RESUMO
Acupuncture possesses the antidepressant potential. In this 6-week randomized controlled trial with 4-week follow-up, 160 patients with major depressive disorder (MDD) were randomly assigned to paroxetine (PRX) alone (n = 48) or combined with 18 sessions of manual acupuncture (MA, n = 54) or electrical acupuncture (EA, n = 58). Treatment outcomes were measured mainly using the 17-item Hamilton Depression Rating Scale (HAMD-17), Self-rating Depression Scale (SDS), clinical response and remission rates. Average PRX dose taken and proportion of patients who required an increased PRX dose due to symptom aggravation were also obtained. Both additional MA and EA produced a significantly greater reduction from baseline in score on HAMD-17 and SDS at most measure points from week 1 through week 6 compared to PRX alone. The clinical response was markedly greater in MA (69.8%) and EA (69.6%) groups than the group treated with PRX alone (41.7%, P = 0.004). The proportion of patients who required an increase dose of PRX due to symptom aggravation was significantly lower with MA (5.7%) and EA (8.9%) than PRX alone (22.9%, P = 0.019). At 4 weeks follow-up after completion of acupuncture treatment, patients with EA, but not MA, continued to show significantly greater clinical improvement. Incidence of adverse events was not different in the three groups. Our study indicates that acupuncture can accelerate the clinical response to selective serotonin reuptake inhibitors (SSRIs) and prevent the aggravation of depression. Electrical acupuncture may have a long-lasting enhancement of the antidepressant effects (Trial Registration: ChiCTR-TRC-08000278).
Assuntos
Terapia por Acupuntura/métodos , Terapia Combinada/métodos , Transtorno Depressivo Maior/terapia , Paroxetina/farmacologia , Inibidores Seletivos de Recaptação de Serotonina/farmacologia , Terapia por Acupuntura/efeitos adversos , Terapia por Acupuntura/instrumentação , Adulto , Transtorno Depressivo Maior/tratamento farmacológico , Feminino , Seguimentos , Humanos , Masculino , Paroxetina/administração & dosagem , Paroxetina/efeitos adversos , Escalas de Graduação Psiquiátrica , Inibidores Seletivos de Recaptação de Serotonina/administração & dosagem , Inibidores Seletivos de Recaptação de Serotonina/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
After reviewing the literatures in recent years, it is of importance to investigate on the key brain region activated by needling with the baseline state fMRI in research of acupoint specificity and brain fMRI. It is valuable to define two ways to determine the key brain region: one is the so called Seek True, while the other one is the so called Prove Wrong, and some examples of applications of the two methods are given in order to prove that the methods are feasible on determining the key brain region.