Efficacy Of Chronic Fatigue Syndrome With Depression Of Liver And Deficiency Of Spleen Treat By Acupuncture Combined With Auricular-Plaster

BackgroundChronic fatigue syndrome is a group of long-lasting fatigue, reduced activity for the outstanding performance, the high incidence of systemic integrated disease. Epidemiological studies have shown that the current prevalence of chronic fatigue syndrome in the population is then an increase, to cause serious public health burden in various countries are subject to different degrees of importance. Western medicine treatment of chronic fatigue syndrome are mainly drug therapy, nutritional support, immune therapy, cognitive behavioral therapy, psychotherapy, exercise therapy. However, due to side effects of drugs and behavioral therapy, psychotherapy is not controllable, so that Western medicine for chronic fatigue syndrome with little success. Chinese medicine for the treatment of chronic fatigue syndrome has potential advantages, particularly acupuncture therapy, effective treatment of this disease. This study was designed to investigate the combination of acupuncture and auricular acupoints pressing method of treating liver and spleen deficiency syndrome chronic fatigue, must be further study of the mechanism of action.ObjectiveThe subject of clinical research uesd methodology, randomized controlled studies were compared with the traditional Chinese medicine, objective evaluation of the efficacy of acupuncture for chronic fatigue syndrome, Clinical acupuncture combined with auricular point pressing on liver spleen Chronic Fatigue Syndrome efficacy, treatment mechanism, feasibility and existing problems.MethodsThis study investigated the case from the December 2014 to February 2016 clinical diagnostic outpatient clinic in Taiwan as chronic fatigue syndrome patients met the inclusion criteria and 93 patients.93 patients were divided into acupuncture combined with auricular point sticking group, simple acupuncture group and the Chinese medicine treatment group,31 patients in each group. Western diagnostic criteria with reference to November 1994 the US Centers for Disease Control (Centers for Diseases Control and Prevention, CDC) revised diagnostic criteria for chronic fatigue syndrome, TCM diagnostic criteria with reference to 2002, "Chinese new drug clinical guidelines" (trial) on the development of "Consumption" diagnostic criteria, stagnation and spleen deficiency syndrome types of traditional Chinese medicine terms referring to the 2002 national textbook "Chinese diagnostics" TCM colleges and universities on liver and spleen deficiency "Consumption" diagnostic criteria developed. Acupuncture treatment acupoints as Yu liver, spleen, Taichong, Sanyinjiao, Zusanli, Baihui; auricular acupoints sticking to the heart, liver, spleen, brain, cortex, sympathetic, God Gate; Chinese medicine group were Xiaoyaosan oral. Acupuncture once every other day,10 times as a course treatment; ear once every other day,10 times as a course treatment; medicine for taking 10 days, a break of two days,10 days for a course of treatment. It was totally 2 courses. The clinical efficacy of TCM type of observation with reference to the Ministry of Health issued the "Chinese medicine clinical research guidelines" to develop liver spleen syndrome evaluation standard, and the use of fatigue rating scale (FAI), Self-Rating Depression Scale (SDS), Self-Rating Depression scale (SDS) efficacy parameters were measured. Laboratory indicators NK cells, IgG, IgM. The overall efficacy criteria refer to "foreign medical · TCM Volume" "The effect of standard Chinese medicine diagnosis and treatment of chronic fatigue syndromeResults①Liver depression and spleen deficiency syndrome types of TCM clinical efficacy of the total scoresAfter a course of treatment, acupuncture + auricular point sticking group, simple acupuncture group, the liver and spleen deficiency traditional Chinese medicine treatment group was not significantly different clinical global impression packet (P> 0.05); after two courses of treatment, ear acupuncture +plaster group of liver and spleen deficiency clinical efficacy overall rating than simple acupuncture group scores decreased significantly (P<0.05).+ Acupuncture auricular point pressing the liver and spleen deficiency group total score although the clinical efficacy than treatment group decreased, but no significant difference (P> 0.05). At follow-up, auricular acupuncture +paste liver and spleen deficiency pressure group compared with the total score of the clinical efficacy of simple acupuncture group, it remained relatively low levels (P<0.05).②Liver depression and spleen deficiency syndrome types of TCM clinical efficacy of each itemAfter a course of treatment, acupuncture combined with auricular-plaster therapy can better alleviate liver and spleen deficiency in patients with chronic fatigue syndrome, tired body fatigue, insomnia, dreams, loss of appetite, abdominal distention symptoms, treatment group in improving patients with irritability, sore throat, insomnia symptoms have a good effect, but simply poor efficacy in acupuncture group short-term efficacy. After two treatment efficacy, liver and spleen deficiency clinical symptoms of each group were improved, especially for tired body fatigue, depression, worry, insomnia, dreams, loss of appetite, abdominal distention and other symptoms better effect. And improving emotional health aspect, acupuncture combined with auricular-plaster therapy is superior to traditional Chinese medicine. The follow up show that simple acupuncture and traditional Chinese medicine treatment in varying degrees rebound, poor efficacy sustained situation, and comprehensive treatment of acupuncture combined with auricular acupoints pressing a better long-term efficacy with a single medicine or acupuncture therapy.③Fatigue Assessment Scale (FAI)After a course of treatment, acupuncture and auricular-plaster+group have to reduce fatigue assessment (P<0.05), simple acupuncture group, although scores of different levels of treatment group decreased compared to the previous scale scores and treatment, but no significant difference (P> 0.05); after two courses, three groups of fatigue rating scale score (FAI) compared with before treatment in varying degrees reduction (P<0.05); at follow-up, only acupuncture auricular point pressing group+the FAI scores improved significantly (P<0.05). Differentials between groups, a course of treatment, the three groups Fatigue Assessment Scale (FAI) score group was not significantly different (P> 0.05); after two courses, acupuncture combined with auricular point sticking group Fatigue Assessment Scale (FAI) there were significant differences (P<0.05) than the simple acupuncture group decreased; when follow-up, acupuncture combined with auricular point sticking group fatigue assessment scale (FAI) than simple acupuncture group, there was a decline treatment group (P<0.05).