Effect of acupuncture combined with low frequency rTMS on comorbid mild-to-moderate depressive disorder and insomnia: a randomized controlled trial.
10.13703/j.0255-2930.20220730-k0001
- Author:
Lu-da YAN
1
;
Peng ZHOU
2
;
Mei-Qi LAI
3
;
Miao WU
4
;
Yu ZHANG
2
;
Run-Dong TANG
2
;
Rui SUN
2
;
Yi LUO
5
;
Mei LI
5
;
Ji-Ling SUN
2
;
Wen-Bin FU
3
Author Information
1. Second Clinical College, Guangzhou University of CM, Guangzhou 510405, Guangdong Province, China; Department of Acupuncture and Moxibustion, Bao'an TCM Hospital, Shenzhen 518100, Guangdong Province; Shenzhen Bao'an Research Center for Acupuncture and Moxibustion, Shenzhen 518100, Guangdong Province.
2. Department of Acupuncture and Moxibustion, Bao'an TCM Hospital, Shenzhen 518100, Guangdong Province; Shenzhen Bao'an Research Center for Acupuncture and Moxibustion, Shenzhen 518100, Guangdong Province.
3. Second Clinical College, Guangzhou University of CM, Guangzhou 510405, Guangdong Province, China; Department of Acupuncture and Moxibustion, Guangdong Provincial Hospital of TCM, Guangzhou
4. Department of Acupuncture and Moxibustion, Bao'an TCM Hospital, Shenzhen 518100, Guangdong Province.
5. Department of Treatment and Prevention of Disease, Bao'an TCM Hospital.
- Publication Type:Journal Article
- Keywords:
acupuncture;
insomnia;
mild-to-moderate depressive disorder;
repeated transcranial magnetic stimulation;
treatment based on heart and gallbladder theories
- MeSH:
Humans;
Sleep Initiation and Maintenance Disorders/therapy*;
Transcranial Magnetic Stimulation;
Brain-Derived Neurotrophic Factor;
Treatment Outcome;
Acupuncture Therapy;
Acupuncture Points;
gamma-Aminobutyric Acid;
Depressive Disorder
- From:
Chinese Acupuncture & Moxibustion
2023;43(4):374-378
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To observe the impacts of acupuncture on depressive mood and sleep quality in patients with comorbid mild-to-moderate depressive disorder and insomnia, and explore its effect mechanism.
METHODS:A total of 60 patients with comorbid mild-to-moderate depressive disorder and insomnia were randomly divided into an observation group (30 cases, 1 case dropped off) and a control group (30 cases, 2 cases dropped off). In the observation group, acupuncture and low frequency repeated transcranial magnetic stimulation (rTMS) were combined for the intervention. Acupuncture was applied to Baihui (GV 20), Yintang (GV 24+), Neiguan (PC 6) and Yanglingquan (GB 34), etc., the needles were retained for 30 min; and the intradermal needles were embedded at Xinshu (BL 15) and Danshu (BL 19) for 2 days. After acupuncture, the rTMS was delivered at the right dorsolateral prefrontal cortex (R-DLPFC), with 1 Hz and 80% of movement threshold, lasting 30 min in each treatment. In the control group, the sham-acupuncture was adopted, combined with low frequency rTMS. The acupoint selection and manipulation were the same as the observation group. In the two groups, acupuncture was given once every two days, 3 times weekly; while, rTMS was operated once daily, for consecutive 5 days a week. The duration of treatment consisted of 4 weeks. Hamilton depression scale-17 (HAMD-17) and Pittsburgh sleep quality index (PSQI) scores were observed before and after treatment, as well as 1 month after the treatment completion (follow-up period) separately. Besides, the levels of nerve growth factor (BDNF) and γ-aminobutyric acid (GABA) in the serum were detected before and after treatment in the two groups.
RESULTS:After treatment and in follow-up, the HAMD-17 scores were lower than those before treatment in the two groups (P<0.05), and the scores in the observation group were lower than the control group (P<0.05). After treatment, the total scores and the scores of each factor of PSQI were reduced in the two groups in comparison with those before treatment except for the score of sleep efficiency in the control group (P<0.05); the total PSQI score and the scores for sleep quality, sleep latency, sleep efficiency and daytime dysfunction in the observation group were all lower than those in the control group (P<0.05). In the follow-up, except for the scores of sleep duration and sleep efficiency in the control group, the total PSQI score and the scores of all the other factors were reduced compared with those before treatment in the two groups (P<0.05); the total PSQI score and the scores of sleep quality, sleep latency, sleep duration, sleep efficiency and daytime dysfunction in the observation group were lower than the control group (P<0.05). After treatment, the levels of serum BDNF and GABA were increased in comparison with those before treatment in the observation group (P<0.05), and the level of serum BDNF was higher than that in the control group (P<0.05).
CONCLUSION:Acupuncture relieves depressive mood and improves sleep quality in patients with comorbid mild-to-moderate depressive disorder and insomnia. The effect mechanism may be related to the regulation of BDNF and GABA levels and the promotion of brain neurological function recovery.
