Volume 8, Number 2 | Summer 2013

Japanese Acupuncture - Current Research
Japanese Traditional Medicine Text (8) – Acupuncture in
the Area of Otorhinolaryngology

1990’s and the remaining reports were prior to that.

Kazuo Sasaki

randomized, placebo-controlled trial of manual andProfessor, Department of Acupuncture and Moxibustion

electrical acupuncture for the treatment of tinnitus”.

Suzuka University of Medical Science

Subjects were 50 patients with tinnitus were divided

Most recently (2010), Wang K, Bugge J et al. ofDenmark

publishedsingle-blindedRCTs”A

into three trial groups, 1) an electro-acupuncture
In this section we will discuss, Otolaryngology
diseases (ears, nose and throat), especially thosesuited to treatment by acupuncture and moxibustion
therapy such astinnitus, dizziness (vertigo) andsudden deafness.
Conditions if the eyes, ears and throat, especiallywith respect to Acupuncture and Moxibustion
Treatment, are considered imbalances within theFang Fu system of organs as Kidney, Liver typediseases. Further, external influences of winddampness and phlegm fire are thought to have astrong connection to these external orifices, sotreatment of these conditions must focus on thesepathogenic processes.
In 1996, the WHO published a list of 49 diseases
effectively treated with acupuncture. Diseases of theear, nose and throat included tinnitus, hearing loss
and Meniere disease. Indications on this list are notbased on evidence obtained through rigorous clinical
trials and, dominated by subjective symptoms, suchas tinnitus and vertigo, so making an objective
evaluation based on the degree of symptoms very
difficult. Because these conditions are not dealt witheffectively by modern medical treatment provided bymedical institutions, patients with these symptoms
tend to seek acupuncture treatment. For thesereasons, Otolaryngology specialty hospitals in Japan
may often offer acupuncture treatment room.
1. Present Status of Foreign Clinical Researcha) Tinnitus
Using Pub Med, we limited our keyword search to[Acupuncture] [hearing disorder] and found 91
references, 8 of which were RCTs. Of those, 4 reports
were published after 2000, 2 reports were from the2group, 2) manual acupuncture group, and 3) a nonacupuncture treatment group. Groups 1 and 2
received acupuncture at intervals of 6 times a week
for one month, after which they completed a survey
concerning the frequency, volume and quality of
their tinnitus and remarked about their subjective
evaluation of the treatment and their progress.
Resultsofthesepost-treatment

subjective

evaluations showed that, compared to the nontreatment baseline levels, manual acupuncture
produced significant improvements and compared tomanual stimulation, electro-acupuncture produced
relatively

moresignificantimprovements.

Frequency and volume of tinnitus was significantly
reduced in the electro-acupuncture group and it wasconcluded that, as for tinnitus, electro-acupuncture
was especially effective.
b) Vertigo
Performing a Pub Med search using key thewords [Acupuncture], [Dizziness], [Vertigo], 23
reports were collected, 3 of which were RCTs.
Aigner N et al. published “Adjuvant laser
acupuncture in the treatment of whiplash injuries: aprospective, randomized placebo ─ controlled trial”
for vertigo resulting from whiplash injuries (45subjects). The subjects were divided into 2 groups, 1)
pharmaceutical treatment combined with laser
acupuncture and2) laser acupuncture with nopharmaceuticals

astheplacebotestgroup.

Comparing results from these two groups revealed
that both groups improved but there was no
significant difference between the results.
Heikkilä

H,etal.,published“Effectsofacupuncture, cervical manipulation and NSAID
therapyon

dizziness

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

andimpairedheadVolume 8, Number 2 | Summer 2013

repositioning of suspected cervical origin: a pilot

to initial evaluation scores, he experienced 50%

study”. They discussed vertigo and its relationship toimprovement in his Patulous Eustachian Tube

disorders of the neck. They performed trials using

symptoms and this improvement was maintained

acupuncture,

followingcervicalmanipulation

andnon-thetreatmentperiod.

Wuetal.

steroidal anti-inflammatory drugs to confirm efficacy.

published ”Acupuncture Treatment for Labyrinthine

Cervical manipulation was found to be the mostTinnitus”. Having recruited 65 subjects, they wereeffective method for reducing the amount of timescreened and divided into deficiency, excessive andpatients suffered dizziness and vertigo. However,intermediate

according to post treatment VAS scores, acupunctureacupuncture treatment. Before and after thewas found to be very effective for relieving thetreatments subjects were asked to evaluate theirvarious pains experienced by these patients.

subjective scores for [tinnitus expression] andUsing a Pub Med search including the key words[Acupuncture] and [sudden deafness], we found 4
reports, none of which were RCTs. Yin CS et al. wasprimaryAll

subjects

received[tinnitus loudness]. Analyzing the data from 65c) Sudden Deafness

thetypes.

researcherforthesereports.

Requirements for entrance into the study were thatthe symptom had continued for more than 3 weeks

subjects showed that, compared to the deficient andintermediate types, the excessive type subjects
showed the greatest reaction to acupuncturetreatments.
b) Vertigo
We performed a web search using jamas.or.jp andand that Western treatments had failed to correct

includingthe condition. Seventeen subjects with obstinate[Moxibustion] and [Vertigo]. We retrieved 98 reports,

deafness joined the study. A specific type of sham

49 of which were case studies and 43 included

acupuncture was used (舎岩鍼法) as the control andresearch commentary. Kadokura et al., recruited 7

manual acupuncture was used as the treatment.

subjects with peripheral (??) vertigo who had not had

After 70.4 days, improvement rates were measured

experienced relief with Western Medical Treatments

at 47.1% (8 of the initial 17 had improved hearing).

