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Acupuncture Reduces Post-Stroke Depression, Restores Function

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Acupuncture Reduces Post-Stroke Depression, Restores Function

Shanghai University of Traditional Chinese Medicine researchers find acupuncture effective for the alleviation of post-stroke depression and the restoration of neurological functions. The research, conducted at the university’s Shuguang Affiliated Hospital, compared outcomes from two groups: acupuncture and control. Both groups received treatment according to the China Guidelines for Prevention and Treatment of Cerebrovascular Disease. This included medications to control blood pressure, improve cerebral circulation, reduce inflammation, promote neuronal regeneration, and for secondary complications such as respiratory infections and pressure sores. In addition, the acupuncture group received a pre-selected set of acupuncture points.

The incidence of depression in each group was also taken into consideration. At baseline, 22 patients in the acupuncture group and 24 in the control group were classified as suffering from depression. After one week of treatment, these figures fell to 17 and 22 respectively. After four weeks of treatment, just seven patients in the acupuncture group were classified as depressed compared with 20 patients in the control group (p<0.05).

Discussion
The outcomes of this study indicate that acupuncture reduces both the incidence and severity of post-stroke depression while simultaneously improving neurological recovery, and is more effective than usual care alone. Treatment may be more effective when administered as early as possible once cerebral bleeding has stopped and the patient is in a stable condition.

 

Reference:
Chen Aiwen, Gao Yuan, Wang Guantao, Li Jia, Shen Weidong (2018) “Effect of early acupuncture on post-stroke depression: a randomized controlled trial” Chinese Acupuncture and Moxibustion Vol.38 (11) pp. 1141-1144.

Source: HealthCMi

 

Acupuncture and Drugs Found Equally Effective For Mild Depression

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Acupuncture and Drugs Found Equally Effective For Mild Depression

 

Guangdong Province Traditional Chinese Medicine Hospital researchers find acupuncture with moxibustion produces similar positive patient outcomes rates as the drug paroxetine for treatment of mild to moderate depression. In the study, true acupuncture produced similar results as paroxetine (a selective serotonin reuptake inhibitor, SSRI) and significantly outperformed a sham acupuncture control group. A total of 105 patients met the eligibility criteria and were randomly assigned to three study groups (acupuncture, paroxetine, control).

The acupuncture group received an integrated acupuncture program of standard acupuncture, moxibustion, and intradermal needling. The acupoints GV20 (Baihui), MHN3 (Yintang), GV26 (Shuigou), PC6 (Neiguan), LI4 (Hegu), and LV3 (Taichong) were selected. Following disinfection, LI4 and LV3 were needled first. Size 0.35 × 25mm filiform needles were selected and inserted perpendicularly to a depth of 10–12mm. GV20 and Yintang were then needled obliquely at a 15 degree angle to a depth of 10–12mm. Finally, GV26 and PC6 were needled perpendicularly to a depth of 10–12mm. All needles were then uniformly manipulated to obtain deqi. Needles were retained for 30 minutes with mild reinforcing–reducing manipulation (Ping Bu Ping Xie) applied every 10 minutes (a total three manual simulation applications).

In addition to the above points, Yin Qi Gui Yuan abdominal acupuncture was used. This method employs the points CV12 (Zhongwan), CV10 (Xiawan), CV6 (Qihai), and CV4 (Guanyuan). With the patient in a prone position, needles were inserted perpendicularly to a depth of 10–12mm, without manually stimulating the needles to obtain deqi. Needles were retained for 30 minutes.

Moxibustion was applied to the Sihua (four flowers) points: BL17 (Geshu), BL19 (Danshu). Moxa cones were sized at 0.2cm in height with a bottom diameter of 0.1cm (approximately the size of a sesame seed) with a burning time of 2–3 seconds. A cotton swab was used to apply a small amount of Dieda Wanhua oil to the moxa bonding point. The moxa was then applied and ignited. Once the patient felt a hot sensation, the operator quickly removed the moxa by hand. Two moxa cones were burned on each point.

