Acupuncture, which was originated and developed in the East Asian countries, has been globalized today. In Japan, acupuncture is more popular than the West, but lagging behind in terms of medical policy, research funding and evidence-based clinical research. Evidence-based approach such as randomized controlled trial has brought new developments in acupuncture research scene. On the other hand, clinical implication of acupuncture “system” seems to have been underestimated in evidence-based clinical research until recently.

Unresolved problems remain in the clinical research methodology of acupuncture. In particular, the creation of placebo group in randomized controlled trial (RCT) is controversial: sham and / or minimal acupuncture may appear more powerful than placebo treatments in trials. Hence, in the future more emphasis should be placed on pragmatic RCTs, which compare typical treatment vs typical treatment plus acupuncture.
In order to more effectively integrate acupuncture therapy into modern Western medicine, evidence of efficacy, safety and cost-effectiveness should be clearly shown from both rational and clinical points of view. At the same time, we should reassess whether or not the present research methodology appropriately evaluates the essence of acupuncture therapy.

This study was conducted to observe autonomic nervous system reactions in the cardiovascular system caused by the new transcutaneous electrical nerve stimulation apparatus CONVALES^®
Autonomic functions were evaluated before and after stimulation of 10 male students between 19 and 42 years of age. The dynamic observation method of autonomic functions proposed by Nishijo et al. was used for evaluating autonomic responses. The activity levels of both the sympathetic and parasympathetic systems were found to increased after stimulation. Neither significant changes in blood pressure nor adverse effects of stimulation were observed.
These results suggest that the apparatus used in this study causes autonomic responses similar to those caused by acupuncture with shallow needling during exhalation phase while sitting, or by laser acupuncture. This study also suggested that this therapeutic method is safe for short periods.

Patients with hemifacial spasm (HFS) sometimes visit acupuncture practitioners for treatment. We can find descriptions of acupuncture procedures and methods for treating facial spasm in textbooks of clinical acupuncture. However, there is almost to literature that presents data on the actual responses of HFS patients to acupuncture. Therefore, we cannot judge satisfactorily whether acupuncture is suitable for treating of HFS at this time.
Six HFS patients (37 to 56 years old) who had not responded to conventional medical treatment were treated with electro-acupuncture therapy (EAT). EAT was applied to facial muscles for twenty minutes once or twice a week.EAT was continued until the patient dropped out or changed treatment. The period of treatment ranged from one month to one year. After a course of weekly treatments, ranging from one week to one month, the frequency and degree of spasms decreased in five of the six patients. No serious adverse events due to the treatments were observed.
It seems that EAT is safe and produces a gentle anticonvulsant effect. Therefore, it is conceivable that EAT could be applicable for HFS. Thus, if the treatment with microvascular decompression or botulinum toxin is contraindicated, EAT may possibly be an alternative.

We introduce the current research on complementary and alternative medicine (CAM) in the West, which we refer to as Evidence-based CAM (EBCAM), and discuss its characteristics, problems, and perspectives. Compared with the common attitude of CAM researchers in Japan, that of EBCAM researchers is more objective and often self-critical. EBCAM research is still developing because randomized controlled trials on CAM have many methodological flaws. Caution should be employed in interpreting provisional conclusions of relevant systematic reviews. CAM researchers in Japan should view the case report method from a perspective other than efficacy. Also, they will have to prepare evidence in response to demands from CAM consumers. Priority of research subjects from various kinds of CAM should be decided according to their popularity. Therefore, a large-scale survey on CAM use in Japan is essential.