral ingestion and treats the body from inside, whereas acupuncture is based on stimulation of acupuncture points of the body surface and treats the body from outside. Based on such difference, Kampo medicine and acupuncture have actually different favorite fields and different favorite disease states. It is therefore possible to realize a complementary therapy by utilizing the characteristics of each other.
At the outpatient office of oriental medicine of Saitama Medical University, various combinations of Kampo medicine and acupuncture have been tried and it is often experienced that such combinations are useful to improve patient's QOL. Furthermore, in not a few patients, it is combination therapy that can show a high effect or combination therapy is essential.
In this lecture, among the cases where combination therapies were effective, those for which the combination effect can be explained easily were presented and discussed. Some cases of chronic urticaria, fibromyalgia syndrome, low back pain (lumbar spondylosis), tension headache and patulous eustachian tube were raised. Kampo medicine added with acupuncture or acupuncture added with Kampo medicine could achieve further QOL improvement such as shortening of the duration of treatment until cure, improvement of complaints not resolved by each monotherapy and alleviation of accompanying symptoms.

[Introduction]There are few studies on the effect of acupuncture on QOL and work ability. Therefore, by this prospective study, we examined the effect of acupuncture treatment for QOL and work ability of visual display terminal (VDT) workers.
[Methods]Sixty-one VDT workers participated as subjects (41 males, 20 females). Acupuncture sessions were performed once a week for 4 weeks. Acupuncture points were decided by individualized VDT workers neck and shoulder symptoms points. Disposable press tack needles were used. Improvement of SF-36 and the work ability index were evaluated.
[Results]All VDT workers completed follow-up. There were statistically significant improvements in Mental Component Score (MCS), Physical Component Score (PCS), Role Physical and Body-Pain of the SF-36, and WAI. Regular correlations between before WAI and MCS, PCS, and 8 subscales of the SF-36 were observed. In addition improvement rate of WAI and Body-Pain were observed.
[Conclusion]Symptoms in the neck shoulder stiffness of the VDT workers was improved by acupuncture, and QOL/work ability improved.

[Introduction]Recently, in the development of information technology, VDT workers are increasing rapidly. Physical and mental health symptoms associated with working at visual display terminals (VDTs) are controversial. However, there are few studies about the effect of acupuncture treatment on eye fatigue, neck and shoulder stiffness that many VDT workers have.
Therefore, in this prospective study, we examined the effect of acupuncture treatment for complaints of VDT workers.
[Methods]Sixty-one VDT workers participated as subjects (41 males, 20 females). Acupuncture sessions were performed once a week for four weeks. Acupuncture points were decided by the patient's muscleskeletal distress.
Disposable press tack needles were used. Visual Analogue Scale (VAS) was used to determine eye fatigue, neck and shoulder stiffness. Improvements of each VAS were evaluated. Then we analyzed improvement on shoulder and neck stiffness associated with eye fatigue.
[Results]The neck and shoulder distress of patients was reduced in four weeks by acupuncture treatment. A regular correlation between the improvement rate of eye fatigue and neck/shoulder stiffness was observed.
[Conclusion]The neck and shoulder stiffness was improved by acupuncture treatment. According to improved symptoms, eye fatigue was mitigated as well. Thus it was suggested that utility of acupuncture is high in the field of industrial medicine.

We evaluated the efficacy, usefulness and safety of acupuncture and moxibustion treatment in rheumatoid arthritis, by the randomized, parallel-group, multi-center study with the drug-treated outpatient group as the control. The endpoints, important in the clinical assessment of acupuncture treatment, included the improvement criteria in ACR core set variables and the Japanese version of the Arthritis Impact Measurement Scales Version 2 (AIMS-2), a system of evaluation of the QOL of patients with RA.
Regarding intervention (therapy), a therapy chart for each stage of disease was drawn up to give local and systemic treatment in consideration of the patient's activity and disability in each stage of rheumatoid arthritis, so that generally consistent therapy adapted to the patient's condition would be provided. Result 1. Patients eligible for analysis were 80 patients of A-group (drug therapy group) (80 females, 2 males, 2dropped) and 90 patients of B-group (drug plus acupuncture and moxibustion group), total 170 patients. 2. Patients who satisfied the improvement criteria in ACR core set variables (improved patients) were 8 of 80 patients in A-group and 20 of 90 patients in B-group. The improvement rate was significantly higher for B-group treated by drug plus acupuncture and moxibustion versus A-group, with P=0.04 in 2×2 table chi square test. 3. In QOL change investigated by AIMS-2 questionnaire, the improvement occurred significantly more frequently in the drug plus acupuncture and moxibustion group, with difference between groups at 12 months after the initiation of clinical study at P=0.001. 4. Changes in the subjects included in AIMS-2 questionnaire: Improvement was significantly more frequent in the drug plus acupuncture and moxibustion group versus drug therapy group in respect to the ability to walk, finger function, housework, sociableness, pain, mood, and the degree of subjective improvement. In the present randomized, parallel-group, multicenter study, a significant improvement was detected in the drug plus acupuncture and moxibustion group versus the drug therapy group in the aforesaid respect, which suggested that the use of acupuncture and moxibustion combined with the conventional therapy would prevent deterioration of physical functions, improve blood circulation, stabilize mental status, and thereby contribute to the improvement of QOL in patients with rheumatoid arthritis.