Following disinfection, granular intradermal needles were inserted with tweezers to the points BL15 (Xinshu) and BL18 (Ganshu). Needles were inserted subcutaneously toward the spine to a depth of 5–8mm with the needle handle retained on the skin surface. The needles were secured with medical tape, using 0.5 × 0.5cm tape under the needle handle and 1.5 × 1.5cm tape on top. Needles were retained for 2–3 days until the next treatment. Treatment was administered twice per week, at intervals of 48 hours or more. Four weeks made up one course of treatment and two courses were administered, for a total of 16 treatments.

For patients in the drug group, paroxetine hydrochloride was orally administered with a starting dose of 20mg per day. After 2–3 weeks, the dosage was increased according to the each patient’s individual reactions. Dosage was increased by 10mg weekly to a maximum of 50mg per day over the course of eight weeks. The patients were treated for a total of eight weeks.

 

Results
The results were evaluated using the Hamilton Rating Scale for Depression (HAMD-17) to assess depressive symptoms, and Short Form 36 (SF-36) to assess overall quality of life. SF-36 rates eight different parameters: physical function (PF), physical limitations (RP), physical pain (BP), general health (GH), vitality (VT), social function (RE), mental health (MH). Assessments were carried out at four, eight, and twelve weeks following treatment.

 

Summary
The total effective rate of the three groups was compared. The integrated acupuncture and moxibustion group had an 84.3% total effective rate, the paroxetine group had an 86% total effective rate, and the sham acupuncture and moxibustion group had a 42% total effective rate. The difference between the integrated group and paroxetine group was not statistically significant (P>0.05) and both were better than the sham acupuncture placebo control (P<0.001).

There were fewer adverse effects in the true acupuncture integrated group, with one case of a hematoma and four of blistering due to moxibustion. In the paroxetine group there were four cases of palpitations, seven of dry mouth, two cases of loss of appetite, four of dizziness, two of constipation, and one patient cut his finger (possibly due to dizziness caused by the drug). Paroxetine and acupuncture produced similar positive patient outcome rates and acupuncture had a significantly lower adverse effect rate. [1]

The results indicate that acupuncture is a reasonable treatment option for patients with mild to moderate depression. To learn more, please contact local therapists or licensed acupuncturists to learn more about treatment options.

 

Related Research
In related research, acupuncture was found effective for alleviating insomnia and depression. [2] Ye et al. find acupuncture 90% effective for improving total sleep duration and sleep quality for patients with depression. Alleviation of insomnia directly correlated to improvements in the mental and physical health of the study participants. Acupuncture treatments lowered relapse rates and produced similar clinical results as antidepressant medication without any adverse effects.

Two groups were compared: group one received acupuncture and group two received oral mirtazapine pills (an antidepressant medication). Acupuncture achieved a 90% total effective rate and mirtazapine achieved a 92.5% total effective rate. Insomnia due to depression (termed depressive insomnia in Traditional Chinese Medicine), is characterized by difficulty falling asleep, dream disturbed sleep, general insomnia, and severe emotional fluctuations. Additional symptoms include major depression, loss of appetite, fatigue, chest tightness, manic states, hypochondriac region pain, and excessive pessimism.

Hamilton Depression Rating Scale (HAM-D) results measured significant improvements in both the acupuncture and drug therapy study groups. The acupuncture group demonstrated a 9.7% HAM-D score improvement within one month of treatment and by 36.2% within three months. The drug group demonstrated a HAM-D score improvement of 15.9% within one month and 32.5% within three months. The acupuncture group achieved a 90% total effective rate and the drug therapy group achieved a 92.5% total effective rate.

Regarding study design, the drug therapy group received 20mg doses of mirtazapine tablets orally at a rate of once per day, for three months. The acupuncture group received acupuncture treatments every other day. An exception was made for extreme cases of depressive insomnia—these patients received acupuncture at a rate of once per day. Treatments were applied over a three month period.

