[Objective]To estimate the number and market size of clinics for acupuncture, moxibustion and amma (traditional Japanese massage) in operation to provide a baseline for regional medical care resources.
[Method]We conducted a postal survey by sending out questionnaires to 5,000 clinics and 1,000 on-call practitioners selected from 16,271 therapists (accounting for 21.0%of the total number in Japan) registered at 98 regional public health centers.
[Results]The survey yielded a response rate of 23%, out of which the rates of non-existing clinics and on-call practitioners at the registered addresses accounted for 20.6%and 31.5%respectively. The rates of the two categories, out of business or suspended, accounted for 12.4%and 41.3%respectively. From these figures complemented by a telephone directory survey, it is estimated that 49,710 clinics were in operation in early 2007. The average annual income for private clinics was 4.88 million yen, and 2.84 million yen for private on-call practitioners, while that of corporate clinics was 34.85 million yen and 16.33million yen for corporate on-call practitioners. Accordingly, the market size of the subject business is estimated at 315 billion yen as of 2006.
[Discussion]A major downward revision should be made in the data included in the national public health statistics. Considering the fact that there are over 16,000 clinics whose current status is unknown, it is desired that the government conduct a national fact-finding survey at an early date.
Conclusion:The total number of acupuncture, moxibustion and amma (traditional Japanese massage) clinics is estimated at 50,000 constituting a market size of 325 billion yen as of 2006.

View full abstract

[Objective]Capsaicin induces flare reaction in the human skin, and repetitive capsaicin applications induce capsaicin desensitization. To investigate the receptors related to flare reaction by acupuncture and moxibustion, we measured pain thresholds and flare reaction in two areas.
[Methods]Thirteen healthy volunteers with informed consent participated in this study. Capsaicin (0.1%) was applied repetitively (6 h/3days) to the forearm skin to desensitize the area. Then, mechanical and heat pain thresholds, flare reactions that induced by acupuncture and moxibustion were measured.
[Results]In the desensitized area, the heat pain threshold was significantly increased but the mechanical pain threshold did not change. Moxibustion induced flare reaction and it was significantly diminished under capsaicin desensitization. On the other hand, acupuncture induced flare reaction and it disappeared completely under capsaicin desensitization.
[Discussion and Conclusion]These results revealed that the flare reaction induced by acupuncture and moxibustion requires TRPV1 activation. For the moxibustion, flare reaction was significantly diminished under capsaicin desensitization but remained significant. Therefore we suggest that TRPV1 mainly mediates the flare reaction but other heat sensitive receptors might be involved in flare reaction. While the mechanical pain threshold was not changed under capsaicin desensitization, flare reaction induced by acupuncture disappeared completely. This suggests that flare reaction is not induced by the mechanical stimuli of acupuncture itself, but other factors such as inflammatory mediators released from damaged cell causing flare reaction by acupuncture.

View full abstract

[Objective]More accurate anatomical data is discussed to reveal the surrounding structures of the new and former BL54 (Zhibian, Chippen) according to the positional modification of acupuncture points by WHO (2006), and also to demonstrate the acupuncture stimulation points to the sciatic nerve as effective methods for acupuncture treatment of the pain in the lower back.
[Methods]Detailed dissections were performed on the surrounding structures of the acupuncture points of the bladder meridian at the gluteal region and the posterior aspect of the thigh in three cadavers at the Unit of Clinical Anatomy, Graduate School, Tokyo Medical and Dental University.
[Results] 1. The new BL54 (WHO, 2006) was situated at or near the infrapiriform foramen, with the posterior femoral cutaneous nerve, inferior gulteal nerve and vessels and sciatic nerve passing through.
2. The former BL54 was situated at or near the suprapiriform foramen with the inferior gulteal nerve and vessels passing through.
3. The acupuncture stimulation points to the sciatic nerve at the gluteal region and the posterior aspect of the thigh were as follows;(1) the initial portion of the sciatic nerve, (2) the infrapiriform foramen (new BL54, WHO), (3) the lateral one third point of the line connecting the sacrococcygeal junction and the greater trochanter, (4) the midpont of the line connecting the ischial tuberosity and the greater trochanter, (5) the point about 1 cm lateral to BL36 (Chengfu, Shofu), (6) the medial half portion of the biceps femoris muscle lateral to BL37 (Yinmen, Inmon).
[Conclusion] 1. The new and former BL54 are situated near the main nerves and vessels of the gluteal region and the posterior aspect of the thigh, so are considered as effective points for the acupunctural treatment.
2. The six positions are showed as the acupuncture stimulation points to the sciatic nerve in the gluteal region and the posterior aspect of the thigh.

