Volume 4, Number 2 | Summer 2009

Clinical Report 1 (Japan)

Peripheral Arterial Disease (PAD) and Acupuncture andMoxibustion
Fumiko Yasuno and Tomomi Sakai
Department of Acupuncture and Moxibustion
Faculty of Healthcare
Tokyo Ariake University of Medical and Health Sciences

Introduction
Japan is moving toward an aging society
unprecedently faster than any other country in
the world. The disease structure that used tomainly consist of acute disorders has changed,
and chronic lifetsyle-related diseases andgeriatric diseases occupy a large share of thestructure. Typical is arteriosclerosis among them.
If arteriosclerosis occurs in the cerebral bloodvessels, it results in cerebrovascular disease suchas cerebral infarction. If it occurs in the bloodvessels of the heart, ischemic heart disease suchas a heart attack or myocardinal infarction iscaused, whereas peripheral arterial disease(hereafter PAD) is caused by arteriosclerosis
occurring in the arteries of four limbs.
PAD is a disease that has narrowings or
blockage of arteries of four limbs due toprogression of limbs arteriosclerosis, resulting incirculatory impairment in the blood perfusionarea. It is anticipated that PAD will increasesignificantly with the growth of aging population.
And dietary problems from westernized lifestyles,
lack of physical activity or a sedentary lifestyle,and increased stresses are also contributing
factors to develop PAD.
Main symptoms of PAD are cold sensation andintermittent claudication and advanced cases
lead to ulcers and gangrene, both of which are
symptoms caused by circulatory obstruction in
the lower limb arteries.
Treatment of PAD differs depending on its
severity. For PAD of Stages I and II of Fontaine
proceduresareClassification1),nonsurgicalmainly used2). However, if they do not have effects,10

a surgery procedure may be used.
Meanwhile,
acupuncture
treatment
isrecognized as being effective for improving
disturbances of peripheral circulation. And a few
reports on effects of acupuncture treatment on
sensitivity to cold or cold sensation3) and
Raynaud's phenomenon symptoms4-6) have beenreleased.
Cases
of
PAD
that
showedimprovements in symptoms7-9) have also beenreported, although limited in number. From these,
there may be possibilities of acupuncture
treatment as a conservative procedure.
We have administered acupuncture treatment
to patients with PAD to verify clinical effects andthe range of indications and also eclucidate a partof these mechanisms. With the results being
analyzed, we will introducea a summary and thecases as below:

1. Clinical effects of acupuncture treatment on
PAD1) Subjects
Subjects were 21 patients (male 17, female 4,
average age 72.1±7.3) having subjective ischemic
symptoms in the lower legs (lower thighs) withthe diagnosis of PAD confirmed throughangiography (or MR angiography). In the
Fontaine Classification showing the levels ofischemia in the lower legs, PAD was categorized
as Stage I (cold sensation and numbness) in 1
patient , as Stage II (intermittent claudication) in
17 ptients, as Stage III (rest pain) in 2 patients,
and as Stage IV (ulcers and gangrene/necrosis) in
1 patient.
2）Methods
Measurement items were lower leg skintemperature (by thermography), heart rate, bloodpressure, plasma CGRP level, the ratio of theblood pressure in the lower limbs to the bloodpressure in upper limbs (arms); Ankle Brachial
Pressure Index (hereafter ABPI), intermittent
claudication distance, pain, and cold sensation(based on pain scores). In the treatment of two