Acupuncture group patients received an acupuncture point prescription comprised of a set of primary acupuncture points for all patients and a set of secondary acupuncture points for specific differential diagnostic conditions. The primary acupoints were the following:

  • Shenmen (HT7)
  • Sanyinjiao (SP6)
  • Yintang (MHN3)

For patients with liver qi stagnation, Taichong (LV3) and Yanglingquan (GB34) were added. For patients with heart and spleen related disorders, Zusanli (ST36) and Jianshi (PC5) were added. Manual acupuncture stimulation was applied to elicit deqi followed by a 30 minute needle retention time. During the needle retention period, manual needle stimulation was applied every 10 minutes using lifting and thrusting techniques for sedation and tonification. The researchers conclude that acupuncture significantly improves sleep time and quality while also improving the overall mental and physical health of patients. Acupuncture did not cause any adverse effects and significantly reduced the relapse rate for depressive insomnia.

 

Notes
[1] Wu Guanghai, Fu Wenbin. “Clinical Study on Improving the Quality of Life of Patients with Mild to Moderate Depression by Acupuncture and Moxibustion” Guangzhou University of Chinese Medicine, R246.6. (2017).
[2] Ye GC & Yan H. (2014). Therapeutic Observation of Acupuncture for Depressive Insomnia. Shanghai Journal of Acupuncture and Moxibustion. 55(6).

Source: HealthCMi

 

IT’S SPRING!! Beat those winter blues!

Get to the Point of Relief: Acupuncture in Seasonal Affective Disorder

 

Do you suffer from depression that only seems to occur during the cold and dreary winter months? If that is the case then you will find that you are often looking for the right remedy to the problem. No one likes to be burdened with depression even when the situation is temporary. Taking medication to relieve the symptoms can be beneficial, but they also tend to have serious side effects that can occur. That is why so many people turn to natural remedies for their symptoms. The winter blues might not be curable, but it is certainly more manageable with the right treatment.

Acupuncture is one of the all natural treatments that people may choose to help fight the problems that stem from a depression disorder. Acupuncture itself is an ancient Chinese remedy that has been used for generations to treat a variety of medical conditions. Those who utilize acupuncture for their health problems swear by the results that it offers.

The art of acupuncture involves using special points located around the body. These points are believed to be centralized to locations that tackle various health issues. There are points geared towards everything from a headache to depression. When undergoing acupuncture, needles will be inserted gently into these special points on the body so that relief can be acquired. The goal is that the acupuncture will treat the symptoms that you are experiencing in an all natural way.

The good part of using acupuncture to treat SAD is that it offers the relief you need without the side effects that come with prescription medications. Those medications can induce sleeping, behavior, eating  and sexual changes in those who take them. Some may even find that their depression gets worse. A few will become suicidal simply from taking the medication. This is not to say that medications do not work. In many people they become the sole source of relief for conditions like Seasonal Affective Disorder. However, those that suffer from side effects would much prefer to have tried an all natural treatment.

The hard part of choosing acupuncture is the cost. In most cases, this method of treatment is not recognized by insurance companies. This means that the entire cost of treatment for any condition, including the winter blues, is going to be paid for out of your pocket. Those who stick primarily to treatment options like acupuncture will find the results to be worth the cost. You simply have to prepare for the cost before seeking treatment.

Acupuncture is a viable alternative for those that want natural treatment options for beating the winter blues. Finding the right person for the job is as simple as asking around. Get references from those that utilize acupuncture and then check into what the services are going to cost. SAD does not have to mean the end of living a decent life. Treating the symptoms will make it far easier to cope with and the use of remedies like acupuncture will allow treatment without the risk.

Research shows Acupuncture helps Depression

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New lab experiments reveal acupuncture has antidepressant effects.

An examination of brain cells following acupuncture treatments uncovered important mechanisms by which acupuncture exerts its antidepressant effects. Acupuncture caused the regulation of brain cell activity associated with therapeutic results.

