Clinical observation of acupuncture combined with medication for mild-to-moderate depression

To discuss the clinical efficacy and plausible mechanism of Tiao Yang Qu Xie (regulating Yang to eliminate pathogenic factors) needling method plus paroxetine in treating mild-to-moderate depression.

Sixty-six patients with mild-to-moderate depression were divided into an observation group and a control group using the random number table method, each consisting of 33 cases. Another 25 healthy subjects were recruited as a healthy group. The control group took oral paroxetine tablets for treatment, and the observation group received additional acupuncture treatment 3 times weekly. Both groups underwent 4-week treatment. Before treatment, after 2-week and 4-week treatment, and 2 weeks after treatment (follow-up), the patients were assessed using the Hamilton depression scale-17-item (HAMD-17), self-rating depression scale (SDS), self-rating anxiety scale (SAS), and traditional Chinese medicine (TCM) pattern element identification scale for depression. The two groups each randomly contributed 25 cases to detect the protein content of brain-derived neurotrophic factor (BDNF) before treatment and after 4-week treatment, and compared with the healthy group.

After 2-week treatment, the markedly effective and total effective rates were significantly higher in the observation group than in the control group (P<0.05); after 4-week treatment, the observation group significantly surpassed the control group in comparing the markedly effective rate (P<0.05). After 2 and 4 weeks of treatment and at the follow-up, the HAMD-17 total score and sleep disorder factor score were lower in the observation group than in the control group (P<0.05); the anxiety-somatic score was lower in the observation group than in the control group after 2-week treatment (P<0.05). After 2 and 4 weeks of treatment and at the follow-up, the observation group was lower than the control group in comparing the scores of SDS, SAS, and TCM pattern element identification scale for depression (P<0.05). After 4-week treatment, the observation group had an increased serum BDNF protein content, higher than that in the control group (P<0.05) and had no significant difference compared to the healthy group (P>0.05).

Compared to the use of oral paroxetine alone, acupuncture plus paroxetine can produce more significant efficacy in treating mild-to-moderate depression and act faster in improving sleep disorder and anxiety-somatic symptoms; increasing the serum BDNF protein content may be a part of the mechanism underlying its antidepressant actions.