(1 male, 6 females).Acupuncture and moxibustion
treatments

thekeywords

involved

retention[Acupuncture],

needlingand

2. Present Status of Clinical Studies in Japan (fromcomfortably warm moxa that did not leave a scar or

2001 to 2012)

blistering. Treatment was continued for between 6-a) Tinnitus15 months. A QOL questionnaire was collected toUsing an online search engine, jamas.or.jp, weevaluate the effectiveness of the treatments: 1

used [Acupuncture], [Moxibustion] and [Tinnitus] as

subject reported complete recovery, 5 reported athe keywords. Retrieving 57 reports, we arereduction in symptoms and 1 reported no changes forreviewing 32 of those here, although none of thesean overall improvement rate of 85%. Further,were RCTs. Muranaka et al. published ”Efficacy of

Sakuraba et al. reported improvement in vertigo, anAcupuncture

Patulousaccompanying symptom experienced by patients

Eustachian Tube symptoms” having recruited a 43

receiving hemodialysis. Specifically, 18 hemodialysis

year old male subject. Needling was performed in thepatients were divided into Group A (10 hemodialysis

area of the Trigeminal nerve using acu-points at thepatients (2 males and 8 females, average age 62.4)

back of the head on the neck. He was treated once aand Group B (5 males and 3 females, average age

week for 25 weeks and the results of his treatments

67.5). The groups were treated with acupuncture,

were reported as follows. ANRS (Numerical RatingalternatelyScale) was used to evaluate his progress. Comparedtreatment method). Acu-points were selected usingandMoxibustionforfor

12

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)-weeksessions(cross-over3Volume 8, Number 2 | Summer 2013

an M-test and embedded needles were then applied.

References

Following the treatments, group A’s VAS scores for1)

Masanori

Takashi:

DialecticalTheory

itchiness decreased significantly from 52.2 to 18.5.

TreatingVertigowithAcupuncture.

Further, slight decreases were reported for general

Acupuncture and Moxibustion OSAKA (22)2:

stiffness, irritability, a sense of dull heaviness, and139-144, 2006
2 ） Xiaoxiang Z, et al.: Jinger moxibustion forvertigo.

treatment of cervical vertigo ─ a report of 40c) Sudden Deafness
Using an online search engine, jamas.or.jp,including

thekeywords,[acupuncture],cases. J Tradit Chin Med 26(1): 17─18, 2006
3） Aigner N, Fialka C, Radda C, et al.: Adjuvant
laser acupuncture in the treatment of whiplash[moxibustion] and [sudden deafness] we retrieved 23injuries: a prospective, randomized placebo ─reports, one of which was original research, 15 werecontrolledcase reviews and 7 were research commentaries.
Additionally, we found no RCTs. Sudden deafness
has been studied by Yamamoto and Takenouchi whoKlin

Wochenschr

Effects of acupuncture, cervical manipulation
and NSAID therapy on dizziness and impaired
head repositioning of suspected cervical origin :body acupuncture treatments, using particularly
Four of the subject (26.7%) reported their treatments

Wien4） Heikkilä H, Johansson M, Wenngren BI, et al.:15 patients for 6 years, providing systematic whole
points around the ears and auricular acupuncture.

trial.

118(3─4): 95─99, 2006

researched classical texts. Since 1981, they followed

a pilot study. Man Ther 5(3): 151─157, 2000
5） Yin CS, Park HJ, Nam HJ, et al.: Acupuncture
for refractory cases of sudden sensorineural

were effective.

hearing loss. J Altern Complement Med 16(9):3. Perspectives and views for the future ofacupuncture
andmoxibustion
therapyofOtolaryngology
As noted earlier, modern medical treatment for973─978, 20106)

these types of symptoms are often based on7)

well as gastric discomfort, menstrual cramps,insomnia, or exercise with fibromyalgia should also
be tracked in future clinical research models.

patients

whocomplainofManta So, Lawrence C ─ L Huang et al.:Concerning the usefulness of clinical researchacupuncture for Labyrinthine Tinnitus using
the "Nakanishi medical combined treatment".
Journal of the Japan Society of Acupunctureon their results from a University Hospital setting,hearing evaluation, symptoms such as dizziness asfor420-424, 2011

treatment is complicated. Kadokura et al. reported

include balance tests, MRI and sensory neural

Narushima,

Society of Acupuncture and Moxibustion 61(4):difficult so we have to conclude that this area ofsuch serious symptoms as intractable Vertigo should

Tomomi

Patulous Eustachian Tube. Journal of the Japansubjective observations, treatment evaluation can besuggesting that special consideration for patients

Nakamura,

Treatment

necessarily get positive results. In many cases, evenafter a successful acupuncture treatment, because

Ryota

Masanori Tojo et al.: Case Study: Acupuncture

patients with Otolaryngology diseases do not4ofand Moxibustion 58(4): 626-641, 20088)

Yo Sakuraba, Kenta Sawasaki, H. Takeuchi etal.: Effects of Acupuncture treatments aimed atmaintaining QOL of hemodialysis patients andimproving implementation (the practice ofacupuncture treatment for itching associatedwith hemodialysis)). Kidney 30(2): 167-174,
2007

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

Volume 8, Number 2 | Summer 20139)

Yoshiyuki

Kadokura,RyouIshida,Ichiro

Yagitani et al.: Effects of Ac puncture andMoxibustion Treatment for Vertigo. Journal of
the Japan Oriental Medicine Journal 59(2): 291295, 200810) Kouki Yamamoto, Shinsao Takenouchi, Sanshi
Takenouchietal.:

AcupunctureandMoxibustion for Sudden Deafness and Tinnitus.
Journal of the Japan Society of Acupunctureand Moxibustion Therapy 40(2): 184-187, 1990

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

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