The researchers discovered that acupuncture exhibits regulatory effects on special brain cells in the hippocampus called neural progenitor cells (NPs). These cells contribute to the maintenance of the brain and spinal cord. A major function of NPs is in the replacement of damaged or dead cells. Injured cells activate NPs to differentiate into the target tissue. NPs vary slightly from stem cells because they are more specific and tend to differentiate into a specific type of cell.

The researchers cite numerous studies showing “that acupuncture is an effective remedy for depression and it may be as effective as antidepressant drugs.” They also note that electro-acupuncture increases neurogenesis in the hippocampus as do SSRIs (serotonin reuptake inhibitors), a class of antidepressant medications. Neurogenesis is the process by which neurons are generated from neural stem and progenitor cells.

The focus of this new study was to map the precise cellular mechanisms responsible for the antidepressant effects of electro-acupuncture. Prior research shows that electro-acupuncture restores proliferation of NPs in the brain when impaired by depression. The focus of this study was a more precise measurement of specific biochemical actions.

The findings revealed that electro-acupuncture applied to acupuncture points DU20 (Baihui) and GB34 (Yanglingquan) on a stress induced rat model group regulated two major subclasses of NPs, quiescent neural progenitors (QNPs) and amplifying neural progenitors (ANPs). The researchers demonstrated that chronic unpredictable stress induced behaviors associated with depression and anxiety in the rat model group. The stress caused cell death of QNPs and “impaired the proliferation of both ANPs and QNPs” in the group. Electro-acupuncture “alleviated depressive-like and anxiety-like behaviors in the rat” group, restored proliferation of ANPs and limited cell death of QNPs. This caused a preservation of NPs in the hippocampus.

The researchers note, “The present study revealed that chronic EA (electro-acupuncture) treatment exerted significant antidepressant effects in a rat model of depression. Further, the mechanisms underlying antidepressant effects of EA were associated with preserving the QNPs from apoptosis and ameliorating the impaired ANPs proliferation in hippocampus.” They note that the work conclusively demonstrates that electroacupuncture is “beneficial to the division of hippocampal NPs.” Further, the researchers note that these findings are consistent with other investigations demonstrating that electro-acupuncture “promotes neurogenesis in different brain regions….”

The researchers note that NPs are important in hippocampal neurogenesis and that chronic induced stress decreases proliferation of NPs and manifests in declined neurogenesis. This decrease in the birth of new brain neurons is associated with both anxiety and depression. Electro-acupuncture exhibited the opposite effects of chronic induced stress by upregulating ANPs. The researchers suggest that this is an “underlying mechanism of antidepressant-like effects of EA (electro-acupuncture).”

About the Acupuncture Points
The acupuncture points used in the study have many indications for use in Traditional Chinese Medicine (TCM). Acupuncture point DU20 is a sea of marrow point indicating its benefit to the brain. Traditionally, it functions to clear the senses, calm the spirit, stabilize the ascendant Yang and to extinguish Liver wind.

Many of these terms require translation into biomedical usage for the modern reader. For example, Liver wind is a term referring to disorders involving seizures, shaking, involuntary movements and other types of internal medicine imbalances. To the outside observer unfamiliar with TCM hermeneutics, the term seems unusual. However, it refers to the ability of DU20 to treat certain types of biomedical disorders including types of hypertension and its sequela. DU20 is also used for the treatment of headaches, tinnitus, vertigo, dizziness, nasal congestion, coma, shock, mental disorders, prolapsed rectum and prolapsed uterus.

Acupuncture point GB34 is traditionally used for many types of indications including lower limb and knee pain or paralysis. It commonly used for benefitting the tendons, muscles. sinew and bones. It is also used to benefit both the liver and gallbladder.
References:
Yang, Liu, Na Yue, Xiaocang Zhua, Qiuqin Hana, Bin Lia, Qiong Liu, Gencheng Wu, and Jin Yu. “Electroacupuncture promotes proliferation of amplifying neural progenitors and preserves quiescent neural progenitors from apoptosis to alleviate depressive-like and anxiety-like behaviours.”

Goldman, Steven A., and Fraser Sim. “Neural progenitor cells of the adult brain.” In Novartis Found Symp, vol. 265, pp. 66-80. 2005.

