Cancer is the leading cause of death in Japan, which boasts one of the longest life expectancies in the world. Some types of cancer cause excruciating pain. Measures are actively being taken to establish palliative care units as specialized facilities to mitigate pain and set up palliative care teams in core hospitals for cancer care. In accordance with the guidelines of the WHO, a method using narcotic drugs as a means of pain relief has been established in Japan, but for patients at the middle to late stages of cancer, sufficient pain control cannot be ensured for many cases. Although various alternative therapies, including acupuncture, moxibustion, and haut care (hand and foot massages) are used to alleviate pain, the effectiveness of these methods is still unclear. Accordingly, we examined the actual conditions of palliative care together with evidence of acupuncture and moxibustion therapies and haut care as a means of pain relief.

[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.

[Introduction]Insomnia and anxiety are major symptoms of depression and severely limit the daily activities of depressed patients. We report the case of a depressed patient who had developed liver dysfunction caused by medication and whose depression was successfully managed by acupuncture after discontinuation of antidepressants.
[Case]A 37 years-old male had been taking noradrenergic and specific serotonergic antidepressant (NaSSA) and Chai Fu Jia Long Gu Mu Li Tang Jia Wei Gui pi Tang for insomnia and anxiety due to depression. Although his symptoms had improved by the medication, abnormalities in his liver functions were found after 3months of medication. After he was diagnosed as having drug-induced liver damage, he was admitted to Meiji University's Integrative Medicine Hospital and all medication was replaced by Glycyrrhizin and Glutathione. Consequently his depression and symptoms returned. We then tried to relieve his symptoms by applying acupuncture, which was prescribed according to traditional Chinese medical diagnosis (TCM diagnosis, Heart Yin Deficiency , Liver Qi Stagnation , and Kidney Yin Deficiency ).
[Results]After 4 acupuncture treatments, the patient's duration and depth of sleep considerably improved compared with that before the acupuncture sessions, and comparable results were maintained until discharge. Beck Depression Inventory (BDI) scores were also markedly improved from 'moderate depression'(24 points) at the beginning of treatment to 'minimal depression'(8 points) at the end (9th treatment, 16 days from the first session).
[Conclusion]The results of this case suggest that acupuncture treatment may be an effective alternative for anti-depressants when there is a limitation to administer those drugs.

[Introduction]This symposium was organized for the adoption of the Tokyo Declaration for Japanese Acupuncture and Moxibustion at the final meeting of the congress and was composed of three subjects that were supposed to become a framework for the declaration draft.
[Subjects] 1. History of acupuncture in Japan 2. Analysis of the present circumstances 3. Tasks for the future
The first subject was an explanation of important matters in acupuncture development in Japan, based on the key note lecture given prior to this symposium. The second subject was analysis from both aspects of research studies and clinical situations. The third subject was to be suggestions for further development of acupuncture after revealing present problems.
There are more or less many issues in the acupuncture field;clinical practice, education, research and clinical training, but these issues may not have been approached either systematically or generally before. Whereas, in the light of opinions gathered from many others, many future issues came apparent through the three subjects of this symposium. In conclusion, the goal was to find a strategy that would make Japanese acupuncture become a prevailing therapy in the future more than what it is today.

