[Introduction] To prevent and improve wrinkles, continuous delivery of moisturizing ingredients into the epidermis is necessary, stopping evaporation of water before the groove reaches the dermis. However, the stratum corneum has a robust barrier function and limited permeability for substances. The objective of this randomized controlled trial was to analyze the efficacy and safety of scattered needling immediately followed by the application of an essence containing moisturizing ingredients.
[Materials and Methods] Eligible participants were randomly assigned to the intervention group (n = 13) or the control group (n = 12). The participants in the intervention group were instructed to perform the following procedure once daily for two weeks: (1) application of a 0.3-mm intradermal thumbtack needle at the corner of one eye after face washing and disinfection, (2) tapping on the needle approximately five times/second for one minute, and (3) immediate application of a specified essence. The participants in the control group were instructed to perform similar skin care procedures, but with a "needleless" intradermal thumbtack needle. The primary outcome measure was the wrinkle grade according to the Guidelines for Evaluation of Anti-Wrinkle Products, wherein grade 0 indicates no wrinkles and grade 7 indicates markedly deep wrinkles. The results were evaluated by quartile. For efficacy evaluation, a decrease in the score by <1 was defined as "reduction" and a decrease by ≥ 1 as "improvement." The secondary outcome measures were adverse events and the degree of pain from acupuncture measured by a numerical rating scale.
[Results] In the intervention group, efficacy was demonstrated in nine (69%) participants including four with "improvement" and five with "reduction," while three (25%) participants achieved "reduction" in the control group, showing a risk ratio of 2.8 (95% confidence interval: 1.0-7.9, P = 0.03). Adverse events in the intervention group were pruritus (n = 4), pain (n = 3), discomfort at the acupuncture site (n = 3), and fatigue (n = 1). The mean pain score was 1.0 ± 0.7 in the intervention group and 0.3 ± 0.5 in the control group (P = 0.01).
[Conclusions] A two-week skin care program consisting of scattered needling with an intradermal thumbtack needle immediately followed by essence application was effective in reducing fine wrinkles in about 70% of the participants, although accompanied by slight pain, with the pain percentage about three times higher than that experienced in application of essence alone.
[Objective] To compare circular skin acupuncture and pushing stimulation using the edema scale.
[Methods] Subjects included 20 women (mean age: 39.0 years; standard deviation: 11.2); 8 underwent pushing stimulation (CG) and 12 underwent circular skin acupuncture (AG). All the participants provided informed consent. The study protocol was approved by the Ethics Committee of Morinomiya University of Medical Sciences. Paionex needles (made by SEIRIN), 0.9 mm for AG and 0.3 mm (noninvasive treatment) for CG, were used, respectively. We set the cure area to Yinlingquan (SP9), Diji (SP8), and Sanyinjiao (SP6). We administered the treatment for seven days (once in two days; a total of three times) and evaluated the results after seven days (Post). Steps for treatment were as follows: first, no treatment was performed for seven days (Pre), followed by the intervention of seven days (Stim) and then a period of no treatment for seven days (Post). We recorded edema and visual analog scale (VAS) scores and examined the 9-cm circumference at the malleolus medialis (ankle circumference). AG and CG were compared with a two-way layout analysis of variance of temporal changes using a mixed model. We also performed multiple comparisons of the groups. A conflict of interest may exist with SEIRIN since we used Paionex needles.
[Results] Compared with the Pre group (14.5 points, 95% confidence interval [95% CI]: 11.7, 17.3), the edema score decreased in the Stim group (9.9 points, 95% CI: 7.1, 12.7) in AG. Compared with the Pre group (12.4 points, 95% CI: 10.5, 14.4), the edema scale fell in the Stim group (7.6 points, 95% CI: 4.9, 10.3) in CG. In CG, the VAS score for edema changed in the Post group (63.7 mm, 95% CI: 51.1, 76.3) compared with the Pre group (33.7 mm, 95% CI: 24.7, 42.7). However, the VAS score for edema did not change in AG. There was no significant difference between the VAS scores of edemas of AG and CG. The ankle circumference remained unchanged.
[Discussion] Circular skin acupuncture and pushing stimulation are effective with the use of a continuous patch.
[Conclusion] Edema scores improved with performance of the two procedures of circular skin acupuncture and pushing stimulation.