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Volume 4, Number 2 | Summer 2009

patients (one with Stage I and the other with
Stage IV), ordinary acupuncture needling (leaving
needles in place and sparrow pecking technique)
was performed, whilst low frequency current wasapplied to insertion needles for the crural musclesof the lower limbs presenting ischemic symptoms.
The assessments of ABPI, intermittent
claudication distance, pain and cold sensation
were carried out before the beginning of thetreatment and after 16 times of the treatment(hereafter assessment time). The treatment period
was 1 to 3 months.
3) Results
The skin temperatures of the affected leg
regions were measured and a comparison wasmade with those of before-treatment against
those read during the period from 15 minutes
from the beginning of the treatment to 15
minutes from the end of the treatment, showing
significant increases. In terms of Fontaine
Classification, the patients with Stage I and thepatients with Stage II manifested more
distinguished increases than those of Stage III
and Stage IV. The heart rates and blood pressures
measuredsimultaneously
did
not
show
significant changes from the beginning to the endof the treatment. Plasma CGRP levels showedsignificant increases after 15 minutes from theend of the treatment compared to before thetreatment.
ABPIs in all patients remained same. At thetime of the assessment, intermittent claudication
distance showed a significant extension compared
to before the treatment.
Both pain and cold sensation showedsignificant decreases at the time of theassessment compared to the VAS values assessed
prior to the treatment. In view of Fontaine
Classificaton, the patients with Stage I andpatients with II had marked decreases, whereas
those with Stages III and those with IV had small
decreases.

Through the entire treatment period, any
adverse event causing disadvantages to thepatients was not observed.
A case of PAD will be introduced as follows.

2. Case of PAD (Fontaine Classification Stage
II)
Relatively
many
patients
who
wantacupuncture and moxibustion treatment visit
our hospital with the complaints such as cold
lower legs, pain, and pain when walking. Since
these symptoms may have developed due tospinal canal stenosis or PAD, knowing theirclinical conditions accurately is necessary andimportant when acupuncture and moxibustion
treatment is performed.
The following patient, who had been a patientof the hospital I had previously worked for, wasreferred to our hospital by her previous
orthopedist due to“crural muscle pain in thelower legs.” According to the patient, “the legs
became painful after dancing (social). Probably
dancing shoes did not fit.” The patient was a
68-year old woman. After the interview, arteriesof lower limbs were palpated, but below-knee
popliteal artery on one side could not be felt. Then,a queston was made to her whether or not she
had pain while walking and stopped walking to
get rest, and became able to walk after rest. She
said “yes.” Then another question was asked:“how far she could walk before she had to stop.”
She said “about 80 meters.” From theconversation, PAD was assumed and treatment
was started. At the same time, I made a hospitalreferral for her.

1) Case[Case] Female of 75 years old[Chief complaint] Pain in the right lower limb
(dull pain with a feeling of heaviness in the calfmuscles)

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[History of present illness] The patient began totake up dance lessons five months ago. Aroundthe time, the symptom of her chief complaint
appeared. She thought it was caused by the heels
she seldom wore and had shiatsu and massages.
Since there were no changes in the condition, shevisited the Orthopedics and had X-ray
photography with the diagnosis of lumber spine
osteoarthritis and osteoporosis. The pain in theleft lower limb was diagnosed as muscle pain
and the patient was referred to us for
acupuncture and moxibustion treatment.
[Past medical history] No special mention[Family history] Younger sister (cardiac disease,died at the ge of 50), younger brother (brain
hemorrhage, died at the age of 53)[Complication] High blood pressure (from theage of 68 to the present): receiving treatment(with drugs) by an internal medicine specialist ofa nearby hospital. Ischemic heart disease (fromthe age of 70 to the present): receiving treatment(with drugs) by an internal medicine specialist ofa nearby hospital.
[History of life] Smoking (-）, drinking a little
alcohol.
[Conditions at the initial visit] Height 152cm,
weight 43kg, blood pressure120/60mmHg, pulse
70/min (regular)
The range of lumber motion was sufficient.
Pain accompanied by motions (-), FFD 0 cm,
SLR-either right or left 90 degrees (-), kempsigns (-), lower limb muscular power - normal,
lower limb muscle atrophy (-), Babinski reflex (-),
PTR(+)/(+), ATR(±)/(±), tactile sense and pain
sense-normal. Limb skin temperatures - lowerd
on the left, and calf pain (+) left>right.
Pulse: Femoral arteries-right and left
palpable, popliteal arteries-right palpable, leftdecreased and weak.
Posteria tibial arteries; right - palpable, left difficult to palpate, dorsalis pedis arteries –12

