He Yu-feng, Guo Rui-lan, He Yi-jun

Rehabilitation Department, Zhongshan Hospital of Traditional Chinese Medicine, Guangdong 528400, China

Clinical Observation on Acupuncture Therapy for Depression at Perimenopause

He Yu-feng, Guo Rui-lan, He Yi-jun

Rehabilitation Department, Zhongshan Hospital of Traditional Chinese Medicine, Guangdong 528400, China

Objective: To observe the effect of acupuncture therapy on depression at perimenopause.

Methods: Sixty patients who had depression at perimenopause were divided into a treatment group and a control group, thirty patients in each group. Patients in the treatment group were treated with Bo’s abdominal acupuncture,while patients in the control group were treated with Prozac. Hamilton depression scale (HAMD) and Beck depression inventory (BDI) were observed before and after treatment to evaluate the clinical effect.

Results: Depression levels decreased after treatments in both groups (P＜0.05). There were no statistical differences between the two groups in the total effective rate and BDI.

Conclusion: Abdominal acupuncture has similar effect in treating depression at perimenopause with Prozac..

Acupuncture Therapy; Perimenopause Syndrome; Climacteric Syndrome; Complications; Depression

Depression at perimenopause is a common mental disorder in women’s perimenopause. At this time, women may change both physically and mentally. The physiological change may appear before mental symptoms and become worse with the development of disease and seriously affect the patient’s work and life. We chose abdominal acupuncture to treat the disease and evaluated the clinical effect of this therapy with Hamilton depression scale (HAMD) and Beck depression inventory (BDI). The report is showed as follows.

1 Clinical Materials

1.1 Diagnostic criteria

We diagnosed the disease according to the diagnostic criteria of depression in the third edition ofChinese Classification and Diagnostic Criteria of Mental Disorders(CCMD-3)[1]combining with HAMD of 21 items[2](total scores of the former 17 items ＞17).

Those who in the low mood and have at least four items of the following nine items: Loss of interest or pleasure; fatigue, tiredness and loss of energy; slowed thinking or agitation; low self-esteem, self-blame and feeling of guilty; trouble thinking or distractibility; frequent thoughts of death or history of suicidal or self-inflicting behaviors; sleep disturbances such as insomnia, early waking up or excessive sleeping; decreased appetite and weight loss; and reduced sex drive.

1.2 Exclusion criteria

Organic mental disorders, or depression caused by psychoactive substances and non-additive substances; those who don’t adapt acupuncture, such as multiple organ failure, hemophilia and etc.

1.3 General data

Sixty females with depression at perimenopause were outpatients from the Neurology Department of our hospital. We divided them into an acupuncture group and a control group with the random number generated by PEMS 3.1. Thirty cases were in the acupuncture group, aged from 45 to 59 years old, with an average of (51.8±4.2) years old; disease duration were 1 to 6 years, with an average of (30.6±10.1) months; 21 cases of them were menopause, while 9 cases were not but disorder. Thirty cases were in the control group, aged from 44 to 57 years old, with an average of (48.9±3.8) years old; disease durations were 1 to 7 years, with an average of (26.3±9.6) months; 19 cases of them were natural menopause, while 11 cases were not (one case was normal and 10 cases were in disorder). There were no statistical differences in age, disease duration, the number of menopausal and premenopausal patients (P＞0.05). The two groups were comparable.

2 Treatment Methods

2.1 Acupuncture group

Acupoints: Yinqiguiyuan [Zhongwan (CV 12), Xiawan (CV 10), Guanyuan (CV 4), Qihai (CV 6)], Qixue (KI 13), Qipang [0.5 cun beside Qihai (CV 6)][3].

Operation: We chose disposable acupuncture needles of 0.22 mm in diameter and 30-40 mm in length. We should avoid the pores and arteries when needling. Then we punctured in strict accordance with three-step acupuncture manipulation of abdominal acupuncture and took a 3-5 min rest to wait for needle sensation. After 3-5 min, we twisted the needles to produce the needling sensation and promote qi. After another 5 min, we manipulated needles again to strengthen the needling sensation, and make the sensation to radiate. The treatment sustained for 30 min everyday.

2.2 Control group

The patients took Prozac 20 mg per time, once a day.

We observed the effects of the two groups after 8-week treatment.

3 Results

3.1 Criteria of therapeutic efficacy

The scores of HAMD and BDI were evaluated before and after treatment. We chose HAMD reduction rate to evaluate the effect.

HAMD reduction rate = (HAMD score before treatment – HAMD score after treatment) ÷ HAMD score before treatment × 100%.

Cure: HAMD reduction rate≥75%.

Significant progress: HAMD reduction rate≥50%, but ＜75%.

Improvement: HAMD reduction rate≥25%, but＜50%.

Invalid: HAMD reduction rate ＜25%.

3.2 Treatment results

There was no statistical difference in total effective rate between the two groups (P＞0.05), (table 1).

BDI scores were processed according to patients’condition levels (severe, moderate, mild, no depression or very slight). After treatment, BDI scores became lower in both group by the Rank-sum test (P＜0.05). It illustrated that the degrees of depression were significantly improved after treatment. However, There was no statistical difference in BDI score between the two groups (P＞0.05). It showed that these two therapies had equivalent effects (table 2).

Table 1. Comparison of effects between the two groups (case)

Table 2. Comparison of BDI scores between the two groups (case)

4 Experience

Depression at perimenopause is thought to be‘depression syndrome’, ‘hysterin’, ‘lily disease’ in traditional Chinese medicine. It is mainly caused by kidney deficiency, and involves the heart, liver and spleen[4-8]. Abdominal acupuncture could adjust visceral balance by stimulating abdominal and other specific acupoints. It could help our bodies gradually come to a stable condition and treat our diseases. It reflects the principle of ‘treating disease to its origin’ in traditional Chinese medicine on the basis of syndrome differentiation. We chose Yinqiguiyuan [Zhongwan (CV 12), Xiawan (CV 10), Guanyuan (CV 4), Qihai (CV 6)], Qixue (KI 13), Qipang [0.5 cun beside Qihai (CV 6)] in Bo’s abdominal acupuncture to regulate functional activities of qi, so we could achieve our goals to treat depression at perimenopause[9-11]. The acupuncture effects are thought to be the same as Prozac by HAMD and BDI evaluation.

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[9] Chen YY, Wang YJ, Huang Y. Observation on therapeutic effects of abdominal acupuncture plus body acupuncture for moderate depression. J Acupunct Tuina Sci, 2012, 10(1): 14-17.

[10] Wang DG, Zhang FL, Yu WJ, Wang B. Observation on the efficacy of abdominal acupuncture plus Chinese herbal medicine in treating hyperlipidemia. Shanghai Zhenjiu Zazhi, 2008, 27(8): 13-14.

[11] Hu ZC, Wu YC, Wang NH. Clinical study on acupuncture treatment of post-stroke depression in recent ten years. J Acupunct Tuina Sci, 2011, 9(5): 324-330.

Translator: Ni Wen-ting

R246.6

A

Date: May 8, 2013

Author: He Yu-feng, physician.

E-mail: zsszyy@21cn.net