Four fibromyalgia syndrome (FMS) patients with complaints of widespread pain, fatigue and difficulty sleeping received acupuncture therapy. The effects of acupuncture treatment were evaluated using a visual analogue scale (VAS), and a pain disability assessment scale (PDAS). After whole body acupuncture treatments, VAS and PDAS values were almost unchanged. However, VAS and PDAS values improved following a 3-treatment course of FMS-specific acupuncture treatments (electroacupuncture at the characteristic tender points of FMS). These results suggest that FMS-specific acupuncture treatment of fibromyalgia patients may relieve their commonly reported symptoms of pain, and fatigue.

It is well known that aconitine-alkaloids is effective for treatment of rheumatoid arthritis (RA). However, the clinical use is limited in part because of its side effects. In this study we examined the therapeutic effects of newly processed “bushi” (Shujibushi) in which the contents of original forms of aconitines were reduced to aboid their undesirable effects. The effectiveness of the “Shujibushi” was recognized in 65.8% (45/67) for clinical and definite RA and in 80.7% (21/26) for probable RA. There were not any adverse side effects.
In order to obtain possible explanations for the high effectiveness of the “Shujibushi”, we analized ingredients of the “Shujibushi” in comparison with “Uzu” another type of aconitine-alkaloids medicine. The “Shujibushi” contained the significantly larger amounts of total alkaloids compared with “Uzu”. The satisfactory effectiveness of the “Shujibushi” might be brought on by the high content of total alkaloids which seem to be composed of aconitine-metabolites and its original forms.

In order to reduce the side effects of aconitine alkaloids, various types of processed Aconitine Tuber have been developed. We have been using 2 types of processed materials: the “Shujibushi” and the “Uzu” for the treatment of rheumatoid arthritis.
Original forms of aconitines (aconitine, hypaconitine and mesaconitine) and total alkaloids of these processed materials were analyzed. Hypaconitine content was 4.9 times larger in the “Uzu” than in the “Shujibushi”. In contrast, the content of total alkaloids was significantly larger in the “Shujibushi” than in the “Uzu”. Accordingly, the amount of total alkaloids eluted to the decoction was 1.3-1.8 times larger in the “Shujibushi” than in the “Uzu”.
Our data indicate that 1) The effectiveness of the processed Aconiti Tuber may depend on the contents of the total alkaloids as well as the original forms of aconitines; 2) Elution rates of total alkaloids to the decoction vary among the types of herb complex resulting in the difference of their clinical effectiveness and reduction of side effects.

The effects of acupuncture and moxibustion on lower back pain in clinical trials were reviewed. First, the effects of Western medicine on lower back pain, patients with specific and nonspecific lower back pain, were systematically reviewed based on online data, and possible mechanisms were discussed. Secondly, the role and potential of acupuncture and moxibustion on lower back pain were considered based on a review of research literature. Finally, the effectiveness of acupuncture and moxibustion on several kinds of lower back pain was systematically examined based on online data. These results suggest that acupuncture and moxibustion may be more effective on non-specific lower back pain.

Case Report : Acupuncture therapy for a fibromyalgia-like syndrome (FMS-like) patient. A 44-year-old woman complained of widespread pain, fatigue and poor quality sleep. Effects of acupuncture treatment were evaluated using a visual analogue scale (VAS), pain disability assessment scale (PDAS) and pressure pain thresholds (PPT) at tender sites of FMS. After 13 whole body acupuncture treatments PPT, VAS and PDAS were almost unchanged. However, three FMS-specific acupuncture treatments (eletroacupuncture at characteristic tender sites of FMS) increased PPT and improved VAS and PDAS. These results suggest that FMS-specific acu-puncture treatment may relieve widespread pain and fatigue symptoms in FMS-like patients.

[Purpose] This study investigated sports injuries in university students and compared two different acupuncture therapy procedures for chronic low back pain (LBP).
[Method] The questionnaire (12 items) was distributed to members of sports clubs at Meiji University of Oriental Medicine. Patients with LBP resulting from sports injuries who had had low back pain for more than a year were treated by two different acupuncture therapy procedures. There were no abnormal findings in their neurological examinations.
[Result] The questionnaire response rate was 68.6%. The overall prevalence rate of sports injuries was 77.6%, and LBP patients were the most common. On the other hand, during and after the preceding therapy, using the traditional acupoints for LBP, there was no remarkable clinical effect on LBP, whereas during and after the succeeding therapy using the trigger point, there were remarkable clinical effects on LBP, as evaluated by the visual analogue scale.
[Conclusion] These results suggest that trigger point acupuncture therapy may be more effective on chronic LBP in sports than therapy which uses traditional acupuncture.

