A History and Current Situations of Acupuncture in Europe, Mainly in France
Journal of the Japan Society of Acupuncture and Moxibustion.2001;51(5):547-556. doi:10.3777/jjsam.51.547
Journal of the Japan Society of Acupuncture and Moxibustion
1948 to Present ISSN: 0285-9955
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1. Acupuncture Treatment in Neurological Disorders
Journal of the Japan Society of Acupuncture and Moxibustion.2001;51(5):572-575. doi:10.3777/jjsam.51.572
Electroacupuncture A practical manual and resource Edited by David F. Mayor
Journal of the Japan Society of Acupuncture and Moxibustion.2007;57(5):658-658. doi:10.3777/jjsam.57.658
Report on the ICMART conference in Den Haag
Journal of the Japan Society of Acupuncture and Moxibustion.2011;61(4):440-445. doi:10.3777/jjsam.61.440
I observed the ICMART (International Council of Medical Acupuncture and Related Techniques) World Congress on Medical Acupuncture held on May 13-15, 2011 in Den Haag (Netherlands). The ICMART is an association of western medical societies mainly interested in scientific evidence for acupuncture and other oriental medical techniques. Naturally, the number of presentations dealing with scientific evidence in relation to oriental medicine outnumbered those dealing with clinical aspects or traditional characteristics. The presented results showed, however, that while one set of evidence proves one thing, for example whether acupoints are really points or rather extended areas, another set proves the exact opposite and thus renders either the scientific questionable and the applied methods and/or the obtained results at least questionable. On the other hand, presentations dealing with traditional characteristics or techniques sometimes presented no evidence at all, or did not explain the rational behind the shown results.
Extensive discussion about the integration of alternative medicine into mainstream medicine showed that this subject is much more related to political and financial questions than patient interests, but there seemed also to be some progress and hope for future development.
Extensive discussion about the integration of alternative medicine into mainstream medicine showed that this subject is much more related to political and financial questions than patient interests, but there seemed also to be some progress and hope for future development.
Report on the TCM Kongress in Rothenburg
Journal of the Japan Society of Acupuncture and Moxibustion.2011;61(4):446-452. doi:10.3777/jjsam.61.446
I participated in the TCM (Traditional Chinese Medicine) Kongress hosted by the AGTCM(Arbeitsgemeinschaft fur klassische Akupunktur und traditionelle chinesische Medizin e.V.) that is held every year (this year: 5/30-6/5, 2011) in the same location, namely the small town of Rothenburg in Germany. While a substantial portion of the attendees are also physicians, this congress is mainly for non-physician practitioners using mainly acupuncture and Chinese herbal therapy. As the name already indicates, the focus here is more on the traditional aspects of oriental medicine that were dealt with during both theoretically and practically oriented presentations. The presentations, or rather study groups, were designed mostly for small groups of about 20-30 people and lasted 3hours each. This allowed extensive discussions that sometimes even took the entire presentation into an unforeseen direction. Although there were a number of presentations dealing with Japanese or Korean acupuncture, etc., naturally the majority discussed the Chinese style and characteristics of theory and practice. This practice seemed to rely, in most cases, mainly on theoretical considerations that could give the attendee the impression that examination of the unique characteristics of each patient (using palpation, etc.) so common in Japan is of rather secondary importance.
Political aspects of alternative medicine and questions pertaining to standardization, etc. played an important role and I found it very interesting that one of the leading executives mentioned that although acupuncture may have developed in China, its future (further development) will probably lie in the West.
Political aspects of alternative medicine and questions pertaining to standardization, etc. played an important role and I found it very interesting that one of the leading executives mentioned that although acupuncture may have developed in China, its future (further development) will probably lie in the West.
What Kind of Control Condition should we use in Trials of Acupuncture?
