ACUPUNCTURE IN THE TREATMENT OF DEPRESSION

描述(申请人摘要)： 令人遗憾的是，抑郁症是一种人们经常寻求的常见疾病 替代(非西方)治疗，也许是因为传统的 治疗并不能持续提供持久的缓解。一项初步研究 (Allen，Schnyer，&Hitt，1996)建议，针灸，一种流行但 研究不足的中医药替代疗法，认为 作为治疗抑郁症的足够承诺，有必要进行更大规模的 临床试验。我们建议测试针灸设计的疗效 特指通过将其与针灸疗法进行比较来治疗抑郁症 旨在治疗不属于抑郁症状的症状 图片和等待名单控制组。因为癌症的复发和复发 抑郁症是相当常见的，我们也建议评估临床 参与者在治疗结束后18个月内的状态，以检查 无论治疗剂量预测复发的可能性还是 复发。在这项双盲随机临床试验的第一阶段 试验，150名符合DSM-IV严重抑郁症标准的男性和女性将 被随机分配到以下三种情况之一：(A)八周 专门针对抑郁症设计的针灸疗法；(B)为期八周的 治疗有效症状的非特异性针灸疗法 除抑郁外；(C)或等待名单控制条件。在…的末尾 在第一阶段，将使用盲法评估来比较治疗 从西方精神病学和中国精神病学的角度看影响 医药。在此阶段之后，所有参与者都将收到 治疗。因此，此试验性设计将解决以下问题 具体目的：(1)评价针灸治疗慢性阻塞性肺疾病的疗效 与等待列表控制和非特定控制相关的严重抑郁 针灸疗法想要治疗不属于 (2)评价针灸治疗抑郁症的临床意义。 评估针灸笔记治疗抑郁症的疗效 不仅针对抑郁症，也针对社交和工作领域的功能；以及 (3)检查是否存在剂量-反应关系，以使 特定针灸治疗的次数与 治疗期间病情缓解，或复发或复发的可能性 在治疗之后。次要目标是：(1)评估 针灸治疗使用根据原理得出的结果的衡量标准 (2)研究西医与中医药学的衔接 从临床意义上讲，以中医药为基础的结果指标； (3)确定能量模式的变化是否中介了 西方定义的抑郁症严重程度；以及(4)探讨患者和 历史变量预测针灸治疗的反应。

DESCRIPTION (Applicant's Abstract): Depression is an unfortunately common condition for which people often seek alternative (non-western) treatments, perhaps because conventional treatments do not consistently provide lasting relief. A pilot study (Allen, Schnyer, & Hitt, 1996) suggests that acupuncture, a popular but under-researched alternative treatment derived from Chinese medicine, holds sufficient promise as a treatment for depression to warrant a larger-scale clinical trial. We propose to test the efficacy acupuncture designed specifically to treat depression by comparing it to acupuncture treatment designed to treat symptoms that are not part of the depressive symptom picture and to a wait list control group. Because relapse and recurrence of Major Depression are quite common, we also propose to assess the clinical status of participants for 18 months after treatment concludes, to examine whether the dose of treatment predicts the likelihood of relapse or recurrence. In the first phase of this double-blind randomized clinical trial, 150 men and women meeting DSM-IV criteria for Major Depression will be randomly assigned to one of three conditions: (a) eight weeks of acupuncture designed specifically to address depression; (b) eight weeks of nonspecific acupuncture treatments designed to treat valid symptom pattens other than depression; (c) or a waitlist control condition. At the end of this first phase, blind assessments will be used to compare treatment effects from the perspectives of both western psychiatry and Chinese medicine. After this phase, all participants will receive specific treatment. This experimental design will thus address the following specific aims: (1) to evaluate the efficacy of acupuncture treatments for Major Depression relative to both a waitlist control and to nonspecific acupuncture treatments desired to treat symptoms that are not part of depression; (2) to evaluate the clinical significance of acupuncture as a treatment for Major Depression by assessing the impact of acupuncture not only on depression but also on functioning in social and work arenas; and (3) to examine whether a dose-response relationship exists, such that the number of specific acupuncture treatments is related to the likelihood of remission during treatment, or the likelihood of recurrence or relapse following treatment. Secondary aims are: (1) to assess the efficacy of acupuncture treatments using measures of outcome derived from the principles of Chinese medicine; (2) to examine the convergence of western-based and Chinese-medicine-based outcome measures in terms of clinical significance; (3) to determine whether changes in energetic pattern mediate changes in western defined depression severity; and (4) to explore whether patient and history variables predict response to acupuncture treatments.