| Summary: | 碩士 === 中國醫藥大學 === 中西醫結合研究所碩士班 === 97 === Background: Depression is one of the most common mental health disorder. Up to 60% of patients do not gain full remission following a standard antidepressant treatment. Many patients only achieve partial response (e.g., 25%-49% reduction in symptoms) or continue to experience residual symptoms. This is of significant concern, as patients with residual symptoms have reduced functioning and a worse prognosis than those who achieve remission. There is still a need to improve the treatment of depression. A wide range of different augmentation and combination strategies are available, but most of them have dissatisfied adverse effects. There is a preference for patients with depression to seek other therapy, particularly use of complementary therapies. Acupuncture is a popular complementary and alternative medicine intervention suggested in the treatment of depression, but its efficacy is uncertain. We conducted a randomized single-blind placebo-controlled study to investigate the efficacy of acupuncture additionally applied to standard antidepressant therapy in major depression. Methods: We randomly included 30 inpatients with a major depressive episode in two different treatment groups: verum acupuncture and sham acupuncture group. Both groups were pharmacologically treated with one kind of freely selected standard antidepressant therapy. The verum group received acupuncture at specific points considered effective in the treatment of depression in addition to standard antidepressant therapy. Needle sensation of De Qi was required. The placebo sham group was treated in addition to standard antidepressant therapy with acupuncture at the same acupoints, inserted superficially, and needle sensation of De Qi was prohibited. Acupuncture was applied twice a week over a period of 8 weeks. Primary outcome measures were 17-item Hamilton Rating Scale for Depression (HAMD-17), Beck Depression Inventory(BDI), and Clinical Global Impressions-Improvement (CGI-I). Secondary outcome measures were Pittsburgh Sleep Quality Index (PSS) and health status of SF-36. All these scales were rated by an independent rater blind to verum/placebo conditions weekly over 8 weeks. Results: 3 of 15 pateints in placebo sham group and none of 15 pateints in verum group terminated before the completion of 8-week intervention. At the end of treatment period, verum acupuncture improved slightly more than placebo acupuncture not only in HAMD-17( p=0.043), BDI( p=0.029) and CGI-I( p=0.007) scores, but also in the following five components of SF-36: bodily pain( p=0.016), general health perceptions( p=0.044), vitality (p=0.003), mental health (p=0.002), and mental component scores (p=0.002). Conclusion: Acupuncture additionally applied to conventional standard antidepressant therapy has extra clinical benefits. It is worth further clinical trails of larger scale and stricter methodology because acupuncture augmentation causes less adverse effects and is more acceptable.
Keyword: acupuncture; major depression
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