Journal of the Japan Society of Acupuncture and Moxibustion.1994;44(3):288-299. doi:10.3777/jjsam.44.288
Disappointingly little has been achieved by literally hundreds of attempts to evaluate acupuncture for chronic pain. Major methodological flaws are apparent in the vast majority of studies. Controlled studies have shown positive findings for low back pain, and equivocal results for migraine and asthma. Nevertheless larger scale studies are warranted for all these disorders, though other types of musculo-skeletal pain, tension headache and arthritis are also possible candidates.
Controlled trials of any treatment have become an immensely difficult and technical undertaking. They are expensive, time-consuming and ideally require the collaboration between practitioners and researchers and consultation with a statistician. It is not really possible for acupuncturists in private practice to mount such trials, and it is very difficult for a professional association or college. However, it is clear that there is no longer any point in conducting small, preliminary studies of acupuncture treatment. There are dozens of such studies, with some encouraging findings. The only way acupuncture can gain full acceptance as a valid form of treatment is through good controlled trials that are large enough to answer the questions they pose.
Ter Riet's list of criteria as a good starting point for anyone designing a trial of acupuncture. Specific points I would emphasize after reviewing the existing research on acupuncture are:
1. Trials should be single blind; it is not feasible to conduct double-blind trials. Some trials are nevertheless incorrectly described as double blind.
2. A range of outcome measures should be used, preferably with some independent assessment. An adequate follow-up is essential.
3. Considerable care needs to be taken in the choice of control group, especially with placebo controls. For a placebo I suggest a form of acupuncture treatment that is designed to have minimal effects. It will be the option that is the closest match to the true treatment and avoids the difficulties inherent in randomizing patients to a non-acupuncture treatment.
4. It is very useful to check the adequacy of any control treatment with a measure of credibility, or similar assessment, as the choice of control is frequently a matter for criticism.
5. Trials have generally been too small to permit firm conclusions. Ter Riet (Ter Riet, Kleijnen et al. 1990) implies that 50 patients per group are needed. This may not be necessary. However preliminary calculations of the necessary size for a reasonable power need to be carried out.
Controlled trials of any treatment have become an immensely difficult and technical undertaking. They are expensive, time-consuming and ideally require the collaboration between practitioners and researchers and consultation with a statistician. It is not really possible for acupuncturists in private practice to mount such trials, and it is very difficult for a professional association or college. However, it is clear that there is no longer any point in conducting small, preliminary studies of acupuncture treatment. There are dozens of such studies, with some encouraging findings. The only way acupuncture can gain full acceptance as a valid form of treatment is through good controlled trials that are large enough to answer the questions they pose.
Ter Riet's list of criteria as a good starting point for anyone designing a trial of acupuncture. Specific points I would emphasize after reviewing the existing research on acupuncture are:
1. Trials should be single blind; it is not feasible to conduct double-blind trials. Some trials are nevertheless incorrectly described as double blind.
2. A range of outcome measures should be used, preferably with some independent assessment. An adequate follow-up is essential.
3. Considerable care needs to be taken in the choice of control group, especially with placebo controls. For a placebo I suggest a form of acupuncture treatment that is designed to have minimal effects. It will be the option that is the closest match to the true treatment and avoids the difficulties inherent in randomizing patients to a non-acupuncture treatment.
4. It is very useful to check the adequacy of any control treatment with a measure of credibility, or similar assessment, as the choice of control is frequently a matter for criticism.
5. Trials have generally been too small to permit firm conclusions. Ter Riet (Ter Riet, Kleijnen et al. 1990) implies that 50 patients per group are needed. This may not be necessary. However preliminary calculations of the necessary size for a reasonable power need to be carried out.
Traditional healing of mind and body
Journal of the Japan Society of Acupuncture and Moxibustion.2014;64(4):190-196. doi:10.3777/jjsam.64.190
We created a new medical interview form which is called chronological analysis for East Asian Traditional Medicine (EATM).
I would like to focus on our medical interview in EATM. Our patient comes to see a doctor with his or her life and medical histories.
