| Depression is a common illness in the modern world.It has a high rate of repetition and suicides,the patients remain in a prolonged state of depressed situation with symptoms of low spirit,physical discomfort and sleeping disorder.Depression can be generalized in three aspects: low spirit,sharp drop in ability and some physical symptoms.Among the depression patients,there are 61.8%who start with the symptoms of sleeping disorder,only 1%of depression patients do not display sleeping disorder.31%of the medium to severe depression patients experience sleeping disorder.Sleeping disorder may worsen the depression and delay the recovery process.Thus,improvement of sleeping disorder is an advantage factor for alleviation and recovery of the depression patients.Sleeping disorder is a predictive factor of any depression relapse,it is also an important symptom for precaution and treatment of depression.Acupunctural treatment for depression involved many aspects such as nervous endocrine, nervous transmitter and its receptor,immunity function,nervous transmitting signals channel. Part of the research involved a different transmitter,and the balancing relation between different parts of the brain,some of the researches might even be keen to know that acupuncture treatment help protect the withering of the sea horse neuron.The research showed that the functional mechanism of depression treated by acupuncture involved multi mechanism and its processes. Furthermore,there are researches that initiate an interest in mechanisms such as the relation among the transmitters of the central nervous,the comparison of the regional tissue and its functions of the brain,comparing the same nervous transmitter located at the central nerve and the relation among the peripheral nerve.The research involved the selection of 5-HT SSRIs as an antidepressant to treat the depression patients cum sleeping disorder,that will help TCM upgrade the effective results in treating depression,seeking a wider clinical space for treatment,alleviate clinical effective results,reduce side effects of the medicine,so as to provide better ways for the treatment of depression.At present,SSRIs likes remains certain shortcomings of unconquerable difficulties, for example,the delay of effects,lots of side effects,the effects to both body and mental are limited,it takes 3 to 6 weeks to show the results,and the effective results is about 70%only.Due to all these problems,seeking non medicine treatment may lead to wider scope and of social significance. In summary,the combination of acupuncture and antidepressant treatment is of much significance to the development of acupunctural treatment.It combines the advantages of medicine and acupuncture,thus exploring a wider and new sphere in treating sickness with acupuncture.Clinically,combining acupuncture with antidepressant in treating depression sickness is more commonly adopted,as the benefits are also more apparent.Acupuncture can be applied in treating and precaution of the depression cum sleeping disorders patients in a long term basis,it will help improve sleep,prevent recurrences,and is a positive way for treatments of the sickness.[OBJECTIVES](1) Theoretical Research1.To confirm that depression is a western medical term.Although various symptoms of depression also manifested in several sickness by definition of TCM.So far,there is no sickness defined by TCM that equalizes the Western term of depression.2.To define sleeping disorder as sleeping at inappropriate times,addiction to sleep or insomnia.3.To explore the reasons that lead to depression and sleeping disorder in Western medical mechanism.4.To justify with statistics that Western treatment of depression produces slow and inconsistent results and are often accompanied by side effects.5.To compare the distinct characteristics between the holistic effects of acupuncture and the single response of Western medicine.6.To explore the guidance theory of "Brain is the house of vital spirit" as an advantage to treat depression cum sleeping disorders by acupuncture.7.To prove that selected acu-points along Du Channel produce results as effective as tricyclic antidepressant;the improvement of anxiety and physical symptoms are also much better by using the acupuncture treatment.(2) Clinical ResearchThis research explores the difference in mechanisms and curative effects of taking Selective Seretonine Reuptake Inhibitors(SSRIs) alone and combining with acupuncture-moxibustion in the treatment of depression cum sleeping disorders simultaneously.The control group underwent treatment by taking SSRIs alone while the experimental group underwent treatment that encompassed acupuncture-moxibustion and SSRIs.This study explores clinical effects of depression cum sleeping disorders as the mechanisms are examined to further develop the acupuncture treatment,raise clinical curative effects, alleviate side effects due to consumption of medicine and raise the quality of life for the patients.[METHODS](1) Theoretical Research1.To collect and assemble the documented data of treating depression cum sleeping disorder by TCM,by analyzing and summarizing the contents of the data.2.To collect and assemble the documented data of treating depression cum sleeping disorder by Western medicine,by analyzing and summarizing the contents of the data.3.To collect and assemble the documented data of treating depression cum sleeping disorder by TCM and Western medicine,by analyzing and summarizing the contents of the data.4.To summarize the above mentioned data,emphasizing the importance of combining acupuncture with medicine in treating depression cum sleeping disorders.