Hsu, Yi-Chao, Don-Ching Lee, and Ing-Ming Chiu. “Neural stem cells, neural progenitors, and neurotrophic factors.” Cell transplantation 16, no. 2 (2007): 133-150.

– See more at: http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1244-acupuncturebraincellgb34du20#sthash.CMrHzjHE.dpuf

Acupuncture may relieve fatigue in Breast Cancer patients

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(Reuters Health) – Acupuncture may help relieve fatigue in women who’ve had breast cancer, a new UK study suggests.

http://www.reuters.com/article/2012/10/29/us-acupuncture-cancer-idUSBRE89S15420121029

Researchers found that women who attended six weekly acupuncture sessions had greater improvements in fatigue as well as anxiety, depression and quality of life, compared to those who only received educational materials.

But that still doesn’t prove it was the needles, themselves, that boosted women’s energy levels, they said. And one cancer and alternative medicine researcher not part of the study team said the acupuncture group only showed a “modest improvement in fatigue – it was not a very remarkable, strong effect.”

Still, acupuncture could be “well worth a try” for some people, Dr. Amit Sood, from the Mayo Clinic in Rochester, Minnesota, Reuters Health.

“Fatigue is the most common symptom for all cancer patients,” said Carol Enderlin, who has studied that topic at the University of Arkansas for Medical Sciences in Little Rock.

She said cancer and cancer treatments can cause chronic pain, psychological stress and anemia – a decrease in healthy red blood cells – all of which contribute to fatigue. In addition, people who are nauseated after chemo might not be getting the most nutritious diet for maintaining energy levels.

Enderlin, who also wasn’t involved in the new study, said acupuncture may help as an add-on therapy for women who’ve had their fatigue checked out by a doctor and tinkered with their physical activity and diet – but are still frequently tired.

Approximately one in eight women will be diagnosed with breast cancer at some point in her life.

For the new research, Alexander Molassiotis from the University of Manchester and his colleagues tracked 227 women with moderate or severe cancer-related fatigue treated with acupuncture and another 75 fatigued women who didn’t get acupuncture.

The women had all received chemotherapy for breast cancer in the five years before the study, and most had felt chronically tired for a year or more. Participants were given a booklet about cancer-related fatigue when they started the study.

The researchers found that after six weeks, general fatigue had dropped by almost four points on a 0-20 scale among women who had acupuncture, compared to a less than one-point decline in the comparison group. That is “mild to modest” improvement, according to Sood – not enough to allow someone who is stuck in bed to start walking, but maybe enough to get people who are too tired to exercise to start doing some activity.

Anxiety and depression scores, measured from 0-21, dropped by two additional points post-acupuncture, compared to scores in women given educational materials only. Emotional and physical well-being got a greater boost with acupuncture therapy as well, Molassiotis’s team found.

The researchers couldn’t tell how much of that benefit might have been due to the “placebo effect” – women who felt better because they expected to benefit from acupuncture.

In an ideal trial, participants would get either real or fake acupuncture, without knowing which. But it’s very hard to design a convincing but ineffective fake acupuncture treatment to use for comparison, researchers noted.

According to an editorial published with the study in the Journal of Clinical Oncology, close to one-third of cancer patients have persistent fatigue that may continue for years after treatment. Doctors typically encourage moderate exercise and talk therapy to improve their energy, wrote psychologist Julienne Bower, from the University of California, Los Angeles.

Still, she added, it’s unclear how well any therapies work over the long term in people with severe fatigue.

Enderlin said people who’ve been treated for cancer should make sure they’re not at high risk of bleeding or infection before considering acupuncture for fatigue.

But if they’re medically cleared, she said the alternative therapy “looks really intriguing.”

Enderlin recommended “maintaining activity to tolerance, unless there are other problems with that, good nutrition, getting adequate sleep, and if the fatigue continues, considering there might be an alternative that could complement (those things).”

SOURCE: bit.ly/gPtMdm Journal of Clinical Oncology, online October 29, 2012.