[Objective]Acupuncture has been described to be effective for acute vomiting induced by anti-cancer drugs of chemotherapy. However, the effect of acupuncture for the prolonged acute nausea that continues more than 24 hours from its onset after chemotherapy has not been satisfactorily investigated. In the present study, we report two cases of prolonged acute nausea induced by chemotherapy and effectively treated with acupuncture and moxibustion.
[Case 1] 79-year-old male who had diagnosed as early adenocarcinoma of the lung had chemotherapy by anticancer drug under hospitalization after right lower lung lobectomy. In spite of administration of anti-emetic agents, he complained of mild but persistent nausea that developed within 24 hours after chemotherapy and continued more than 24 hours from onset. Acupuncture at PC6 (Neiguwan) and ST25 (Tianshu) with moxibustion at CV12 (Zhongwan) and ST25 (Tianshu) were performed in addition to anti-emetics.
[Case 2] 64-year-old female who had undergone radiation therapy by gamma knife for metastatic brain tumors of adenocarcinoma of the lung had chemotherapy by anti-cancer drug under hospitalization. Since administration of anti-emetics during the first period of chemotherapy was less effective, moxibustion at ST25 and CV12 in addition to anti-emetics was performed during the second period of chemotherapy.
[Results]In both cases, the prolonged acute nausea was improved showing significant decrease in the VAS immediately after the treatment of acupuncture.
[Discussion]Severe nausea and vomiting might have been suppressed by anti-emetic agents, but mild acute nausea was prolonged and persisted. Prolonged acute nausea caused poor appetite and deterioration of Quality of Life (QOL) of patients in two cases.
Acupuncture with moxibustion and moxibustion could improve prolonged acute nausea and its related symptoms. These results of acupuncture with moxibustion and moxibustion suggest that acupuncture and moxibustion are useful treatment for prolonged acute nausea induced by chemotherapy and can be applied as complementary medicine to patients receiving anti-cancer chemotherapy.

[Background]Functional abdominal pain syndrome (FAPS) represents a chronic pain disorder localized in the abdomen and the symptoms largely are unrelated to food intake and defecation, which differ from other painful functional gastrointestinal disorders.
We report a case of FAPS whose symptom was successfully improved by acupuncture.
[Case Report]A 75-year-old female had been hospitalized at Meiji University of Integrative Medicine Hospital because of left lower abdominal pain from which she had repeatedly suffered for more than 2 years. Despite strict medication, her symptom had not been improved. After admission to the hospital, according to recommendation by her physician, acupuncture treatment was started. The patient received TCM-based acupuncture treatments five times a week over 13weeks. Primary acupuncture points used for the patient were LV3(Taichong), SP6 (Sanyinjiao), ST36 (Zusanli) and PC6 (Neiguan). Evaluation of the left lower abdominal pain was carried out with a Visual Analogue Scale (VAS). The Gastrointestinal Symptom Rating Scale (GSRS) was used to evaluate QOL related to the digestive symptoms. VAS for the left lower abdominal pain showed a remarkable decrease immediately after the initial acupuncture session. The symptom disappeared within 4 weeks after commencement of the treatment and never appeared during her hospitalization. GSRS was also improved and it was maintained during hospitalization.
[Conclusion]We suggested that acupuncture treatment might be one of the useful, non-pharmacological alternatives for symptoms of FAPS.

Pneumonia is one of major causes of cough, which sometimes resists medication and remarkably deteriorates QOL of the patient. We report a case of pneumonia in a person suffering from severe cough and pain in the general body accompanied by cough for which conventional medication did not work but was improved by acupuncture treatment.
A 47-year-old woman was diagnosed by her physician with pneumonia on August 2, 200X. Although antibiotics were administered, her symptoms were not improved. She visited Meiji University of Integrative Medicine Hospital and was hospitalized on the same day. Despite strict medication with antibiotics, antitussive agent and expectorant during hospitalization, her severe cough and body pain remained unchanged.
Acupuncture treatment was then started on August 7. The basic meridian points used were LU1 (Zhongfu), LU5 (Chize), BL13(Feishu), LU7 (Leique), LI4 (Hegu), GB20 (Fengchi), GB14 (Danzhui), ST12 (Quepen), ST11 (Qishe), and CV22 (Tiantu). The acupuncture needles were retained for ten minutes at these points in each session. After ten acupuncture treatments for over seven days, the VAS for body pain accompanied by cough showed a remarkable improvement. Also, significant relief in cough was observed every time immediately after treatment.
We suggested that acupuncture treatment might be useful for cough and/or pain in the body accompanied by cough in a patient with pneumonia.