Volume 9, Number 2 | Summer 2014

Clinical Report 1 (Acupuncture)
Acupuncture and Moxibustion Treatment for a Patientwith Chronic Complex Health Prblems, where theCooperation by the Family too Contributed to theImprovement

visited our clinic because her husband strongly
recommended it.
I: Overview over the time-series analysis (Figure 1)
Figure 1 shows an overview over the time-series analysis

Takara Yamami

developed in this facility. Explanation of the frame fromAcupuncture Departemtn of Ehime Prefectural Central Hospital

the left shows first housing and work, in the middle dailylife events are entered and on the right side the start ofMany patients with chronic complex health problems visit

QOL impairments is recorded. In the left lower area theour facility affiliated with one of the local general hospitals

family structure is entered and allows to grasp the nursinginpotential of the family.

Shikoku.

On

thisoccasion

weadministeredacupuncture and moxibustion treatment with theFrom the time-series analysis it is possible to assess thatcooperation of the family and report our experiences withthe health problems seemed to be due to decreased stressa case with chronic complex health problems where thisresistance and a mild degree of blood stagnation. Again, wetreatment form led to their relief.

surmised the chief complaint developed before abackground of work related severe stress or problems

Patient: 57-year old female. Works at a loan counter in a

related to the marriage of the daughter. For the healthfinancial institution.

problems based on the time-series analysis presumably beChief complaint: insomnia, depressive mood, palpitation,

due to decreased stress resistance and a mild degree offatigue at the back of her eyes;

blood stagnation we considered the application of

Past history: underwent a hysterectomy at the age of 36;

moxibustion by the family to be most suitable.

no special health problems after the surgery;
Character traits from childhood: having an obsessive,

II: Findings at point locations (Figure 2)

depressive, pessimistic nature she had low resistance toAt the points on the back we observed depressions at SI14,

mental stress;

BL15, BL20, BL52, swelling from BL17-BL18, congestion

Family environment: lives in a family of three with herin the back of the neck, floating fine vessels in the vicinity

husband and daughter; nothing specifically notable.

of GV14 and GV4 and edema on the anterior chest and on

Present illness: started her employment at the age of 20

the top of the head. Based on the findings at point locations

and since a change in her work duties in October X-2 began

we came to the conclusion, that the build-up of blood

noticing stiffness of the back, loss of appetite, sincestagnation and decreased resistance to mental stress led toSeptember insomnia developed and she started to takethe reported health problems.

Zolpidem prescribed by a local physician. She became
again able to fall asleep, but usually woke up at 3 o'clock inthe morning and then could not fall asleep again. Fromthat time palpitations, fatigue at the back of her eyes anddepressive mood also developed. She lost appetite anduntil now lost about 10 kg weight. The local physician
diagnosed "depression" and prescribed western-style
medicines like Fluvoxamine, Zolpidem, Ethyl Loflazepate,
Sulpiride, Estazolam, Domperidone etc. Her meal size
decreased extremely, she developed hypersensitivity tolight and sounds and spend the whole day in bed. She

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

Volume 9, Number 2 | Summer 2014

Figure 1

Overview over the time-series analysis

Figure 2

Findings at point locations

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

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Volume 9, Number 2 | Summer 2014

Figure 3 Acupuncture and Moxibustion treatment

III: Acupuncture and moxibustion treatment (Figure 3)
Based on the findings of the time-series analysis and on
the findings at the point locations the treatment wasadministered according the findings at the point locations.
In this case (1) required care from the family. Regarding(2)thefamily

requestedmoxibustion

treatment.

Regarding (3) we considered self-treatment by the patient
herself to be appropriate. Thus, the treatment centered on
moxibustion. Moreover, regarding the moxibustion
treatment we concentrated on a persistent regimen (there
are two treatment concepts: switching formulas asrequired and maintaining the same regimen over time),
instructing the patient to treat herself at home using
mainly GV12, BL15, BL20, BL52, LI11, ST36, SP6, KI3.
Further, upon her visiting our clinic, we performed
additionally skin pricking in the vicinity of GV16.

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IV: Course and evaluation (Figure 4)
This shows the course over a period of 12 years from thefirst visit. The patient visited our clinic in intervals of 4 to
8 weeks for acupuncture and moxibustion treatment andtreated herself at home with moxibustion 3 to 7 times aweek. She also took the prescribed medicine and her
condition followed a favorable course. In our clinic six
treatment sessions represent one set and after each set wechecked the changes using a questionnaire. Evaluation
criteria for the QOL included physical, mental and socialparameters. Regarding the physical aspects, we evaluatedthe various symptoms, as mental aspects her healthrelated worries and for the evaluation of the social aspects
the patient evaluated any inconvenienced during her daily
life herself.

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

Volume 9, Number 2 | Summer 2014

Evaluated symptoms included constipation, strained neck,

After 15 months a dose reduction of the westernsweating, flushes, back stiffness, inappetence, insomnia,

medications was attempted. Body weight had recovered todepressive mood, palpitations, fatigue at the back of the62.0 kg. The patient could later overcome her mother'seyes, easy fatiguability and hypersensitivity to sounds.

sudden death and the death of her father from disease

Evaluation results over the period of 12 years showed forwithout problems, remained stable and graduallyalmost all items an evaluation as either A or B, which weimproved.

assessed to be a highly satisfactory.

Currently she is on a western medical regimen of(A: improved; B: improved but occasionally worsening)

Fluvoxamine 25 mg ½ tablet and Zolpidem 10 mg ½ tablet.

Two weeks after initiation of the moxa treatment she

In her daily life she manages general household chores,

reported "I was no longer aware of palpitations and a sortseeing off and welcoming back her grandchildren,of black lump in the depth of my heart has dissipated".

attending swimming, table tennis and PC classes,

After half a year her body weight was 55.8 kg. After 10

indicating improvement of the QOL.

months we added treatment for blood stagnation in theback of the neck. At the same time we observed changes inappetite and sleep and while there were some fluctuations,the number of days of good physical condition increased.

Survey of the course over a period of 12 years from the first visit (excerpt)
Evaluation items

I-(1)

I-(4)

II-(4)

III-(4)IV-(4)

General physical condition

B―――

B

Health related worries

B―――

A

Inconveniences during daily lifeC―――AConstipation

Neck muscles

A B

B B

A B

A A

A B

SweatingFlushes

B B

B A

A B

A A

A A

Back stiffness

Inappetence

B C

A A

A A

A A

A A

Insomnia

Palpitations

C A

C A

B A

B A

B A

Eyestrain

Mood

B B

A B

B A

C A

B A

Phonophobia

Easy fatigability― ―A A

A A

A C

B B

Figure 4 Course and evaluation

A: improved

B: improved but occasionally worsening

C: remains bad

D: getting gradually wrose

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

19Volume 9, Number 2 | Summer 2014

V: Conclusions and discussion
Insights into her inner life rather than her physical life
history based on the results of the time-series analysis led
us to the conclusion, that a decreased resistance towardmental stress and the formation of blood stagnation had
caused her health problems. Findings at the point
locations led to the same conclusion. The author believes
the moxa treatment administered by the family had ahealing effect on the patient and promoted the recovery
process of her resistance. Moreover, the main indication for
GV16 is "maniac behavior with death wishes, eye rollingand hallucinations" and its role in this case is highlyinteresting.

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