Analysis of Adverse Events in Acupuncture and Moxibustion Treatments in Japan and the Current Situation of Hiroshima University Hospital Kampo Clinical Center.

Background: Acupuncture and moxibustion (AM) are effective for pain relief and chronic disease management but carry risks of adverse events (AEs). Japan prioritizes AM safety, and Hiroshima University Hospital Kampo Clinical Center (HUHKCC) follows strict professional standards to ensure both safety and efficacy. Objectives: The study analyzes AM-related AEs in Japan over the past decade, compares them with HUHKCC practices, and proposes risk mitigation strategies. Methods: AM-related AEs from 2013 to 2024 were reviewed using case reports from the Ichushi-Web, CiNii, and Accident Information Data Bank System (AIDBS) databases, alongside data from HUHKCC (October 2023-2024). Patient information and AEs were collected from electronic medical records and a survey of six acupuncturists. Data analysis was performed using bibliometric methods in Excel and BioVenn. Results: An analysis of 55 studies and 153 AEs showed a fluctuating trend, with insertion needle technique (INT) accounting for 89.1%. Common AEs included internal injuries (32.7%) and infections (21.8%). AIDBS data indicated 12 AEs annually, with 66% from INT and 33% from moxibustion. Conversely, HUHKCC's 568 sessions reported no adverse effects; however, side effects such as fatigue or localized pain were reported in 10 cases. One reason for less AEs is that contact needle technique (CNT) was used in 96.8% of sessions. Conclusions: Despite Japan's emphasis on AM safety, AM-related AEs remain consistent. Although effectiveness of each technique requires evaluation, the HUHKCC model, with its focus on CNT, diagnostics, and practitioner training, might effectively mitigate AEs and offer a valuable framework for improving AM safety.