The effect of acupuncture on depression and its correlation with metabolic alterations: A randomized controlled trial.
The effect of acupuncture on depression and its correlation with metabolic alterations: A randomized controlled trial.
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针刺对抑郁症的影响及其与代谢改变的相关性：一项随机对照试验。
DOI：
10.1097/md.0000000000022752
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发表时间：
2020-10-23
期刊：
影响因子：
1.6
通讯作者：
Xu S
中科院分区：
文献类型：
--
作者：
Li W;Sun M;Yin X;Lao L;Kuang Z;Xu S
电针治疗具有抗抑郁作用，电针与抗抑郁药合用，其作用可维持较长时间。但电针联合基于代谢的抗抑郁药的疗效尚处于初步观察阶段，有待进一步研究。将60例中度抑郁症患者按1：1的比例分为电针组（电针+抗抑郁药）和对照组（单纯服用抗抑郁药）。电针治疗每周3次，连续8周，随访4周。采用汉密尔顿抑郁量表（HAMD）分别于治疗前、治疗4周、治疗8周、治疗12周评定抑郁情绪。采用气相色谱-质谱联用仪（GC-MS）分析治疗前后晨尿中抑郁症及电针治疗相关代谢指标的变化。与对照组相比，电针组在治疗第4周（16.89 ± 5.74 vs 25.58 ± 7.03，P <0.001）、第8周（9.59 ± 5.13 vs 25.04 ± 7.49，P <0.001）和第12周（11.07 ± 6.85 vs 27.25 ± 7.14，P <0.001）的HAMD抑郁症状改善更明显。 电针治疗前后尿中特异性代谢产物的显著差异为丙二酸（脂肪酸生物合成）、半胱氨酸（谷氨酸代谢）、谷胱甘肽（谷氨酸代谢）、色氨酸（色氨酸代谢）、脯氨酸（谷氨酸代谢）和N-乙酰基-5-羟色胺。这些代谢物参与色氨酸代谢、谷氨酸代谢和脂肪酸生物合成。电针结合抗抑郁药治疗在改善抑郁症状方面比单独使用抗抑郁药更有效。EA可能通过影响色氨酸代谢、谷氨酸代谢和脂肪酸生物合成来治疗抑郁症。中国临床试验注册中心：ChiCTR-2000030786。
Electroacupuncture (EA) treatment has antidepressant effect and when patients were treated with EA and antidepressants, the effect could be maintained for a longer time. However, the effect of EA combined with antidepressants based on metabolism is still in the initial observation stage, which requires further research. A total of 60 patients with moderate depression were assigned into 2 groups at a ratio of 1:1, the EA group (receiving EA and antidepressants) and the control group (taking antidepressants only) in this randomized controlled pilot trial. The EA treatment was performed 3 times a week for 8 consecutive weeks and then follow up for 4 weeks. The patients’ depressive mood was measured by the Hamilton Depression scale (HAMD) at baseline, week 4, week 8 and week 12. Before and after 8-week treatment, morning urine samples from all patients were analyzed by the gas chromatography–mass spectrometry (GC–MS) to find possible metabolic markers of depression and of EA treatment related changes. Compared with the control group, the EA group showed more significant improvements in depressive symptoms measured by HAMD at week 4 (16.89 ± 5.74 vs 25.58 ± 7.03, P < .001), week 8 (9.59 ± 5.13 vs 25.04 ± 7.49, P < .001) and week 12 (11.07 ± 6.85 vs 27.25 ± 7.14, P < .001). The significant differences in urinary specific metabolites before and after EA treatment were malonic acid (fatty acid biosynthesis), cysteine (glutamate metabolism), glutathione (glutamate metabolism), tryptophan (tryptophan metabolism), proline (glutamate metabolism), and N-acetyl-5-hydroxytryptamine. These metabolites are involved in tryptophan metabolism, glutamate metabolism, and fatty acid biosynthesis. EA treatment combined with antidepressants is more effective in improving depressive symptoms than antidepressants alone. EA may treat depression by acting on tryptophan metabolism, glutamate metabolism, and fatty acid biosynthesis. Chinese Clinical Trial Registry: ChiCTR-2000030786.