1.Cancer and acupuncture & Moxibustion 3
Takayoshi OGAWA ; Masahiro KANAI ; Taneomi KUROKAWA ; Fumihiko FUKUDA ; Shunichi MAGARA ; Satoru YAMAGUCHI ; Ai KOUCHI ; Tatuzo NAKAMURA
Journal of the Japan Society of Acupuncture and Moxibustion 2010;60(4):693-706
This is the third symposium on 'cancer and acupuncture and moxibustion'. Many physicians and intellectuals are skeptical of the use of Western medicine for cancer patients, which often lead to serious adverse events. Acupuncture and moxibustion, which is capable of improving quality of life (QOL) and activating immunity with minimal side effects is also expected to have beneficial effects on various stages of cancer patients, such as prevention of development or recurrence of cancer and palliative care. In fact, evidence has recently accumulated in the field. Dr. Fukuda, Associate Professor of Meiji University of Integrative Medicine, who reported the usefulness of acupuncture and moxibustion in palliative care in the first symposium and bibliographical information in the second has reported this time on the topic of safety and effectiveness of acupuncture on chemotherapy-induced peripheral neuropathy. Dr. Kurokawa from the National Defense Medical College reported the effectiveness of acupuncture on physical and psychological symptoms, QOL, prevention of adverse events, and pre-and post-operative disorders in cancer patients. Dr. Kouchi from Saitama Medical School reported on the usefulness of acupuncture in the university hospital and factors which influence the effect. Dr. Nakamura from Morinomiya University presented a case with chemotherapy-related symptoms who had been cared for with a long-term application of moxibustion. In contrast to these reports on the efficacy of the acupuncture for chemotherapy-and radiotherapy-induced side effects, Dr. Magara from Somon Hachipuji Clinic, who had consistently reported a preventive effect of autonomic immune therapy that involves acupuncture without Western clinical treatment from the first symposium, this time presented topics regarding improvement in the immunity by increasing various cytokines, the possibility of reduction of a tumor even in a case of advanced cancer that cannot be treated with a surgical approach, reduction of the recurrence rate among cases who were treated with his approach as compared with those under conventional approaches. He insisted we should concentrate our efforts on research on preventing the recurrence of cancer with approaches that activates the natural healing process of human beings.
We concluded that clinical trials with a larger sample are needed to clearly identify the usefulness of acupuncture and moxibustion for cancer patients.
2.Shrinking of Allodynia Area by Surrounding Acupuncture with Electroacupuncture in Two Cases of Postherpetic Neuralgia: A Case Report
Masaki MURAHASHI ; Shintaro IBATA ; Go HORIBE ; Ai KOUCHI ; Satoru YAMAGUCHI
Journal of the Japan Society of Acupuncture and Moxibustion 2023;73(4):259-268
[Objective] Postherpetic neuralgia (PHN) is commonly associated with allodynia in around 90% of patients, which is related to both physical and psychosocial distress. In this report, we report two cases in which surrounding needling with electroacupuncture (EA) at 2Hz was performed for allodynia in the thorax and upper limb, resulting in a reduction of the allodynic area. [Case 1] A 67-year-old male with right-sided anterior thoracic pain. He experienced the initial symptoms in December of a certain year and was diagnosed with herpes zoster the following day. Despite receiving antiviral medication, the pain persisted, leading to a referral to our Saitama Medical University in June of the following year. [Case 2] An 80-year-old female complained of left upper limb pain because of herpes zoster following chemotherapy for multiple myeloma in February of a certain year. In September of the same year, she was referred to our department due to persistent pain and allodynia, despite receiving analgesic medication for PHN since June. [Evaluation] The allodynic areas were calculated as the ratio of the allodynic area to the total area of the anterior thorax and upper limb using Image J. Pain intensity was assessed using the Visual Analogue Scale (VAS). [Treatment] We applied surrounding needling with electro-acupuncture for two cases. Acupuncture needles in the specification of 0.18 × 50 mm (Seirin Co., Ltd, Japan) were inserted transversely as like surrounding the allodynic region and connected to the EA apparatus (Zeniryou Co., Ltd, Japan). EA parameter was selected as dilatational wave. [Time course 1] The ratio of allodynic area was 20.0% at the first session, with a VAS of 28mm. After 8 months, the ratio decreased to 1.7%, and the VAS reduced to 18mm. The analgesics that were being taken at the first session were discontinued by the end of the session. [Time course 2] The ratio of allodynic area was 66.1%, with a VAS of 82mm at the first session. After 6 months, the ratio decreased to 24.1%, and the VAS reduced to 48mm. The analgesics were unchanged, while there was a reduction in the rescue medication. [Discussion] In two cases of intractable PHN with allodynia, EA reduced pain intensity and improved quality of life, with Image J serving as a useful assessment tool. [Conclusion] Surrounding needling with EA at 2Hz may be effective for two cases of PHN with allodynia.
