Efficacy Observation Of Percutaneous Auricular Vagus Nerve Stimulation In The Treatment Of Mild To Moderate Depression

Objective:To observe and compare the clinical efficacy and safety of taVNS and citalopram in the treatment of mild to moderate depression.Methods:This study adopted a randomized controlled trial and recruited patients with depression in the outpatient department of the Acupuncture Department of Huguosi Hospital from September 2018 to April 2019.36 patients were randomly divided into experimental group and control group according to the random number table,18 cases in each group.The experimental group was giventaVNS treatment,The dilatational wave with frequency of 20Hz was selected,and the patients were asked to adjust the intensity to be tolerable without pain.The patients were treated continuously for 5 days every week,with a rest of 2 days.The instrument was used for 30 minutes in the morning and evening of the treatment day;The control group was given oral citalopram treatment,10 mg on day 1-3,increased to 20 mg on day 4-7,and maintained at 40 mg after 8 days.The course of treatment is 8 weeks.After 0,2,4,6 and 8 weeks of treatment,17HAMD,SDS and 14HAMA were scored respectively.17HAMD was the main efficacy evaluation,while SDS and 14HAMA were the secondary efficacy evaluation.The adverse reactions were observed and recorded during the treatment.Results:1.Comparison of main therapeutic effectsThe 17HAMD scale scores of the two groups decreased to varying degrees after 2,4,6,and 8 weeks of treatment(P<0.05),and both groups showed a gradual downward trend with the extension of time,but there was no significant difference between the two groups at the same time point(P>0.05).After 8 weeks of treatment,the total effective rate of the experimental group was 88.89%,and that of the control group was 83.33%.There was no significant difference between the two groups after 8 weeks of treatment(P>0.05).Before treatment and 8 weeks after treatment,the scores of block,cognitive impairment,sleep disorder,anxiety and somatization decreased in both groups(P<0.05),and there was no significant difference in the scores of the above factors between the two groups after treatment(P>0.05),but there was no significant difference in the scores of body weight factor before and after treatment(P>0.05).These results indicate that both taVNS and citalopram can improve the blocking factor,cognitive disorder factor,sleep disorder factor,anxiety and somatization factor in patients with mild to moderate depression,but there is no difference in the degree of improvement between them.2.Comparison of secondary therapeutic effectsAfter 2,4,6 and 8 weeks of treatment,the SDS scale scores of the two groups decreased in varying degrees(P<0.05).The experimental group showed a gradual downward trend with the extension of time during the treatment,while the control group showed a gradual downward trend with the extension of time 6 weeks before the treatment,but increased in the 8th week.There was no significant difference in SDS score between the two groups at the same evaluation time points(P>0.05),so both of them could reduce the SDS score of patients with mild to moderate depression,indicating that both of them could improve the self depression of patients with mild to moderate depression,but there was no difference in the degree of reduction between them.After 2,4,6 and 8 weeks of treatment,the scores of 14HAMA scale decreased in different degrees in both groups(P<0.05),and both groups showed a gradual downward trend with the extension of time.There was no significant difference in 14HAMA score between the two groups at the same evaluation time points(P>0.05),so both of them could reduce the 14HAMA scale score of patients with mild to moderate depression,indicating that both of them could improve the anxiety level of patients with mild to moderate depression,but there was no difference between them.3.Comparison of adverse reaction rateThe adverse reaction rate of the experimental group was 0%(0/18),and that of the control group was 16.7%(3/18).There was no significant difference in the adverse reaction rate between the two groups(P>0.05),indicating that the two methods are both safe.Conclusion:Both transcutaneous auricular vagus nerve stimulation and citalopram can improve the degree of depression and anxiety in patients with mild to moderate depression.