[Purpose] We know of no reports on the effects of electro-acupuncture (EA) stimulation, on human skeletal muscle blood flow (MBF), examined quantitatively with a direct method. Therefore, we investigated changes in MBF before, during and after EA with a new clearance method. [Methods] Ten healthy adult volunteers (8 men and 2 women; median age 30.5 years) were given EA to the trapezius at the BL 10 and GB 21 acupoints, employing the left trapezius as the non-EA side to contrast with the right trapezius as the EA side, and using stainless needles of 50 mm length and 0.18 mm gauge. MBF data were surveyed for 2 minutes before EA, for 4 minutes during EA, and for 4 minutes after EA, and a total of10minutes were analyzed l(?). Blood pressure and heart rate were simultaneously measured. [Results] MBF on the EA side increased significantly during EA (p < 0.05). On the other hand, diastolic blood pressure and heart rate were shown to decrease during EA (p < 0.05). [Discussion] These results, showing that MBF increased on the EA side, while diastolic blood pressure and heart rate decreased, suggest a regional muscle pump action with EA. [Conclusion] In evaluating a new, direct means of quantitatively examining _99mTc0_4- clearance, an increase in MBF with right side EA stimulation was clearly shown. Because the present method is simpler and easier, and higher in accuracy than past methods, we believe it may be used more aggressively in future clinical studies of acupuncture/moxibustion.

Objective: This study was conducted to analyze the effects of acupuncture regarding prevention of migraine attacks based on the measurements of headache days, and tenderness and muscle tightness in the neck and shoulder muscles and in the masticatory muscles, and to evaluate the relationship between them. Methods: The subjects were 70 patients (22 men and 48 women) who satisfied the diagnostic criteria of migraine according to The International Classification of Headache Disorders, 2nd edition. The mean age was 35.5±14.3 years (mean±S.D.). Thirteen patients had migraine with aura and 57 had migraine without aura.   Acupuncture was performed for 2 month; the number of days with a moderate or severe headache as well as tenderness and muscle tightness of the neck, shoulder and masticatory muscles, were assessed before and after acupuncture treatment. In addition, the relationship between the decrease in the number of headache days and improvement in tenderness and muscle tightness was analyzed. Results: Acupuncture reduced the number of days with a moderate or severe headache (p<0.05) and improved tenderness and muscle tightness (p<0.01). Also, a positive correlation was noted between the decrease in the number of headache days and improvement of neck, shoulder and masticatory muscle tenderness; the correlation with the improvement of neck tenderness was the strongest. Discussion and Conclusion: When acupuncture was performed continuously for a certain period, the number of headache days decreased, and tenderness and tightness in the neck, shoulder and masticatory muscles improved, demonstrating the efficacy of acupuncture. The results suggest that acupuncture prevents the attacks by relieving muscle tightness. The mechanism by which acupuncture would prevent migraine attacks can be its effect on higher brain centers via the spinal nucleus of the trigeminal nerve through the upper cervical plexus and trigeminal nerve as the afferent pathways.

[Introduction] The effects of combining acupuncture and kampo medicine on in vitro fertilization (IVF) outcomes is unclear. Therefore, we aimed to investigate their combined effects on promoting conception in patients with multiple IVF attempts.[Methods] Participants with at least two IVF attempts who gave informed consent were included in this study. Administering acupuncture and kampo medicine, the study was conducted across three facilities from 2013 to 2017 using a case series design． Case 1: A 40-year-old woman presented after 13 months of infertility, having experienced a natural conception and subsequent miscarriage 10 months prior, which led to IVF. After a second embryo transfer, she miscarried again 3 months before visiting. She began kampo medicine and acupuncture for support in our department. Case 2: A 46-year-old woman with a 36-month infertility history did not achieve pregnancy after three IVF cycles． Case 3: A 37-year-old woman with a 20-month infertility history failed to conceive after two IVF attempts． Case 4: A 26-year-old woman, new to infertility treatment, received acupuncture for fertility preservation, experiencing headache, shoulder stiffness, and widespread pain. Case 5: A 38-year-old woman with a 108-month infertility history suffered from shoulder stiffness due to prolonged IVF therapy. The main outcome measured was pregnancy. Standard acupuncture points utilized included L14 (Hegu), CV12 (Zhongwan), CV7 (Yinjiao), ST27 (Daju), ST29 (Guilai), BL18 (Ganshu), BL20 (Pishu), BL23 (Shenshu), BL33 (Zhongliao), SP10 (Xuehai), ST36 (Zusanli), and SP6 (Sanyinjiao)． [Results] Four out of five participants achieved pregnancy． [Discussion] Our findings reveal a positive effect of combining acupuncture and kampo medicine on enhancing pregnancy rates in patients undergoing multiple IVF treatments, suggesting clinical effectiveness in fostering an appropriate environment for conception．