3.A patient with chronic low back pain stratified at the initial visit by the Keele STarT Back Screening Tool and then treated with acupuncture and saibokuto
Go HORIBE ; Yoshikazu MIZOI ; Ai KOUCHI ; Shintaro IBATA ; Satoru YAMAGUCHI
Journal of the Japan Society of Acupuncture and Moxibustion 2023;73(3):186-191
[Introduction] Psychosocial factors are associated with chronic low back pain (CLBP), but there are no known reports of screening for psychosocial factors and combined acupuncture and Kampo treatment for this. We present the case of a patient with CLBP with neuralgia of the posterior right thigh whose quality of life (QOL) improved after evaluation of psychological factors and treatment with acupuncture and saibokuto.[Case presentation] A 38-year-old woman developed low back pain with neuralgia in the posterior right thigh in August of the X year. She visited a nearby orthopedic clinic and was diagnosed with a lumbar disc herniation. In November she visited a nearby psychiatric clinic because she noticed dizziness, was diagnosed with an adjustment disorder and was prescribed bromazepam. Six months later, she was diagnosed with sciatica by an orthopedic surgeon at our hospital. In the following month, she visited the psychiatrist at our hospital and was diagnosed with depression in April. In April, she also visited our department, hoping for improvement of her low back pain and neuralgia in the posterior right thigh. Neurological and orthopedic manual examinations showed normal results, but pain in the lumbar region when flexing the trunk and baikakuki and kyo-kyo-kuman were noted. The Keele STarT Back Screening Tool classified her under medium risk, and the Roland-Morris Disability Questionnaire (RDQ) showed a score of 16 with a deviation score of 1.22. We administered acupuncture and saibokuto to improve her symptoms. The acupuncture treatment was performed on the right L2/L3 lateral sacral border, piriformis equivalent area, BL37, and BL40. As a result, after the third acupuncture treatment, her RDQ score improved to 2 points and the deviation score to 50.14 points.[Discussion] Our results suggest that acupuncture and saibokuto may improve the QOL of CLBP patients with neuralgia in the lower limbs who have psychological factors.
4.Case report of acupuncture and medication for a patient with bilateral peripheral facial paralysis as suspected case of neurosarcoidosis
Go HORIBE ; Nobuo ARAKI ; Ai KOUCHI ; Shintaro IBATA ; Satoru YAMAGUCHI
Journal of the Japan Society of Acupuncture and Moxibustion 2023;73(1):34-40
[Objective] This report describes a patient with bilateral peripheral facial paralysis who was strongly suspected to have neurosarcoidosis and whose facial paralysis improved after acupuncture treatment.[Case] A 73-year-old man developed right facial nerve paralysis on July 24, X followed by left facial nerve paralysis three days later. The patient visited our Department of Neurology on August 2 and was hospitalized the next day. Upon examination, neurosarcoidosis was strongly suspected, and steroid pulse therapy was performed until he was discharged from the hospital on August 26. On September 13, still experiencing bilateral facial paralysis, the patient was referred to our department for acupuncture treatment. The patient's height was 159 cm and weight was 48.6 kg. Valley signs and pathologic reflexes were negative, and deep tendon reflexes and sensory tests of the upper and lower extremities were normal. MMT was fair only for the dorsiflexion movement of the left ankle. The Yanagihara score was 26 on the right and 10 on the left. Facial muscle contraction response to electrical acupuncture stimulation targeting the facial nerve showed contraction at 0.04 mA on the right side and no contraction at 0.30 mA on the left side. According to these examinations, the right side was considered to be mildly paralyzed and the left side was considered to be severely paralyzed, and acupuncture was performed to improve the symptoms of paralysis and prevent sequelae.[Treatment] Acupuncture was applied to GB2 and ST7 on the right side of the face. On the left side, acupuncture needles were placed on the frontalis muscle, orbicularis oculi muscle, elevator muscle of upper lip and wing of nose, nasalis muscle, zygomaticus major and minor muscle, orbicularis oris muscle, depressor angle oris muscle, and platysma muscle. From the 106th day of illness, asynchronous electroacupuncture was applied to the left side only. Acupuncture was performed once or twice a week for 10 minutes per session. The degree of paralysis was assessed by the Yanagihara score.[Progress] Acupuncture was combined with corticosteroids prescribed by the Department of Neurology. As a result, the right side had a score of 38 points after 170 days after start of illness and the left side had a score of 38 points after 204 days.[Discussion and Conclusion] The combined treatment of medication and acupuncture was effective and showed excellent results for this patient taking into account the degree of facial nerve damage. Acupuncture may be considered as an effective treatment option for bilateral peripheral facial paralysis.