palpable on the right and decreased and weak on
the left.
Lower limb pain appeared in the calf muscles
when the patient walked up to the distance of 80
meters at a slower pace. Constricting pain on theleft was marked, so she had to stop when she
walked 120 meters. Cold sensation: left legs (+),
feeling of numbness in the left sole (±), rest pain
and ulcers (-).
Straight leg raising test: Left (±), right (-).
Straight leg lowering test: Left (±), right (-),
edema (-), cyanosis (-), ABPI; Right 0.71, left 0.53

2) Acupuncture treatment and the purpose
Since the patient had pain behind the lower
thighs,theacupuncture
treatmentwasadministered by applying low frequency current to
the regions of triceps surae muscles of the calf withthe aim of relieving ischemic pain. The needlingpoints were heyang (the motion point of the triceps
surae muscles) and chengshan (paninful region ofcalf muscles) (Fig. 1) with the needling depth of 20
to 30 mm. Stainless needles 50mm long with adiameter of 0.22 mm were used. Stimulation
conditions were 1 Hz, pulse width 0.25 ms,
stimulating intensity 1 mA, at which the patient
did not feel unpleasant and is high enough tocause contractons of triceps surae muscles. The
time to apply current was 20 minutes. The low
frequency acupuncture equipment Ohm Pulser
4000A (for all medical cares) was used.
Drugs used previously were maintained during
the treatment periodd with same dosages.

3) Assesssment of treatment effects
Skin temperatures and heart rates, and theratio of the blood pressures in the upper limbs tothe blood pressure in the lower limbs; Ankle
Brachial Pressure Index (ABPI), intermittent
claudication distance, pain and coldness werereviewed and studied. Concerning ABPIs, theintermittent claudication distance, pain, and

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Volume 4, Number 2 | Summer 2009

coldness were assessed before the beginning oftreatment and after three months.
(1) Lower limbs skin temperature and heartrate/blood pressure
Skin temperatures caused by acupuncture
were measured in a constant temperature room
maintained at 26.5±0.5 Celsius with humidity
55±5 % using a thermography machine(Thermoviewer JTG-5370 manufactured by
Nippon Denshi (JEOL Ltd.). Before measurements,
it was ensured that skin temperatures became in astable equilibrium state after the patient had beenat rest in the recumbent position for more than 15
minutes. Tempertures were taken 10 times in total
with the frequency of every 5 minutes: before theacupuncture treatment, during 20 minutes of thetreatment and till 20 minutes from the end of thetreatment. For analyzing variations in lower limb
skin temperatures, the nail bed of the second toe
finger on the affected side was determined as afixed point and temperatures were read from thethermographic images. At the same time, bloodpressures and heart rates were also measured(with Omron Automatic Blood Pressure Monitor).
(2) Ankle Brachial Pressure Index (hereafter
ABPI) (Ratio of the blood pressures in the leg
joints to the blood pressure in the upper arms)
Systolic blood pressures in the upper arms
and leg joints at rest were measured using an
ultrasonic Dopper bloodflow meter (ES-1000SPⅡ,ARS Inc.): specifically blood pressures in the rightand left brachial arteries, and posterior tibial
artery on the affectd side and dorsal pedis arteries.
The highest values were used, based on which
ABPIs were derived using the following equation.
Leg joint blood pressure（mmHg）
ABPI= ―――――――――――――――――――――
Upper arm blood pressure（mmHg）(3) Intermittent cludication distanceTo determine intermittent claudication
distance, the distance that the patient was able towalk on the flat (hospital level corridor) before
she had to stop due to pain was measured.
(4) Pain and cold sensation
Changes in subjective symptoms of pain andcold sensation were self-recorded by the patient on
the Visual Analogue Scale (hereafter VAS). In
regard to pain, the left end of the straight line 100
mm in length was made as “absolutely no pain.” Inregard to cold sensation, it was made as“absolutely no cold sensation.” The right end interms of pain was for “most cruel pain the patient
had ever experienced” whle in terms of cold
sensation, it was for “most unbearably cold thanever.” For the intensity of the symptom the patient
felt, the patient wrote the mark 「ヽ」 on the line.
Intensities were assessed by the length (distance)of the line from the left end.

