The Rapid-onset Of Antidepressant Of Central 5-HT Receptor Mechanism And Clinic Study In Acupuncture Combining Medicine

[Objective] Observation of effect of acupuncture combined with SSRI treatment of depression and to explore the role of the characteristics of its rapid-onset of central 5-HT receptor mechanism.[Method]①92 cases of depression were randomly divided into groups with acupuncture combining SSRI antidepressants and sleep promoted medicine 50 cases (needle-group) and SSRI antidepressants group 42 cases (control group). Hamilton depression scale (HAMD), Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI) and self-made TCM Syndromes Scale were used to be clinical evaluation scale.②The rat model of depression were randomly divided into drug group (fluoxetine), electro-acupuncture group, acupuncture medicine group, after 7 days treatment, Open-Field behavior assessment, experimental dessert consumption,and determination of raphe nucleus, hippocampus, frontal cortex of 5-TH1A receptor mRNA , 5-TH2A receptor mRNA expression by real-time RT PCR method.[Result]①After four weeks treatment, efficiency of both groups on HAMD, SDS , PSQI points of the difference was significant (P <0.01). HAMD after 2, 4 weeks treatment, the difference was significant (P <0.01). SDS score at the rate of reduction compared with a difference (P <0.05). The difference of five factors of PSQI in the two groups like sleep quality, falling sleep time, sleep time, sleep efficiency and day dysfunction were significant (P <0.01). But in sleep disorder, no difference (P> 0.05). Liver depression and spleen deficiency group and heart-spleen deficiency group had a considerable effect (P> 0.05), kidney-spleen yang deficiency group had a less effect (P <0.05).②After 7 days treatment on the rat model of depression, each group was lower than normal group (P <0.01) in behavioral score, weight, and dessert consumption. Model group, drug group, electro-acupuncture group and acupuncture combining medicine group were no difference in vertical score and body weight (P>0.05). However, at the level score and dessert consumption, electro-acupuncture group, acupuncture combining medicine group were higher than the model group and drug group (P <0.05), electro-acupuncture group and acupuncture combining medicine group are equivalency (P> 0.05), drug group and model group are equivalency (P> 0.05). After 7 days treatment, prefrontal cortex 5-HT1A receptor mRNA and 5-HT2A receptor mRNA expression there is no difference between the groups. Hippocampal 5-TH2A receptor mRNA decline, and 5-TH1A receptor mRNA increased. For the 5-HT2A receptor mRNA, electro-acupuncture group and acupuncture combining medicine group in raphe nucleus and hippocampus are significantly increased, while the drug group in the raphe nuclei did not change, although in the hippocampus improved but less than electro-acupuncture group and acupuncture combining medicine group. Electro-acupuncture group was significantly higher than acupuncture combining medicine group in the raphe nucleus and hippocampus of 5-HT2A receptor mRNA expression.[Conclusion]①Acupuncture combining medicine has clinical efficacy in the treatment of depression precisly, superior SSRI antidepressants, and the fast onset, HAMD depression scale on the anxiety / somatization factor scores improve significantly characterized;②With acupuncture combining medicine can improve sleep disturbance caused by depression, has advantages sleep quality, sleep time, sleep time, sleep efficiency and daytime dysfunction;③Acupuncture combining SSRI antidepressants on the treatment of liver depression and spleen deficiency depression effected better;④TCM syndromes symptom score table of Chinese medicine treatment methods Clinical Evaluation of sensitive and more accurate, it is worth further study;⑤At the level score and dessert consumption, electro-acupuncture group, acupuncture combining medicine group were higher than the model group and drug group, electro-acupuncture group and acupuncture combining medicine group are equivalency;⑥The rapid-onset of antidepressant in electro-acupuncture and acupuncture combining medicine may be through increased hippocampal 5-HT2A receptor levels, reducing the level of 5-HT1A receptors, while avoiding the excitation of raphe nuclei negative feedback mechanism works.⑦Taking into account the rapid-onset of antidepressant are equivalency between the electro-acupuncture and acupuncture combining medicine group, so that the electro-acupuncture played a major role.