When we interview and write them on CHRONOLOGICAL ANALYSIS CHART, we can give them into several groups. Each group is characterized as a chronic health problem (CHP) and named by the traditional major pattern diagnosis and the symptom-to-medicine pattern diagnosis. The former base on TCM (Traditional Chinese Medicine) and the latter Japanese Kampo Medicine.
On this chart the patient's life events are written in the left side and his or her active symptoms are written in right side. We write them to make in the same longitudinal time line. Comparison with light life events and right illnesses makes us understand the structure consisting of several groups. We already saw more than three hundred thousand patients in 30 years. A 52 year-old women came to see us. We interviewed by our chronological analysis. Her history consist of several groups:The 1 st group is Detoxication pattern, the 2 nd is heat in intestine blood, the 3rd is congestion in blood, and the 4 th is Liver "CHI"congestive dysfunction and finally we diagnosed as Toukakujyoukitou decoction for climacteric dysfunction.
The most significance is we could guess that she had a stressful time in the blue colored part.
After observing each patient's chronic health problems, we relate them chronologically to their life events and develop a graphic structure for each patient comprehensively. To see a patient from this kind of this view, we call emphasize them in both modern and traditional medicine. We show a new interview way using chronological chart to understand patients more deeply.
Amid the growing medical needs of an aging society this chronological analysis is significant to understand our patients comprehensively.
Through these medical approach we understand patients and give them traditional healing of mind and body.
I would like to focus on our medical interview in EATM. Our patient comes to see a doctor with his or her life and medical histories.
When we interview and write them on CHRONOLOGICAL ANALYSIS CHART, we can give them into several groups. Each group is characterized as a chronic health problem (CHP) and named by the traditional major pattern diagnosis and the symptom-to-medicine pattern diagnosis. The former base on TCM (Traditional Chinese Medicine) and the latter Japanese Kampo Medicine.
On this chart the patient's life events are written in the left side and his or her active symptoms are written in right side. We write them to make in the same longitudinal time line. Comparison with light life events and right illnesses makes us understand the structure consisting of several groups. We already saw more than three hundred thousand patients in 30 years. A 52 year-old women came to see us. We interviewed by our chronological analysis. Her history consist of several groups:The 1 st group is Detoxication pattern, the 2 nd is heat in intestine blood, the 3rd is congestion in blood, and the 4 th is Liver "CHI"congestive dysfunction and finally we diagnosed as Toukakujyoukitou decoction for climacteric dysfunction.
The most significance is we could guess that she had a stressful time in the blue colored part.
After observing each patient's chronic health problems, we relate them chronologically to their life events and develop a graphic structure for each patient comprehensively. To see a patient from this kind of this view, we call emphasize them in both modern and traditional medicine. We show a new interview way using chronological chart to understand patients more deeply.
Amid the growing medical needs of an aging society this chronological analysis is significant to understand our patients comprehensively.
Through these medical approach we understand patients and give them traditional healing of mind and body.
Journal of the Japan Society of Acupuncture and Moxibustion.2014;64(4):196-203. doi:10.3777/jjsam.64.196
[Objective]The purpose of this study was to clarify the current status of cooperation between acupuncturists and physicians providing palliative care at home care support clinics.
[Methods]We studied 297 home care support clinics that provide cancer palliative care in the home. We mailed a self-administered questionnaire to the physicians belonging to the clinics. The questionnaire was created to clarify the number of clinics that provide home palliative care, current status of cooperation with acupuncturists, and methods of information-sharing.
[Results]We received responses from 98 clinics (33.3%response rate). Of these, 14 clinics (14.3%) currently provide care for terminal cancer patients in cooperation with acupuncturists, 9clinics (9.2%) reported having done so in the past. Patient's conditions treated in cooperation with acupuncturists were things such as pain, hiccups, edema, ascites, and constipation. The benefits attributed to cooperation with acupuncturists included "relief of symptoms,""improved patient satisfaction,"and "improved patient motivation."Regarding the presence or absence of information-sharing with acupuncturists, 7clinics (50%) responded that they "always share," 7clinics (50%) responded that they "share depending on the situation,"and no clinic reported "does not share information."Regarding the prospect for cooperation with acupuncturists in providing home palliative care in the future, 9clinics (9.2%) responded that they "actively want to cooperate,"and 65 clinics (66.3%) stated that they would "think about cooperation in some circumstances."