4) Results(1) Lower limb skin temperature and heartrate/blood pressure
The leg skin temperature on the affected side
was 30.3 Celsius before the treatment. It rose to
31.4 Celsius when 5 minutes elapsed from the
beginning of the treatment and reached a peaktemperature of 31.4 when 5 minutes elapsed fromthe end of the treatment. Then, it lowered slightly
20 minutes from the treatment being finished to
31.0, which was higher than that of pre-treatment.
Heart rate, systolic blood pressure, and diastolicblood did not change practically from the
beginning of the treatment and to 20 minutes after
the end of the treatment.
(2) The ratio of the blood pressure in the upper
limbs and the blood pressure in the lower limbs;
Ankle Brachial Pressure Index (ABPI)The ABPI of pre-treatment was right 0.71and

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Volume 4, Number 2 | Summer 2009

left 0.53, showing no changes from the values ofright 0.71and left 0.53 gained at the time ofassessment.
(3) Intermittent claudiction distance
Whereas the caludication distance ofpre-treatment was 120 meters, it extended to 200
meters when the assessment was made. The
patient became able to walk twice faster than she
could before treatment.
Further, the recovery time from becoming
unable to walk to resuming walking was
shortened.
(4) Pain and cold sensation
Whereas the VAS of pain before the treatment
was 85.0 mm, it became 70.9 mm at the time ofassessment.
(5) Adverse event
Through the entire treatment period, any
adverse event causing disadvantages to thepatient was not observed.
Moreover, as the patient was suspected ofhaving PAD as soon as the treatment began, an
examination request was made to the Departmentof Angiology. As a result, anteriography indicatedcommon femoral artery occulsons on both sides
with the diagnosis of PAD. In the patient, there
were risk factors of her being elderly (76) and acomplication of cardiac disease and hypertension.
The patient had also intermittent claudication.
Symptoms were prominent on one side. Lower
limb arteries could not be palpated. On the basis ofthese, PAD was presumed.

5) Discussion(1) Mechanism of acupuncture treatment (froma case series of 21 cases)
In order to elucidate part of the mechanism
producing acupuncture treatment effect in thepatient, skin temperatures and plasma CGRP

14levels were measured. The results showed that theskin temperature of the leg being treatedsignificantly increased during the time from 15
minutes from the beginning of the treatment to 15
minutes from the end of the treatment. Plasma
CGRP levels also significantly increased after theend of the treatment. However, almost no changes
took place in blood pressures. These results
suggest the possibilities that the rise in the skintemperature after the treatment was not caused
by a blood-pressure-dependent passive increase of
the blood flow but rather it was related to theperipheral circulation that was improved inassociation with vasodilation caused by thesecretion of CGRP, a vasodilatory substance.
In regard to effects of low frequency
electroacupuncture on the peripheral circulation,
there is a study by Sakai, et al.10) who performed
low frequency electroacupunture on triceps suraemuscles in a similar manner as we did for thepatient. With healthy adults as study subjects,
they have verified in the study that after applying
low-frequency electroacupuncture stimulation totriceps surae muscles, the lower thigh deep
temperature of the muscles rose and muscle bloodflow volume and skin blood flow as well as thepain threshold also increased.
Similarly, Tokutake, Yoshikawa, et al.11,12) havealso reported that stimulating the lower thigh by
low frequency electroacupuncture caused anincrease in the deep temperature of the targetedmuscles．They pointed out that its mechanism
might have involved the muscle pumping function
performed by muscle contractions. In the case of
the low frequency electroacupuncure we
conducted, a similar mechanism might haveworked, in addition to the action of thevasodilatory substance like CGRP.
For the treatment of PAD, bypass surgery or
percutaneous angioplasty is carried out. And there
is a document reporting that these procedures
significantly increase lower limb skin temperature