[Introduction] Sciatic nerve stimulation using electro-acupuncture in the buttocks area is commonly used clinically; however, there are few anatomical studies on the pathways of the acupuncture needle. In this study we simulated the pathways of the acupuncture needle on CT images, and investigated the anatomy of the sciatic nerve, organs and vessels around the pathways, and evaluated the safety of these methods.
[Materials and Methods] Three typical stimulation methods were investigated; a) stimulation in the parasacral area, b) stimulation in the infrapiriform foramen area, c) stimulation in the subgluteal space between the greater trochanter and ischial tuberosity. These and the surrounding areas of each pathway were set as zones A, B, and C, respectively. We analyzed the structures in each zone using pre-existing CT images (five males and seven females), and evaluated the safety of each method.
[Results] The sciatic nerve is derived from the presacral region and leaves the pelvis through the infrapiriform foramen. It, then, goes down on the dorsal side of the superior and inferior gemellus muscles, the internal obturator muscle, and the quadrate muscle between the greater trochanter and the ischial tuberosity in the subgluteal space. The superior and inferior gluteal arteries arising from the internal iliac artery have various branching patterns and extensions. The large superior gluteal artery exists on the cranial side of zone A, and the large inferior gluteal artery lies in zones A and B. The small inferior gluteal artery accompanying the sciatic nerve is also present in zone C. In addition, there may be pelvic organs on the ventral and medial sides of zones A and B.
[Discussion] There is a possibility of pelvic organ injury in zones A and B when the tip of the acupuncture needle is inserted medially and deeply. There is a risk of blood vessel damage to the superior gluteal artery in zone A and the inferior gluteal artery in all zones. In zone C, however, the blood vessel diameter is small, so the risk of bleeding is low.
[Conclusion] The subgluteal space between the greater trochanter and ischial tuberosity is the safest site for sciatic nerve stimulation using electro-acupuncture in the buttocks area.
[Objective] We report on the usage of a conditioning room to treat patients with acupuncture, moxibustion, and massage, which was installed at the wheelchair basketball, table tennis, sound table tennis, and ground softball games of the 17th National Sports Festival for People with Disabilities held in Ehime.
[Method] The subjects were athletes, managers and coaches who visited the conditioning room. The period of use was four days, including during official practice. We asked subjects about their "Injury site," the "condition" of their injury and "symptoms." The data was analyzed by Chi-squared test using SPSS Ver. 26 (IBM Inc.). The significance level was 5%.
[Results] The number of patients reached 225 (52 wheelchair basketball players, 128 table tennis players, 31 sound table tennis players, 14 ground softball players). Single use was made by 84 players (59.6%) and multiple use by 57 players (40.4%). The most common site of injury was the shoulder joint (128 players (56.9%)). Responses on the purpose of their visit was "to treat injury" made by 146 players (64.9%), "Recovery from fatigue" made by 91 players (40.4%) and, "Improving performance" made by 24 players (10.7%). The most common symptom was "pain" in 111 players (49.3%). And, "tiredness/lethargy" was experienced by 100 players (44.4%), and "stiffness" was experienced by 78 players (34.7%). The content of the treatments included 200 massages (88.9%), 55 acupuncture treatments (24.4%), and 53 stretch exercises (23.6%). There was no moxibustion treatment given. Wheelchair basket players had the highest usage of acupuncture treatment (15 players, 28.8%). Acupuncture users had statistically significant symptoms of "pain" and "numbness."
[Discussion and Conclusion] Many players used the conditioning room and multiple-time users reached about 40%. This means that the medical support system for sports for people with disabilities is insufficient. There were few users of acupuncture and moxibustion, which was the same as 10 years ago. In order for acupuncture and moxibustion to contribute to sports, it is necessary to further promote and build dissemination activities and evidence.
[Objective] To report the short-term impact of coronavirus disease (COVID-19) pandemic on therapists providing massage, acupressure, acupuncture, moxibustion, and Judo therapy.
[Materials and Methods] From the Family Income and Expenditure Survey, we collected data on the expenditure per household (consisting of two or more persons) on massage, acupressure, acupuncture, moxibustion, and Judo therapy from the first quarter of 2015 (mean from January to March) to the second quarter of 2020 (mean from April to June). The expenditure in the second quarter of 2020, during which the spread of COVID-19 led to the declaration of a state of emergency, was compared with the expenditures in the first quarter of 2020 and the corresponding second quarter of the previous year. It was also compared with the expenditure in a control group, comprising other therapies (e.g., manual therapy, chiropractic manipulation, reflexology, and pelvic adjustment) provided by therapists who are not required to be legally qualified but who are subject to closure requests.