[Conclusion]From this study, it was concluded that cooperation exists between acupuncturists and physicians in 14.3%of home care support clinics providing palliative care. In addition, the possibility that cooperative patient care provides not only symptom relief but also other benefits has been suggested. On the other hand, it is necessary for acupuncturists, as part of a healthcare team, to have access to patient information and the status of other treatments, so that the acupuncturists can be involved in the field of home palliative care. Furthermore, management should promote an environment for cooperating with professionals in other medical occupations, including physicians.
[Methods]We studied 297 home care support clinics that provide cancer palliative care in the home. We mailed a self-administered questionnaire to the physicians belonging to the clinics. The questionnaire was created to clarify the number of clinics that provide home palliative care, current status of cooperation with acupuncturists, and methods of information-sharing.
[Results]We received responses from 98 clinics (33.3%response rate). Of these, 14 clinics (14.3%) currently provide care for terminal cancer patients in cooperation with acupuncturists, 9clinics (9.2%) reported having done so in the past. Patient's conditions treated in cooperation with acupuncturists were things such as pain, hiccups, edema, ascites, and constipation. The benefits attributed to cooperation with acupuncturists included "relief of symptoms,""improved patient satisfaction,"and "improved patient motivation."Regarding the presence or absence of information-sharing with acupuncturists, 7clinics (50%) responded that they "always share," 7clinics (50%) responded that they "share depending on the situation,"and no clinic reported "does not share information."Regarding the prospect for cooperation with acupuncturists in providing home palliative care in the future, 9clinics (9.2%) responded that they "actively want to cooperate,"and 65 clinics (66.3%) stated that they would "think about cooperation in some circumstances."
[Conclusion]From this study, it was concluded that cooperation exists between acupuncturists and physicians in 14.3%of home care support clinics providing palliative care. In addition, the possibility that cooperative patient care provides not only symptom relief but also other benefits has been suggested. On the other hand, it is necessary for acupuncturists, as part of a healthcare team, to have access to patient information and the status of other treatments, so that the acupuncturists can be involved in the field of home palliative care. Furthermore, management should promote an environment for cooperating with professionals in other medical occupations, including physicians.
Development of a Scale for Measuring Medical Communication Skills of Acupuncturists
Journal of the Japan Society of Acupuncture and Moxibustion.2014;64(4):204-211. doi:10.3777/jjsam.64.204
[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.
[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.
Journal of the Japan Society of Acupuncture and Moxibustion.2014;64(4):212-218. doi:10.3777/jjsam.64.212
[Objective]We report herein the use of acupuncture to counteract gait disturbance in a patient with Parkinson's disease (PD). A portable gait rhythmogram was used to objectively demonstrate gait improvements.
[Case]Case:A 72-year-old woman, who a 64 experienced a tremor of the right hand and was diagnosed with PD. Symptoms improved with anti-PD medication, but at 71 years old, she experienced heaviness of the neck and shoulders and stiffness of the anterior thighs, and her step length decreased. Acupuncture therapy was initiated to relieve these symptoms.
Present illness:On examination, she presented a wobbly gait, cold feet, and reported frequent falling. Heaviness in the neck and shoulders extended from the neck to the suprascapular region, and increasing heaviness resulted in a forward-flexed posture and decreased step length. Muscle hypertonia of the quadriceps muscles was bilaterally observed, explaining the perceived stiffness in the thighs. She was at stage III on the Hoehn and Yahr Scale.