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Volume 4, Number 2 | Summer 2009

and that a strong correlationship exists between
an increase after surgery in ABPI, which is anindex of perfusion pressure in the peripheral siteof the lower leg, and an increase in skintemperature of the lower thigh peripheral site13).
These improvements are attributable to thesurgery resolving the stenotic lesion, resulting in amarked increase in the blood flow volume in the
major artery of the lower limb and the skin bloodflow volume. This means that in tissues of such asa PAD affected leg that have extremely reduced
supplies of blood, an increase of blood flow in the
major artery diretly induces skin blood flow and
the ABPI to increase. However, there were effects
on pain and cold sensation from 1-3 monthtreatment but no changes occurred in the ABPI.
This indicates that improvements in organic
lesions such as constriction or obstruction of ablood vessel cannot be expected from acupuncture
treatment for a short period of 1-3 months.
However, the result showing that theintermittent cludication distance, pain, and cold
sensation significantly improved prompted us tothink of the possibility that collateral blood
circulation paths gradually developed. Recently,
Oda, et al.14) conducted an experiment with ratsand histologically verified the findings of VEGF
production
byapplying
low-frequency
electroacupuncture stimulation using an ischemic
muscle model of rats’ anterior tibial muscles. From
the findings, it may be possible that theelectroacupuncture for PAD induced the
production of VEGF and the development ofcollaterial blood routes. We want to leave thismatter as one of the agenda to be investigated in
the future.
(2) Acupuncture indication range for PAD
For chronic artery obstructions such as PAD,
Fontaine Classification for lower limb ischemic
symptoms １） is widely used to classify diseasestages. Non-surgical procedures for PAD are used
for the patients with Stage I and the patientswith Stage II according to the Fontaine
Classificationc 2). Since acupuncture treatment is
one of non-surgical methods, acupuncture wasadministered mainly to the patients with Stage I
and the patients with Stage II. Furthermore, inorder to find out and study indications and thelimit of acupuncture treatment for PAD,
acpunture treatment was also provided to as few
as three patients with Stage III and Stage IV
respectively.
In terms of effects on clinical symptoms, bothpain and cold sensation of pre-treatment
significantly improved from post-treatment. Fromthe viewpoint of the Fontaine Classification, theintensites of these symptoms markedly decreasedin Stage I and Stage II while their improvements
in Stage III and Stage IV were slight.
The intermittent claudication distance after
acupuncture treatment improved significantly
compared to that before the treatment with anextension of the distance. On the other hand,almost no changes were shown in ABPIs in all
lpatients.
In regard to the method of PAD treatment,
severe cases of chief complaints such as ulcer,
necrosis, and rest pain are considered positive
candidates for surgery such as revascularization
surgery. In the case of the patient with Stage IV(necrosis developed on the toe) in this report, theskin temperature increased after the acupuncture
treatment but cold sensation and pain did notchange and subsequent treatment did not yield
effects, leading to a toe amputation. Ｉn the twopatients with Stage III of Fontaine Classification,
cold sensation and pain were relieved slightly, notto the extent that they could be assessed as clinicaleffects. Changes in ABPIs were also not observed.
As shown above, serious cases were only threepatients, but acupuncture has a limit to its effects
if the severity of ischemia from artery obstruction
is high, which exceeds the indication range ofacupuncture.

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From the results above, we consider that thetreatment with acupuncture for clinical symptomsof PAD with Fontaine Stage I and Stage II iseffective and Stage I and Stage II symptoms arewithin the indication range of acupuncture
treatment.

