Randomized Controlled Trial
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 21, 2022; 10(3): 929-938
Published online Jan 21, 2022. doi: 10.12998/wjcc.v10.i3.929
Efficacy of acupuncture at ghost points combined with fluoxetine in treating depression: A randomized study
Yi Wang, Yu-Wei Huang, Dilnur Ablikim, Qun Lu, Ai-Jia Zhang, Ye-Qing Dong, Fei-Cui Zeng, Jing-Hua Xu, Wen Wang, Zhi-Hai Hu
Yi Wang, Yu-Wei Huang, Ai-Jia Zhang, Jing-Hua Xu, Wen Wang, Zhi-Hai Hu, Department of Acupuncture and Moxibustion, Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200082, China
Dilnur Ablikim, Department of Acupuncture and Moxibustion, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Qun Lu, Department of Clinical Laboratory, Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200082, China
Ye-Qing Dong, Department of Traditional Chinese Medicine, Jiangwan Hospital, Shanghai 200081, China
Fei-Cui Zeng, Department of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200081, China
Author contributions: Wang Y, Huang YW and Hu ZH designed the experiment; Wang Y and Huang YW used the work, Dilnur A, Lu Q and Zhang AJ, and Dong YQ collected data; Zeng FC, Xu JH and Wang W analyzed and interpreted data, and articles written by Wang Y, Huang YW and Hu ZH.
Supported by Shanghai Science and Technology Commission TCM Guidance Project, No. 19401935500; Shanghai University of Traditional Chinese Medicine Budget Scientific Research Project, No. 2020LK079; and Medical Innovation Research Special General Project of Shanghai Science and Technology Commission, No. 21Y11923500.
Institutional review board statement: The study was reviewed and approved by the Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Hai Hu, Doctor, Chief Physician, Department of Acupuncture and Moxibustion, Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, No. 230 Baoding Road, Hongkou District, Shanghai 200082, China. zhh1708@hotmail.com
Received: November 16, 2021
Peer-review started: November 16, 2021
First decision: December 9, 2021
Revised: December 11, 2021
Accepted: December 25, 2021
Article in press: December 25, 2021
Published online: January 21, 2022
Processing time: 60 Days and 6.6 Hours
Abstract
BACKGROUND

Depression affects more than 350 million people worldwide. In China, 4.2% (54 million people) of the total population suffers from depression. Psychotherapy has been shown to change cognition, improve personality, and enhance the ability to cope with difficulties and setbacks. While pharmacotherapy can reduce symptoms, it is also associated with adverse reactions and relapse after drug withdrawal. Therefore, there has been an increasing emphasis placed on the use of non-pharmacological therapies for depression. The hypothesis of this study was that acupuncture at ghost points combined with fluoxetine would be more effective than fluoxetine alone for the treatment of depression.

AIM

To investigate the efficacy of acupuncture at ghost points combined with fluoxetine for the treatment of patients with depression.

METHODS

This randomized controlled trial included patients with mild to moderate depression (n = 160). Patients received either acupuncture at ghost points combined with fluoxetine (n = 80) or fluoxetine alone (control group, n = 80). Needles were retained in place for 30 min, 5 times a week; three treatment cycles were administered. The Mann–Whitney U test was used to compare functional magnet resonance imaging parameters, Hamilton depression rating scale (HAMD) scores, and self-rating depression scale (SDS) scores between the acupuncture group and control group.

RESULTS

There were no significant differences in HAMD or SDS scores between the acupuncture group and control group, before or after 4 wk of treatment. The acupuncture group exhibited significantly lower HAMD and SDS scores than the control group after 8 wk of treatment (P < 0.05). The acupuncture group had significantly lower fractional Amplitude of Low Frequency Fluctuations values for the left anterior wedge leaf, left posterior cingulate gyrus, left middle occipital gyrus, and left inferior occipital gyrus after 8 wk. The acupuncture group also had significantly higher values for the right inferior frontal gyrus, right insula, and right hippocampus (P < 0.05). After 8 wk of treatment, the effective rates of the acupuncture and control groups were 51.25% and 36.25%, respectively (P < 0.05).

CONCLUSION

The study results suggest that acupuncture at ghost points combined with fluoxetine is more effective than fluoxetine alone for the treatment of patients with mild to moderate depression.

Keywords: Traditional Chinese medicine; Acupuncture; Ghost point; Fluoxetine; Depression; Resting state magnetic resonance

Core Tip: Acupuncture is an effective auxiliary method for the treatment of clinical depression. In this study, the authors found that the combined use of acupuncture at ghost points and fluoxetine may be more effective than fluoxetine alone for the treatment of patients with mild to moderate depression.