Antidepressant Effect Of Acupuncture On Auricular Branch Of Vagus Nerve(ABVN) Combined With Medicine:A Random Control Clinic Research

Objectives:To observe the effects of acupuncture on auricular branch of vagus nerve(ABVN)for behavioral changes and serum levels of pro-inflammatory cytokines in depressive patients.To explore the underlying mechanism of the anti-depressive effects of auricular acupuncture and thus enlighten clinical acupuncture treatment for depression.Methods:All the patients in this study were enrolled from the Medical Psychology Department of Nanjing Brain Hospital.After numbered by the sequence,all the patients were randomized into 2 groups:auricular acupuncture + medicine(group A)and medicine only(group B)with 30 and 23 patients,respectively.Both groups were administered with antidepressants(SSRIs and SNRIs)and tranquillizers to safely control depression.Group A was combined with auricular acupuncture on ABVN and each session lasted for 4h,once per day,5 times per week.The whole treatment course was 2 weeks.The patients’ conditions were evaluated by HAMD-17 and venous blood was collected before/after treatments.Serum levels of CRP、IL-1、IL-6 and TNF-a were detected by ELISA.All the scale scores and serum levels of pro-inflammatory cytokines of both groups were compared after the course.Results:(1)Clinical efficacy:Both obvious curative rate and effective rate of group A is significantly higher than group B(P<0.01);(2)Behavioral changes:Group A significantly decreased HAMD-17 total scores and its four factors(anxiety/somatization,sleep disorders,weight loss and retardation)(P<0.01);compared with group B,group A significantly decreased HAMD-17 total scores and fators of anxiety/somatization and sleep disorders(P<0.01);(3)Serum levels of pro-inflammatory cytokines:neither of the two groups changed serum levels of CRP、IL-1、IL-6 and TNF-a with significance(P>0.05);(4)Correlation of pro-inflammatory cytokines with depression:The change rate of IL-6 exhibited medium correlation with score-reducing rate of HAMD-17 total scores(P<0.01),along with that of factor scores of anxiety/somatization,retardation and sleep disorders(P<0.05);while the change rate of TNF-a was strongly correlated with score-reducing rate of HAMD-17 total scores and factor scores of anxiety/somatization and retardation(P<0.01),and was moderately correlated with score-reducing rate of weight loss and sleep disorders(P<0.01).Conclusion:(1)Auricular acupuncture on AB’VN combined with antidepressants achieves better efficacy than antidepressants alone in two weeks.(2)Using antidepressants alone or in combination with auricular acupuncture on ABVN can reduce the total scores of HAMD and the scores of its 4 factors(except cognitive disorder),and the latter is better at improving the total scores of HAMD and the scores of anxiety/somatization and sleep disorder.(3)Peripheral pro-inflammatory cytokines like IL-6 and TNF-αmay have positive correlation with the severity of depressive disorder,especially symptoms related to anxiety/somatization and sleep disorder.(4)Neither 2 week-treatment of antidepressants alone nor in combination with auricular acupuncture on ABVN would lead to significant changes of relative peripheral pro-inflammatory cytokines.