Stasis -. Journal of the Japan Society for
Oriental Medicine, 45 (4): 919-925, 1995.
4）ONO Takahiko, YOSHIDA Yoshinori, SO Heibun,
MATSUMOTO
Acupuncture

Katsuhiko:on

Peripheral

Effectsof

Circulation

Disturbance in Patients with Collagen Disease.
Journal of the Japan Society of Acupunctureand Moxibustion (jsam), 40 (3): 254-258, 1990.

Heyang (the motion point of the triceps
合陽（下腿三頭筋運動点）
muscles of calf)
Chengshan
承山（疼痛部）(paninful region of calf muscles)

Figure 1 Acupuncture points to insert needles
Fig. 1 shows acupuncture points to insert
acupuncture needles in the low frequeny
electroacupuncture stimulation method. The
insertion depth was 20-30 mm. Stainless steel
needles 50 mm long with a diameter of 0.20 mm
were used. Stimultion conditions were 1 Hz, pulse
width 0.25 ms, and pulse strength 1 mA, theintensity that did not make patient feel unpleasantbut strong enough to cause contractions of triceps
surae muscles.

References
1) FONTAINE R., KIM M., KIENY R.: Surgicaltreatment of peripheral circulation disorders.
Helvetica Chirurgica Acta. 21: 499-533, 1954.
2) MATSUO Hiroshi: Chiryou (1) Chiryoukijyun to
Sono Jissai. Heisokusei-Doumyakukoukashou
Shinryou no Jissai-Masshou Shougai no
Shinryou Shishin-, p29-32, Bunkodo, 2002.
3）SAKAGUCHI Shunji: The Effect of Acupuncture
Therapy on Cold Hands and Feet (“Hiesho) Relationship with Signs and Symptoms of Blood
165) APPIAH R., HILLER S., ALEXANDER L.,
CREUTZIHG A.: Treatment of primary
raynaud’s syndrome with traditional chineaseacupuncture. J Int. Med., 241: 119-124, 1997.
6) MAEDA M., KACHI H., ICHIHASHI N.,OYAMA Z., KITAJIMA Y.: The effect ofelectrical acupuncture-stimulation therapy
using thermography and plasma endothelin（Et-1） levels in patients with progressive
systemic sclerosis（PSS）. J. Dermatol Sci., 17:
151-155, 1998.
7) YASUNO Fumiko, SAKAI Tomomi: Geriatric
Disorders and Oriental Medicine (5) - peripheralarterial
obliterative
disease,especiallyarteriosclerosis obliterans and acupuncture
treatment - Riryou, 28 (1): 2-9, 1998.
8) YAGI Shinichi: Heisokusei
Doumyakukoukashou niyoru Sokushi-Kaiyou
nitaisuru
Sekichu-Kiritsukin
eno
Haritsuuden-Chiryou no Kouka. ClinicalAcupuncture & Moxibustion, 2: 8-13, 1996.
9) IMAI Kenji: Hari Tsuuden to Yakubutu no
Heiyou-Ryouhou
niyori
Rinshou
Shoujyouno
Kaizenga
Erareta
Heisokusei-Doumyaku-KoukashounoIchirei. Journal of Meiji Shinkyu Igaku, 23:
19-24, 1998.
10) SAKAI Tomomi, YASUNO Fumiko, TAWA
Munenori, YANO Tadashi: Clinical Study ofElectro-Acupuncture
Therapy(EAT):
Examination of muscle-EAT and nerve-EAT -.
Journal of The Japanese Society of Balneology,
Climatology and Physical Medicine, 67 (2):87-108, 2004.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 4, Number 2 | Summer 200911) TOKUTAKE Tadashi, YOSHIKAWA Keishi,
NAKANO Hideki: Teishuha Hari Tsuuden
Chiryouga Masshou-junkan ni oyobosu Eikyou.
Journal of Nissho Electrotherapy Association
11: 43-48, 1997.
12) YOSHIKAWA Keishi: Teishuha Tsuuden ni
okeru Hari-Denkyoku to Hyoumen Denkyoku
no Hikaku – Kin-nai Ondo, Shimpaku-suu,
Ketsuatsu ni Ataeru Eikyou. Journal of The
Japanese Society of Balneology, Climatology
and Physical Medicine, 62 (3): 141-146, 1999.
13) AMANO Ikuji: Heisokusei Doumyaku-Koukashou
niokeru Keihiteki-Kekkan-Seikeijyutsu Zengo no
Hifu-Ondo Henka. Biomedical Thermology, 16 (2):94-97, 1996.
14) ODA Tsuyoshi, IMAI Kenji, SHINBARA Hisashi,
SAKITA Masakazu: Rat Soketsu-Kashi eno
Hari-Chiryou niyoru Kin-Ketsuryu-Ryou noHenka. Journal of the Japan Society of
Acupuncture and Moxibustion, 54 (2): 163-178,
2004.

