心身医学的な病態に対する鍼灸治療の効果と脳報酬系に及ぼす影響(シンポジウム : 東洋における心身医学療法,2007年,第48回日本心身医学会総会(福岡))  [in Japanese] Effect of Acupuncture on Psychosomatic Diseases and its Influences on the Brain Reward System(Symposium/Asian Psychosomatic Therapies)  [in Japanese]

鍼灸医学は,鍼と灸という微細な物理的刺激を用いてさまざまな心身医学的病態に対しても治療を行うが,それは心身一如の身体モデルを根底に置いているからである.筆者らはこれまで抑うつ気分,過敏性腸症候群,アトピー性皮膚炎などの心身医学的な病態に対して臨床研究を行うとともに脳報酬系に及ぼす影響についての基礎的研究も展開してきた.1.脳報酬系に対する鍼灸刺激の効果鍼灸治療の非特異的効果として鍼灸刺激の快適性に注目し,その機序の一端を解明するために脳報酬系の主要部位である側坐核におけるモノアミンを指標に検討した.実験対象はSD系ラットとし,鍼刺激および灸刺激によるモノアミン量とその代謝産物量を測定した.その結果,鍼刺激および灸刺激は,側坐核のセロトニン分泌を高めることが示唆された.これらのことから鍼灸刺激は脳報酬系に影響を及ぼし,心地よさやリラクセーション効果を引き出す可能性が示唆された. 2.鍼灸治療の臨床的効果過敏性腸症候群(IBS)(n=4)に対しては,1事例研究法により検討した.いずれの症例も罹病期間が長く,薬物療法に抵抗性を示した症例であった.鍼灸治療の臨床的効果の評価は,腹部症状および全身状態,QOL,弁証スコアおよびPOMSを用いて行った.その結果,心身にわたる症状の軽減がみられ,鍼灸治療はIBSの治療の1つになりうることが示唆された.また,抑うつ気分に対する鍼灸治療の効果については,65歳以上の高齢者(n=33)を対象として検討した.抑うつ気分はGDS簡易版,主訴の評価はVASを用いて行った.鍼灸治療は原則週1回とした.その結果,抑うつ気分には随証療法による鍼灸治療が効果的であることが示唆された.

Acupuncture, the traditional medicine which gives minute physical stimulation such as needling or moxibustion to the body, has also been used to treat psychosomatic diseases. The reason for this is that the theory of the remedy is based on the physical model of which the body and the mind are united. We have been studied clinical effects of acupuncture on several kinds of psychosomatic diseases such as depression, irritable bowel syndrome (IBS) and atopic dermatitis, as well as its influences on the activities of the brain reward system. 1. Clinical Effect of Acupuncture We have been studing the effect of acupuncture on IBS using a single-case research design. All of the patients we studied (n=4) had persistent and refractory symptoms due to IBS. Primary outcome measure in the study includes abdominal symptoms, general conditions, quality of life (QOL), Oriental medical score and the profile of mood states (POMS). The result showed that acupuncture affected both somatic and psychological symptoms, which indicated that the remedy have certain ability to improve symptoms of IBS. On the other hand, in the study where elderlies with depression (n=33) had been involved and evaluated with geriatric depression score (GDS) and visual analogue scale (VAS), we found that acupuncture treatment based on traditional chinese medical thery (TCM theory) was useful in such cases. 2. Effect of Acupuncture on the Brain Reward System We have been studing with the focus on the comfortableness of the acupuncture treatment, the effect of acupuncture on the brain reward system through observation of the changes in the monoamine in the nucleus accumbens. Using Sprague-Dawley (SD) rats, we observed changes in the monoamine level and its metabolite after acupuncture or moxibustion. The results showed that both acupuncture and moxibustion appeared to have ability to increase serotonin level in the nucleus accumbens. These results indicate that acupuncture may affect the brain reward system and consequently causes comfortableness and/or relaxation