[Results] In the second quarter of 2020, the mean expenditure per household on massage, acupressure, acupuncture, moxibustion, and Judo therapy decreased by 9% and 13% from those in the first quarter of 2020 and the corresponding second quarter of the previous year, respectively. The mean expenditure per household in the control group decreased by 46% and 41% from the first quarter of 2020 and the corresponding second quarter of the previous year, respectively.
[Conclusions] In the short term, the COVID-19 pandemic seems to have caused a 13% decrease in revenue for therapists providing massage, acupressure, acupuncture, moxibustion, and Judo therapy. As this decrease was smaller than that for therapists who are not required to be legally qualified, this study revealed a steady demand for the services provided by legally licensed therapists.
[Objective] We report a case of acupuncture treatment for a patient with fecal incontinence and perianal sensory disturbance after a pelvic fracture. Stool leakage and perianal numbness were successfully improved after the electroacupuncture in the sacral region.
[Patient] A man in his 60s was injured in a traffic accident in May, the X-1 year. He was diagnosed with a pelvic fracture and underwent surgery; however, stool leakage, numbness, and hypesthesia around his anus remained. In April, the X year, he visited our center. He received electroacupuncture treatment once a week, at acupoints BL32, BL33, BL34, and BL35 bilaterally. The Numerical Rating Scale (NRS) and Japanese version of the Fecal Incontinence Quality of Life Scale (FIQL) were used for evaluation of fecal incontinence. Also, the Visual Analogue Scale (VAS) was used to measure numbness.
[Result] The NRS score gradually decreased from 8 to 2 by the 7th treatment. The FIQL also improved from 2.9 to 3.2. The numbness disappeared by the 9th treatment, with improvement of the VAS score from 69 to 0 mm.
[Discussion] Fecal incontinence occurs with dysfunction of the external anal sphincter caused by pudendal nerve disturbance. Electro-acupuncture around the posterior sacral foramen stimulated the posterior branch of the sacral nerve, which might affect the function of the pudendal nerve. Recently, Sacral Neuromodulation Therapy (SNM) has become common for the treatment of fecal incontinence.
[Conclusion] Electroacupuncture therapy is a favorable option for the treatment of fecal incontinence. It can be performed safely and less invasively compared to SNM.
[Purpose] We report a case of successful acupuncture for hearing loss associated with severe sudden sensorineural hearing loss (SSNHL). The patient was diagnosed by an otolaryngologist and was treated with acupuncture one month after symptom onset, resulting in hearing recovery.
[Case] A 74-year-old woman presented with left-sided hearing loss and a history of severe right-sided hearing loss secondary to a surgical treatment of right acoustic tumor. She experienced sudden left-sided hearing loss on October 4, XX, and was diagnosed with left-sided SSNHL. An intratympanic steroid injection was attempted but was ineffective. She was diagnosed with grade 4 SSNHL according to a severity classification. SSNHL progressed slowly, and she experienced tension in her neck and shoulders. Physical examination showed unremarkable neurological findings except for bilateral hearing loss. Acupuncture treatment was initiated to improve blood flow to the inner ear.
[Results] At her initial visit, the patient's average hearing level (average of 5 frequencies) in the left ear was 91.3 dB, which improved to 82.5 dB one week later. Four months later, her hearing improved to 68.8 dB. Her average hearing level was improved to grade 3 from grade 4 of the disease severity classification for sudden deafness.
[Discussion and Conclusions] Acupuncture treatment may improve blood flow to the cochlea and hair cells through the inner ear artery.
The 2020 Annual Conference of World Federation of Acupuncture and Moxibustion in Netherland was canceled due to the COVID-19 pandemic. On 28th and 29th November, a substitute conference was held to be both on-site and online at the Hilton Haikou Meilan in Hainan, China. The Executive Committee (EC) was convened in the evening on 28th November, and 59 out of 107 EC members were attended. In this committee, the JSAM submitted a recommendation that the Declaration of Helsinki was supposed to be included under the WFAS Code of Ethics since the former EC meeting had approved the addition of the article officially. In addition, WFAS Standardization Committee was scheduled after the EC meeting and focused on clinical practice guidelines (CPGs) for acupuncture. Brief summaries of presentations regarding CPGs were introduced in this article.