Acupuncture therapy:Acupuncture therapy was performed weekly for 12 weeks to alleviate the muscle hypertonia associated with muscular rigidity. Acupuncture points comprised the points in the muscle hypertonia where tenderness was observed, including BL 10, DU 16, ST 32, SP 10 and ST 34.
Evaluation:A portable gait rhythmogram was used to measure the ground reaction force (GRF), velocity and step length. Dynamic balance functions and PD symptoms, were respectively evaluated using the Timed Up and Go Test (TUGT) and Unified Parkinson's Disease Rating Scale (UPDRS). Evaluations were conducted on initial examination and after the 12th therapy session.
[Results]After the fourth session, perceived stiffness in the neck, shoulder region and thighs decreased. all frequency decreased from 5 times/day to 3times/day (4th session) and then once/day (7th session). There were no falls after the 8th session. Reduction in gait disturbance was objectively observed as follows:Increases were observed in GRF (0.15 to 0.17 m/s 2), gait velocity (49 to 53m/min), and step length (47 to 49 cm), while TUGT time decreased (11.8 to 9.5 s). Improvements in PD symptoms were also observed with decreased UPDRS score (41 to 28 points).
[Discussion and Conclusion]The use of acupuncture therapy achieved improvements in Parkinson-related gait disturbance (objectively demonstrated using a portable gait rhythmogram). Acupuncture improved not only gait disorder but also other PD symptoms.
[Case]Case:A 72-year-old woman, who a 64 experienced a tremor of the right hand and was diagnosed with PD. Symptoms improved with anti-PD medication, but at 71 years old, she experienced heaviness of the neck and shoulders and stiffness of the anterior thighs, and her step length decreased. Acupuncture therapy was initiated to relieve these symptoms.
Present illness:On examination, she presented a wobbly gait, cold feet, and reported frequent falling. Heaviness in the neck and shoulders extended from the neck to the suprascapular region, and increasing heaviness resulted in a forward-flexed posture and decreased step length. Muscle hypertonia of the quadriceps muscles was bilaterally observed, explaining the perceived stiffness in the thighs. She was at stage III on the Hoehn and Yahr Scale.
Acupuncture therapy:Acupuncture therapy was performed weekly for 12 weeks to alleviate the muscle hypertonia associated with muscular rigidity. Acupuncture points comprised the points in the muscle hypertonia where tenderness was observed, including BL 10, DU 16, ST 32, SP 10 and ST 34.
Evaluation:A portable gait rhythmogram was used to measure the ground reaction force (GRF), velocity and step length. Dynamic balance functions and PD symptoms, were respectively evaluated using the Timed Up and Go Test (TUGT) and Unified Parkinson's Disease Rating Scale (UPDRS). Evaluations were conducted on initial examination and after the 12th therapy session.
[Results]After the fourth session, perceived stiffness in the neck, shoulder region and thighs decreased. all frequency decreased from 5 times/day to 3times/day (4th session) and then once/day (7th session). There were no falls after the 8th session. Reduction in gait disturbance was objectively observed as follows:Increases were observed in GRF (0.15 to 0.17 m/s 2), gait velocity (49 to 53m/min), and step length (47 to 49 cm), while TUGT time decreased (11.8 to 9.5 s). Improvements in PD symptoms were also observed with decreased UPDRS score (41 to 28 points).
[Discussion and Conclusion]The use of acupuncture therapy achieved improvements in Parkinson-related gait disturbance (objectively demonstrated using a portable gait rhythmogram). Acupuncture improved not only gait disorder but also other PD symptoms.
Country
Japan
Publisher
全日本鍼灸学会The Japan Society of Acupuncture and Moxibustion
ElectronicLinks
http://jsam.jp/contents/050000/Editor-in-chief
Shunji Sakaguchi
honbu@jsam.jp
Abbreviation
J Jpn Soc Acupunct Moxibust
Vernacular Journal Title
全日本鍼灸学会雑誌
ISSN
0285-9955
EISSN
Year Approved
Current Indexing Status
Currently Indexed
Start Year
1948
Description
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