④Self-Rating Depression Scale (SDS)After a course of treatment, the three groups of self-rating depression scale (SDS) and the treatment was no significant difference (P> 0.05) before; self assessment after two courses, acupuncture + auricular point sticking group, depressive simple acupuncture group table (SDS) scored better than before treatment reduced (P<0.05), no significant improvement in treatment group (P> 0.05); at follow-up, only acupuncture and auricular - plaster + group self-rating depression scale (SDS) have significantly improved (P<0.05). Comparisons between groups, when two courses of treatment and follow-up, acupuncture combined with auricular point sticking group Fatigue Assessment Scale (FAI) compared with the treatment group, the score decreased statistically significant (P<0.05).⑤Health Survey SF-36 scoresAfter a course of treatment, acupuncture + auricular point sticking, simple acupuncture, traditional Chinese medicine to improve liver and spleen deficiency in patients with chronic fatigue health of efficacy was not significant syndrome. After two courses of treatment, acupuncture + auricular point sticking to alleviate the patient’s body pain, improve daily living conditions, maintain mental health have a certain effect, and in the patient’s body to alleviate pain, improve quality of life, acupuncture and auricular- plaster + superior to traditional Chinese medicine. As for the social function of patients with respect, three treatments of little use.⑥ Comparison of biochemical indicesNK cell activity comparisons, after a course of treatment, the expression level of NK cells before treatment and three comparison groups did not change significantly (P> 0.05); after two courses of treatment, NK cell activity in the three groups were improved (P<0.05), but no significant difference between groups (P> 0.05). At follow-up, Chinese medicine treatment of NK cell activity increased in comparison with the simple acupuncture group was statistically significant (P<0.05).IgG comparisons, after a course of treatment, the three groups of IgG expression levels before treatment and compared, no obvious improvement (P> 0.05); after two courses of treatment, the three groups of IgG expression levels before treatment with varying degrees of comparison increase (P<0.05), but no significant difference in the groups (P> 0.05). At follow-up, IgG expression and treatment of traditional Chinese medicine treatment group compared to the statistically significant increase in the former, and with simple acupuncture group significantly different (P<0.05).IgM comparison, the three groups in a course of treatment, two courses, at follow-up compared with before treatment IgM expression no significant difference (P> 0.05).Tip:For improving the liver and spleen deficiency biochemical indices in patients with chronic fatigue syndrome aspect, after two courses of treatment, acupuncture+auricular point sticking, simple acupuncture and traditional Chinese medicine can enhance the activity of NK cells and IgG expression levels of the patient, but long-term effect is not ideal. The difference between groups respect, NK cell activity than simply upgrading traditional Chinese medicine acupuncture significantly. To improve aspects of IgM expression patients, three groups of poor treatment.⑦ Comparison of the three groups overall efficacy of the treatment of chronic fatigue syndromeAfter three treatment groups by rank sum test, H= 17.09, P= 0.039, statistically significant (P<0.05), acupuncture and auricular - plaster + group, the total effective rate of 87.10% among the three groups, the simple acupuncture group, the total effective rate of 68.74%, treatment group total effective rate was 70.97%. Tip:For improving the liver and spleen deficiency efficacy in patients with chronic fatigue syndrome general aspect, auricular acupuncture+paste treatment pressure than simple acupuncture and Chinese medicine treatment group significantly.ConelusionBased on the above findings, acupuncture combined with auricular point sticking group, simple acupuncture group, the treatment group of liver and spleen deficiency of chronic fatigue syndrome have varying degrees of clinical efficacy. Liver and spleen deficiency clinical symptoms in each group had some improvement, especially for tired body fatigue, depression, worry, insomnia, dreams, loss of appetite, abdominal distention and other symptoms better effect. And three types of therapy for patients with chronic fatigue syndrome, fatigue, the symptoms of depression, health status are effective, and can enhance the activity of NK cells and IgG expression levels in patients. About Fatigue Rating Scale aspect (FAI), poor short-term efficacy simple acupuncture and traditional Chinese medicine, and acupuncture is better to combine auricular-plaster therapy on the maintenance of temporal efficacy; Self-Rating Depression Scale (SDS) connection, acupuncture + auricular -plaster therapy for long-term efficacy is superior to simple acupuncture, traditional Chinese medicine to improve liver spleen chronic fatigue syndrome the patients with depressive symptoms was not obvious; health survey (SF-36) connection, in remission body pain, improve quality of life, acupuncture and auricular - plaster + is superior to traditional Chinese medicine. As for the social function of patients with respect, three treatments of little use. The overall effect of the comparison result of chronic fatigue syndrome Showing: for improving liver and spleen deficiency efficacy in patients with chronic fatigue syndrome general aspect, auricular acupuncture + paste treatment pressure than simple acupuncture and Chinese medicine treatment group significantly. In summary, the combination of acupuncture and auricular plaster therapy without side effects, simple treatment, a significant effect and lasting effect, worthy of promotion.