Study On The Effect Of The Combination Of Acupuncture And Antidepressant On The Mechanisms Of The Hippocampus Neurons Signal Transduction Of Depressed Model Rats And Clinical Research

Keywords: depression; electric-acupuncture; fluoxetine; cAMP; CREB[Purpose]: 1. Demonstrate the curative effect of the combination of acupuncture treatmentin combination with antidepressant and analyze and summarize the benefits of the treatmentmethod 2. Explore the signal transduction mechanism of the hippocampal neuronsprotection and the neurogenesis promotion of depressive model rats when treated byelectric-acupuncture, fluoxetine, and combination of both treatment approaches. 3. Explorethe pathogenetic knowledge of depression within the area of traditional Chinese medicine:based in the review of the differentiation of the symptoms and signs according to thepathological patterns of the disorders of depression by identify the location of the disorderand target the cause of depression, continue by analyzing which method will be theappropriate one to apply and propose the rationale explanation behind the choice of thecombination therapeutic regiment for the treatment of depression.[Methods]: Purposel: (1) Summarize recent clinical and experimental studies andliteratures about the treatment of electric-acupuncture and the combinationelectric-acupuncture and anti -depressants. (2) Clinical research involves 45 patientsdivided into an observation group and control group unilaterally blind randomly. Thecontrol group was only treated by SSRIs anti-depressants and the observation groupreceived acupuncture as well as anti-depressants. The choice of points was mainly from theDu channel and the manipulations were based on fortifying method. Both groups weretreated for 6 weeks. The evaluations were done by the HAMD score at the onset of thetreatment as well as the first, second, fourth and sixth weeks. The differences wereevaluated by T-test the scores of two groups. The clinical therapeutic effects were evaluated on the reduction of the basis of chi square rating scale of the HAMD score. Purpose 2: (1)The overview of medical literatures explaining the function and the importance of signaltransduction in the neurobiological mechanisms of hippocampus neurons injury andneurogenesis condition during depression. Analyze the effects of antidepressant (fluoxetine)in the transduction of the post-acceptor signal and observe the situs in the signal oftransduction of the treatment in the combination treatment of acupuncture and anti--depressant. (2) Experimental research: After replicated the model, and divided thedepressed rat into the electric-acupuncture group and fluoxetine group. Evaluate thecombination group and fluoxenie group according to ethological scores by observing theweight of model rats, open-field behavior scores, sacchar consumption within 24hours, anddensity of cAMP, CREB, BDNF in hippocampus when treated by different therapy at day 7and day 21. Analyze the data within each therapy groups through F-test and compared withnormal group. Purpose 3: (1) Statistical analysis were done on the type of syndromefactor’s frequency in all literatures about depression differentiation of symptoms and signsand rules of entrails differentiation of symptoms and signs about depression and elementarypathogenesis were evaluated to remove the pathological nature. (2) Summarize the methodsof differentiation of symptoms and signs about depression. (3) Analyze the theory of the"brain in relation to the mind". (4) Discuss the relationship between the brain and internalorgans from the view of the theory of ascend and descend.[Result]: Purpose 1: (1) The literature overview indicated the treatment of combinationacupuncture and antidepressant could have three purposes:①improve the effect ofsymptoms such as insomnia and weight-loss better than the single antidepressant treatment;②reduce the dosage of antidepressant.③redeem the delay of the effect of theantidepressant since electro-acupuncture also has an anti-depression curative effect. (2)Clinical research result: After the first week of treatment, HAMD total scores, and anxiety,body weight, emotional and intellectual blockage, insomnia factors of the observationgroup improved faster than the control group and increased during the following 4 weeks.Only the cognition factor had no obvious difference when compared with the control group(P＞0.05). According to the HAMD score, there was an obvious difference between the twogroups. The observation group had better results according to the HAMD score whencompared with the control group (P＜0.05). Purpose 2: (1) Hippocampal neurons damagedand neurogenesis blocked occur in depressive disorder. Down-regulation BDNF expressionis the key point. The pharmaceutical effects of antidepressant contribute to the post-receptor signal transduction mechanism adaptability regulation after the increase of density ofmonoamine transmitter in synaptic cleft. Path of cAMP-CREB is a critical link which madethe mediate BDNG expressions increased. (2) The weight of model rats, open-fieldbehavior scores, sacchar consumption within 24 hours all increased in the combinationtreatment of electro-acupuncture with antidepressant and the controlled group with nosignificant difference (P＞0.05).The density of cAMP within 7days which have nodifference with controlled group (P＞0.05 ) however, after 21 days of treatment, it increasedin the three groups with no difference existing among them (P＞0.05). Average optical ofCREB and BDNF descended in hippocampal CA3 and dentatus gyrus(DG) area ofdepressive model rats. Only the average optical of CREB and BDNF of the CA3 or DGarea of the combination group ascended to the normal level when treated in 7days to 21 days.Purpose 3: (1) Statistical analysis was effectuated on the syndrome factor’s frequencyinvolved in the differentiation of symptoms and signs in the depression syndrome.Stagnation of liver-Qi and correlated type of syndrome is the only excessive syndrome witha high frequency and occurs in the early period. Other types of syndrome are all deficiencysyndrome. The disorders of qi are based on the pathogenesis of depression. (2) Basicpathological nature of depression is asthenia syndrome. (3) The location of the syndromeof depression is in brain and is closely related with the internal organs. The differentiationof the signs and symptoms of depressions and the treatment should affect three aspects:functional disorder of the brain and internal organs and the disharmony between the brainand internal organs. (4) Yang deficient is the principle aspect of the differentiation of thesyndrome of depression.[Conclusion]: 1. The combination of electro-acupuncture and fluoxetine group andcontrolled groups can both regulate the hippocampal signal transduction pathway ofdepressive model rats. However, the combination treatment is the most effective one.2. InChinese medicine: The disorders of qi are the basis pathogenesis of depression. The basicpathological nature of depression is asthenia syndrome. Yang deficient is the principalaspect of the differentiation of the depressive symptoms and signs of the brain.3. It’seffective and necessary when depression is treated by the combination of acupuncture andwestern medicine. Acupuncture treatment carries out a multitarget multipath clinical effect.It can redeem antidepressant efficiently, treat depression entirety, generically, andsystematically.