| [Purpose]This research explores the mechanisms and effects of acupuncture combined with Selective Serotonin Reuptake Inhibitor (SSRIS) on the treatment of depression through theories study, clinical observation of curative effect and laboratory animal experiment Based on the importance of the brain in occurrences and treatment of depression, the study also proposes the "fortify brain and regulate mind" therapy method and its relating differentiation. It provides clinical data and theories as a roadmap for clinical treatment. Through the study of "fortify brain and regulate mind" therapy, it objectively reflects the mechanisms of TCM in treating depression, broadening treatment possibilities, provides better clinical results and reduces drug side-effects.[Methods]In order to systematically observe the curative effect of acupuncture, when combined with SSRIs in the treatment of depression, and to explore the mechanisms involved, this study is divided into three parts: theories research, clinical research and laboratory experimentThe theories research is done through review of a vast literature, both from TCM and modem medicine, to describe the etiology, pathology, diagnosis, treatment and current research on depression. It provides the foundation for clinical and laboratory researches.The clinic research observes 66 cases of depression patients, randomly divided into acupuncture-drug combination group (36) and drug only group (30). The 2 groups both use SSRIs for treatment of depression. The acupuncture-drug combination group uses "fortify brain and regulate mind" points which are: Baihui (DU20), Shenting (DU24), Yintang (EX), Neiguan(PC6), Sanymjiao (SP6), combined with other points according to differentiation and related symptoms. The treatment is applied 5 times per week. 6 weeks constitute a treatment cycle. Prior to treatment as well as 1,2,4 and 6 weeks into treatment, the Hamilton Depression Rating Scale (HAMD), the Clinical General Impression Scale (CGI) and the Treatment Emergent Symptoms Scale (TESS) are used to measure the curative effect Changes in scale total scores and different factor scores, and differences in side-effect symptoms for both treatment group and control group are noted. The peripheral blood content of monoamine transmitter for patients in bom groups are compared prior and after treatments.The animal experiment study combines stimulation and separated maintenance, classical methods for replicating depressed rat models. There were 60 experimental rats, randomly separated into 6 groups, 10 per group - they are: control, model, per os, fluoxetine, acupuncture and acupuncture-drug combined group. After 21 days, model group is decapitated and dissected. Fluoxetme group is given fluoxetme 1.8mg/kg dissolved in 2ml of saline solution. Acupuncturegroup is given acupuncture treatment - using: Baihui (DU20 ), Shenting (DU24), Neiguan (PC6),Sanyinjiao (SP6); Acupuncture-drug group is given acupuncture treatment and orally administeredfluoxetine 1.8mg/kg saline solution. Control and per os group are both given oral administration of saline solution. All groups are observed for behavioral changes and using electro chemical methods to examine and compare hypothalamus, hippocampus, striatum and frontal lobe for the amount of monoamine transmitters such as norepinephrine (NE), serotonin (5-hydroxvtrytamine, 5-HT), dopamine (DA) and their metabolites.[Results]1, Theories research: Through research of modern medicine and TCM regarding the etiology, pathology and treatment of depression, this study raises existing questions, providing a solid foundation for effective treatment methods.2, Clinical research: The result indicates mere is no clear difference in marked effective rate through CGI for both acupuncture-drug combined group and drug only group. However, there is significant difference in HAMD total score and different factor scores. There is no difference between 2 groups in the first week, but significant change of anxiety/somatization has been shown in the acupuncture-dru...
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