(2) Clinical ResearchThe observation was based on 60 cases of depression patients(all diagnosed by psychiatrists) extracted from KONG's TCM Singapore and Yu Guo Chinese Clinic Singapore during the period from September 2006 to December 2008.They were randomly assigned to two groups,the drug only group under control group and acupuncture-drug combination group under treated group,30 cases each,with comparability of sickness and age.Both used SSRIs for treatment of depression-the treated group with additional acupuncture treatment at Yintang,Shenting,Dazhui,Fengchi,Shenmen,Sanyinjiao,and moxibustion of the Baihui, combined with other acupoints according to differentiation and related symptoms,and control group by drug only,without acupuncture-moxibustion.To visit the patients of both groups once every 2 weeks,6 weeks constitute a treatment cycle.Prior to treatment as well as at the end of 2nd and 10th week on treatment,the Hamilton Depression Rating Scale(HAMD), Pittsburgh Sleep Quality Index(PSQI),SDS,Asberg Side Effects Rating Scale(SERS) and Clinical General Impression Scale(CGI) are used to measure the curative effects of both of the groups through the changing rating scales of the instruments.[RESULTS](1) Theoretical Research 1.By using the acu-points of Du channel,there is an apparent increase in the activities of 5-HT energy neuron within rapheal nuclei,at the same time it will increase the quantity volume contained in the substantia nigra and hypothalamus etc.It also will improve the blood circulation of the brain,upgrading the ability of antioxidants and improve the memory function.2.Moxibustion of Baihui helps to regulate Ying and Yang,activate the brain and to tranquilize the heart.Moxibusting this acu-point helps to improve the blood circulation in the brain tissue and elasticity of the veins.Through the reflex of cerebral cortex,it helps to regulate the autonomic nervous systems.It also treats the sickness of nervous systems.Moxibusting Baihui will help to control the brain from excessive excitement,to recover balance and coordination the brain functions from disorganization.(2)Clinical ResearchUsing the HAMD rating scale,the acupuncture-drug group rated P＜0.01 in terms of before-after treatment conditions,whereas the drug-only group displayed only P＜0.05.This shows that although both treatment methods are effective,the acupuncture-drug group's condition improved much more significantly.During the second week of treatment,there was a difference of P＜0.05 in the two groups' conditions.During the tenth week of treatment,it appeared that there was no difference of improvement(P＞0.05) for both groups.Through the rating scale of HAMD,the effects of treatment showed no difference for both groups,though acupuncture combined group had earlier effects than that of the drug only group.Using the Pittsburgh Sleep Quality Index(PSQI),the acupuncture-drug group rated P＜0.01 in terms of before-after treatment conditions,whereas the drug-only group showed no difference with a rating of P＞0.05.Thus,it demonstrates that the acupuncture treatment is effective to the rating scale of PSQI for the depression patients with significant statistics purposes.During the second week of treatment,there was a difference of P＜0.05 in the two groups' conditions.This demonstrates that the acupuncture-drug group acquired results much faster than the drug-only group.Using the SDS scale,both groups displayed no difference(P＞0.05) in terms of beforeafter treatment,although there was a difference of P＜0.05 in the two groups' conditions during the second week.However,there was no difference(P＞0.05) in the two groups' conditions during the tenth week. Through the rating scale of SDS,the effects of treatments showed no difference for both groups,though acupuncture combined group had earlier effects than that of the drug only group.Using the Asberg Side Effects Rating Scale(SERS),both groups demonstrated no difference(P＞0.05) before and after treatments,thus it demonstrated that both of the groups do not have any significant improvement purposes to the rating scale of SERS.During the second week,as well as the tenth week of treatment,there was a significant difference of P＜0.01 between the two groups' conditions.On the SERS scale,these statistics demonstrated that the acupuncture-drug group acquired faster and better effects than the drug-only group.The severity of illness(SI) for both groups has no difference(P＞0.05).After ten weeks of treatment,the acupuncture-drug group showed better results than drug only group in regard to curative effects general index(GI),which has significant statistics purposes(P＜0.05);there is no difference in the Effects Index(P＞0.05).It demonstrated that combining acupuncture with drug has an affirmative curative effect on insomnia-depression.[CONCLUSIONS](1)Theoretical Research1.The advantages of curative effectiveness of acupuncture-antidepressant mainly showed in improving anxiety,sleeping disorder and physical symptoms.2.Acupuncture combining antidepressant compensate for the shortcomings of slow results of taking antidepressant alone and to reduce side effects from Western medicine;It is also clinically proven that the effective results are fast and the curative effective high.3.The foundation functions of acupuncture is to stimulate the patient's own endogenous regulatory mechanism,without the help from medicine,hence the absence of side effects.4.Documented data showed that the depression treated by acupuncture acquired 76.67%, The rate of effectiveness by acupuncture-drug combination was also apparently higher.5.Acupuncture can raise the function of monoaminenergic nervous system in the brain,increase the quantity volume contained in 5-HT,NE,DA of specific location of the brain,so as to improve the effective results of clinical symptoms of the depression patients.(2)Clinical Research1.Acupuncture-SSRIs combination for treatment of depression has an affirmative Curative effect;2.Acupuncture-drug combination for the treatment of depression could effectively raise clinical curative effects,reflected by the quick results,especially towards improving sleeping disorder and anxiety insomnia:,whereas the control group did not produce the same results at the same rate.3.Acupuncture-drug combination for the treatment of depression can reduce symptoms of sideeffects.
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