On 26 May 2024, the Panel Discussion 2 " Cooperation between medical doctors and acupuncturists: With a view to future medical care " was held at the 73rd Annual Meeting of the Japan Society of Acupuncture and Moxibustion was held in Sendai, Miyagi, Japan. Three panelists presented the attempts of cooperation between medical doctors and acupuncturists at medical institutions and medical field in Japan, including the fact that acupuncture and moxibustion have been successful in improving and alleviating patients' illnesses and symptoms in psychiatry, general internal medicine and palliative medicine, contributing to shorter hospital stays for patients, and the challenges for cooperation between medical doctors and acupuncturists at medical institutions and medical field in Japan. A designated speaker also presented on the development of highly specialized acupuncturists at the Japan Society of Acupuncture and Moxibustion to establish cooperation between medical doctors and acupuncturists, among others. Finally, we discussed issues and future prospects for cooperation between medical doctors and acupuncturists at medical institutions and medical field in Japan, with a view to future medical care where acupuncture and moxibustion will be utilized. One of the challenges in improving the utilization rate of acupuncture and moxibustion in Japan is the cooperation between medical doctors and acupuncturists at medical institutions and medical field. This report summarizes the contents of this panel discussion.

[Introduction] The effects of combining acupuncture and kampo medicine on in vitro fertilization (IVF) outcomes is unclear. Therefore, we aimed to investigate their combined effects on promoting conception in patients with multiple IVF attempts.[Methods] Participants with at least two IVF attempts who gave informed consent were included in this study. Administering acupuncture and kampo medicine, the study was conducted across three facilities from 2013 to 2017 using a case series design． Case 1: A 40-year-old woman presented after 13 months of infertility, having experienced a natural conception and subsequent miscarriage 10 months prior, which led to IVF. After a second embryo transfer, she miscarried again 3 months before visiting. She began kampo medicine and acupuncture for support in our department. Case 2: A 46-year-old woman with a 36-month infertility history did not achieve pregnancy after three IVF cycles． Case 3: A 37-year-old woman with a 20-month infertility history failed to conceive after two IVF attempts． Case 4: A 26-year-old woman, new to infertility treatment, received acupuncture for fertility preservation, experiencing headache, shoulder stiffness, and widespread pain. Case 5: A 38-year-old woman with a 108-month infertility history suffered from shoulder stiffness due to prolonged IVF therapy. The main outcome measured was pregnancy. Standard acupuncture points utilized included L14 (Hegu), CV12 (Zhongwan), CV7 (Yinjiao), ST27 (Daju), ST29 (Guilai), BL18 (Ganshu), BL20 (Pishu), BL23 (Shenshu), BL33 (Zhongliao), SP10 (Xuehai), ST36 (Zusanli), and SP6 (Sanyinjiao)． [Results] Four out of five participants achieved pregnancy． [Discussion] Our findings reveal a positive effect of combining acupuncture and kampo medicine on enhancing pregnancy rates in patients undergoing multiple IVF treatments, suggesting clinical effectiveness in fostering an appropriate environment for conception．

[Objective] The aim of this study was to investigate the therapeutic effects of acupuncture in patients with chronic primary musculoskeletal pain. First, factors influencing treatment outcomes were identified using multiple regression analysis. Second, factors related to treatment selection were identified using logistic regression analysis. Third, the effects of non-electroacupuncture and electroacupuncture were compared using propensity score matching. [Subjects and Methods] This study utilized a retrospective observational design, enrolling participants based on the International Classification of Diseases, 11th Revision. In the multiple regression analysis, the dependent variable was the change in Visual Analogue Scale score before and after treatment, and in the logistic regression analysis, the dependent variable was the presence or absence of electroacupuncture. To compare the therapeutic effects of the non-electroacupuncture group and the electroacupuncture group, propensity scores were calculated based on factors related to treatment selection, and matching was performed to adjust the background characteristics of the two groups. The change in pain intensity was compared between the two groups using a two-sample t-test. [Results] First, in the multiple regression analysis, the initial Visual Analogue Scale score, Body Mass Index, and Undergoing electroacupuncture treatment were significantly associated with the change in pain before and after treatment. Second, the logistic regression analysis indicated that previous acupuncture experience and gender were related to treatment selection. Third, the comparison between the two groups revealed that the change in pain intensity was significantly greater in the electroacupuncture group (p = 0.03). [Discussion] The influence of initial Visual Analogue Scale score and Body Mass Index on treatment outcomes was consistent with previous studies. Regarding treatment selection, it was suggested that there is a tendency to avoid high-intensity treatments such as electroacupuncture for patients without prior acupuncture experience. The comparison between the non-electroacupuncture and electroacupuncture groups showed that both treatments resulted in a reduction in pain exceeding the minimum clinically important difference, indicating that both methods may be effective for pain management. [Conclusion] In patients with chronic primary musculoskeletal pain, electroacupuncture may be more effective than non-electroacupuncture, suggesting a greater therapeutic effect.

[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.