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Introduction of Tokyo Ariake University of
Medical and Health Sciences (TAU)
About TAUTokyo Ariake University of Medical and Health
Sciences (TAU) opened in 2009 in Ariake of Tokyo
the capital of Japan is a four-year university.
Ariake is a waterfront area included in the new
Tokyo Waterfront Subcenter of the urban project
developed by the metropolitan government.
Ariake is one of the most promising areas inTokyo with good access to urban central areas as
there are two public transportation systems(Rinkai Line and Yurikamome Line) and the
networks of Tokyo Metropolitan expressways.
Hanada Gakuen, the mother organization of
TAU was founded in 1956 by Hanada Tsutou who
made great contributions to improving the status
of Japanese traditional medicine and developing
the traditional medicine after the war. The school
is a traditional college that has so far produced
over
15,000acupuncture/
moxibustion
practitioners and Judo therapists.
TAU is organized with the Faculty of
Healthcare to which the Department of
Acupuncture
andMoxibustion
andtheDepartment of Judo Therapy belong, and theFaculty of Nursing. Education is provided by 43
full-timeteachers
and
a
team
of
vastly-experienced part-time instructors. TAU
aims to contribute to the society by training
well-balanced specialists that have a wealth ofknowledge and solid techniques as well as aninvestigative point of view and can giveconsideration to the position of patients and theirneeds.
Department of Acupuncture and Moxibustion
In the Department of Acupuncture andMoxibustion of TAU, education is given by
full-time teachers (1 doctor, 1 doctor of traditional

18

Chinese medicine, 3 researchers of basic
researches, 13 practitioners of acupuncture andmoxibustion, and 1 athletic trainer (AT) who is acertified practitioner of acupuncture andmoxibustion) and other 90 part-time specialists.
The education aims to nurture practical humanresources so that it is not only designed forstudents to gain a wide range of medical
knowledge
relating
toacupunctureandmoxibustion but also field-oriented, focusing on
on-the-job
trainings
about
the
optimalimplementation method of acupuncture andmoxibustion under the modern medical caresystem and evidence-based indications andcontraindicationsofacupunctureandmoxibustion treatment. The education has also
an important purpose of contributing to thedevelopment of acupuncture and moxibustion
medicine through basic clinical research andstudies.
Adjunct facilities of TAU
A center for acupuncture and moxibustion with
17 beds will open as adjunct facilities of TAU in
September 2009. In the center, practitioners ofacupuncture and moxibustion of the Departmentof Acupuncture and Moxibustion will perform
clinical activities on a rotating system to help
maintain and improve health of the community
residents. And at the same time, students of the
Department of Acupuncture and Moxibustion will
have on-the-job trainings. Furthermore, a clinic ofmodern medicine (internal medicine andorthopedics) and a Judo-therapy center areplanned to open two years later. Through theircooperation, these centers will assume a role ofbecoming an implementation example ofintegrated medicine in Japan.

(Tomoaki Kimura, Department of Acupunctureand Moxibustion)

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Tokyo Ariake University of Medical and Health Sciences (TAU)

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