[Objective]Acupuncture has been reported to be useful for temporomandibular disorders. There have been many reports on muscle problems in temporomandibular disorders (TMD) but only a few reports on disc problems. We report on the use of acupuncture in a temporomandibular disorder patient with disc disorders.
[Case]A 19-year-old female complained of pain upon opening her mouth and trismus. We applied acupuncture with the aim of resolving the disc problems and providing analgesia by a contributing muscle needling approach.
[Methods]The following were measured:intensity of jaw pain, anxiety and satisfaction (visual analogue scale:VAS), position and form of disc and caput mandibulae (MRI) and presence of jaw deviation.
[Results]The following were improved after acupuncture treatments:intensity of jaw pain, anxiety and satisfaction, limitation of jaw movement and jaw deviation. However, the positions of the discs did not change.
[Conclusion]These results suggest that acupuncture may be effective for temporomandibular disorder patients with disc disorders.

In Chinese medicine, Saiko-ka-ryukotsu-borei -to (SRT; Chai-hu-jia-long-gu-mu-li-tang) and Saiko-keishi-kankyo-to (SKT; Chai-hu-gui-zhi-gan-jiang-tang) are frequently used for patients with nervous constitutions who exhibit psychoneurotic symptoms. Specifically, SRT is used for patients of the excessive constitution type (Shi Zheng), and SKT is used for patients of the deficient constitution type (Xu Zheng).
In this study, in order to clarify the action of SRT and SKT on the central nervous system, the effects of these formulas on the monoamines and their metabolism in discrete brain regions in mice were examined.
1) Single-dose administration of SRT and SKT increased the levels of neurotransmitters and stimulated the metabolism in the dopaminergic nervous system of the corpus striatum (including the serotonergic nervous system for SRT).
2) Repeated administration of SRT stimulated the metabolism in the dopaminergic nervous system of the hypothalamus and hippocampus, and inhibited metabolism in the adrenergic nervous system. On the other hand, SKT stimulated dopamine metabolism in the hippocampus and inhibited the metabolism of serotonin.
From these results, it became apparent that single-dose administration of SRT and SKT caused the hyperfunction of the dopaminergic nervous system, and that repeated administration of the agents caused the hyperfunction of the dopaminergic nervous system and the dysfunction of the serotonergic nervous system. This suggests that the actions of SRT and SKT on the central nervous systems may exert an influence on the regulation of psychoneuroic symptoms by stimulating the doperminergic nervous system and inhibiting the serotonergic nervous system.

The therapeutic efficacy of Hachimi jio-gan on pain, weakness, numbness and coldness of the limbs and lower back was investigated in 37 aged patients. After administration for 4 weeks, improvement in the global improvement rating was 55.9%, and improvement in pain, weakness, numbness and coldness were 44.8%, 39.3%, 59.1% and 31.8%, respectively. For the improvement of numbness, more significant improvement was seen in patients 60 years old or greater than in those 59 or less. Such symptoms as hair thinning or hair loss, dimming of the eyes, constipation, pain in the upper limbs, numbness in the lower limbs, coldness of the upper limbs and coldness of the lower limbs showed significant improvement. These results suggest that Hachimi jio-gan is effective in the treatment of pain, weakness, numbness and coldness in aged patients.

This study was conducted to assess the proper fee for dispensing herbs prescribed under the national health insurance. We investigated the cost of dispensing a) general medicine and b) Kampo formulae in relation to the time needed in three pharmacies. One prescription of general medicine including packed extract of Kampo formulae, and one Kampo formula consisting of different kinds of herbs, were counted as one sample each. The former counted 125 samples, and 176 samples of the latter. The mean time for dispensing one sample of Kampo formulae was 9 minutes and 33 seconds, and it was 5.4 times longer than for the general medicine (1 minute and 46 seconds). The time for dispensing herbs grew longer as the days of the prescription increased; with a mean number of 9-12 herbs in the formulae about twice the time was needed for a prescription for 22-28 days than for one of 8-14 days. As the number of herbs in the formulae increased, the time for dispensing them also increased. The cost of pharmacist's work was calculated based upon the time expended and the pharmacist's hourly wage. It amounted to one fifth of the fee for dispensing general medicine, but it was nearly equal or higher when involving herbs. According to the Regulation of Dispensary Awards revised in 2004, the fee for dispensing herbal medicine is \1200 whatever the formulae. We would like to recommend that a re-evaluation of the fee should be made based on the number of days of the prescription, the number of herbs in the formulae, and the cost of preserving herbs in pharmaceutical facilities.