View full abstract

[Purpose]Ginger-partitioned moxibustion is indirect moxibustion of putting sliced ginger between the skin and the moxa. It can give mild stimulation with damp heat. The characteristic of the temperature by the thickness of the ginger was investigated with a temperature sensor without changing the weight of the moxa. Moreover, the relation between the result of a questionnaire on thermal sense and maximum temperature was investigated by applying different thicknesses of ginger-partitioned moxibustion to participants.
[Method]A thermometer was fixed on a wood board 3mm thick. Ginger was cut in a 2 cm square, in three kinds of thickness; 3mm, 5mm, and 7 mm. The temperature change was measured every 30 seconds when the cone-shaped moxa (weight: 200 mg, diameter: 2cm, height: 2cm) was burnt on the ginger for each thickness. Next, the thermal sense of the human body was investigated for ginger-partitioned moxibustion. The maximum temperature of ginger-partitioned moxibustion to the forearm of participants was measured by the thermometer set between the sliced ginger and skin. After moxibustion, we did a questionnaire survey about thermal sense and comfort sense.
[Result]As a result of measuring the temperature on the wood board, the maximum temperature decreased and the time to reach the maximum temperature took a long time according to ginger thickness. Ginger-partitioned moxibustion applied to the human body resulted in a correlation between thermal sense and the maximum temperature. The thinner sliced ginger had the stronger thermal sense. Participants who answered little comfort, comfortable or very comfortable were 5/10 people in the 3mm thickness sliced ginger, 9/12 people in the 5 mm ginger group, and 5/9 persons in the7 mm ginger group.
[Discussion and Conclusion]The thickness of ginger can be an important factor that influences the quantity of stimulus of ginger-partitioned moxibustion. In investigating the comfort sense, the stimulation of ginger-partitioned moxibustion was expected to give the comfort. But four of ten participants who received ginger-partitioned moxibustion with a 3mm thickness felt uncomfortable. If we apply ginger-partitioned moxibustion of 200 mg to patients without discomfort, it is undesirable that the ginger thickness be 5 mm or less.

View full abstract

[Introduction]Recently, in the development of information technology, VDT workers are increasing rapidly. Physical and mental health symptoms associated with working at visual display terminals (VDTs) are controversial. However, there are few studies about the effect of acupuncture treatment on eye fatigue, neck and shoulder stiffness that many VDT workers have.
Therefore, in this prospective study, we examined the effect of acupuncture treatment for complaints of VDT workers.
[Methods]Sixty-one VDT workers participated as subjects (41 males, 20 females). Acupuncture sessions were performed once a week for four weeks. Acupuncture points were decided by the patient's muscleskeletal distress.
Disposable press tack needles were used. Visual Analogue Scale (VAS) was used to determine eye fatigue, neck and shoulder stiffness. Improvements of each VAS were evaluated. Then we analyzed improvement on shoulder and neck stiffness associated with eye fatigue.
[Results]The neck and shoulder distress of patients was reduced in four weeks by acupuncture treatment. A regular correlation between the improvement rate of eye fatigue and neck/shoulder stiffness was observed.
[Conclusion]The neck and shoulder stiffness was improved by acupuncture treatment. According to improved symptoms, eye fatigue was mitigated as well. Thus it was suggested that utility of acupuncture is high in the field of industrial medicine.

View full abstract

[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.

View full abstract

[Objective]Chuwa plays a role in practical education. A number of patients to some extent are needed in order to make practical education effective. The reason we did the research was that we thought it was necessary to seek a trend and consciousness of patients for securing regular patients.
[Design]The investigation was carried out with the following two items as objectives;one is the medical record of 218 patients (the rate of samples 63.4%) among 344 new patients visiting the clinic. The other is the medical record of 172 renewal patients (rate of samples 51.8%) who were accepted among 332 renewal patients,
[Method]The number of patients was calculated by classifying the motives for visiting the clinic from the medical record of new patients. In the research by questionnaires, the following items were asked and made up:the generation, sex, whether the place where the treatment was given for the first time is a clinic or not, treatment pattern given in the clinic, and degree of pain for patients before and after treatment. From the results of investigations, the trend and consciousness of patients were speculated.
[Result]For motive for visiting the clinic, an introduction was the most common at 70%.
From analyzing the questionnaire it was discovered that there was no relationship between age and sex and treatment pattern of amma (traditional Japanese massage) and acupuncture. There were more amma-choice patients than patients of acupuncture-choice. The significant difference (P <0.05) in the range of Visual Analogue Scale (VAS) was recognized by investigating the change of degree of pain after visiting the clinic by the Chi-square test.
[Conclusion]Many patients came to the clinic with an introduction as a trigger and it was speculated that in the experience pattern of Amma, Acupuncture and Moxibustion (AAM) there was a difference between amma and acupuncture. What is important is to repeatedly send appropriate information about AAM and to make better use of introductions as a motive for visiting the clinic. The introduction as an incentive to visit clinic is useful in securing a number of patients. In order to make the most of this, it is important to transmit the information concerning the each method of treatment as simply as possible.

View full abstract

A WFAS meeting for a standard for acupuncture needles was held in Suzhou, China on September 16, 2010. A delegate from the Department of International Affairs of JSAM accompanied by three experts from an acupuncture needle manufacture (Seirin Corporation) attended the meeting with the purpose of requesting modifications of the draft.
Suggestions from Japan included;(1) clearly define type of needle as 'Sterile filiform acupuncture needles for single-use', (2) not to limit the materials used for the needle body, (3) not to define upper/lower limitations in the size of the needle, (4) add some tests to guarantee safety such as limits for acidity or alkalinity and limits for extractable metals and an endotoxin test, (5) elimination of unnecessary tests regarding needles including hardness, puncture performance, strength, (6) change the term 'normative'in the quality testing method to 'informative'.
According to the suggestions from Japan, modifications in the 'Scope'(defining type of needle as 'filiform') and in the 'Material'section (any kind of materials in accordance with ISO/TS 15510:2007) were annexed to the resolution. However, there is still a need to continue requesting modification of other issues to develop a better draft of the WFAS standard, which will be submitted to an ISO/TC 249 meeting in the near future.

View full abstract