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1、World Journal of Acupuncture-Moxibustion (WJAM),Vol.20,No.4,30th Dec.20101Clinical ResearchEffect of acupuncture at Bihu (百会 GV 20) and Zsnl (足三里 ST 36) on the level of serum inflammatory cytokines in patients with depression* 针刺百会、足三里对抑郁症患者血清炎性细胞因子水平的影 响* SUN Hua (孙 华)1 ZHAO Hui (赵 慧)2 ZHANG Jie (张
2、 捷)3 BAO Fei (包 飞)1 WEI Jing (魏 镜)1 WANG Dao-hai (王道海)1 ZHANG Yun-xiang (张云祥)1 1.Department of TCM,Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730,China；2.Institute of Basic Medical Sciences, Chinese Acadamy of Medical Sciences and School of Basic Medicine,
3、 Peking Union Medical College；3.Beijing Hospital of TCM（1.中国医学科学院北京协和医学院北京协和医院中医科,北京100730,中国；2.中国医学科学院基础医学研究所 北京协和医学院基础学院; 3.北京中医医院） ABSTRACT Objective To investigate the immunologic mechanism of acupuncture at Bihu(百会 GV 20) and Zsnl(足三里 ST 36) for treatment of depression. Methods Eighty-four case
4、s of depression patients were randomly divided into an electroacupuncture observation group(group A), an electroacupuncture control group(group B) and a medication control group(group C), 28 cases in each group. Bihu(百会 GV 20) and Zsnl(足三里 ST 36) were used in the group A; Tichng (太冲 LR 3), Snynjio (
5、三阴交 SP 6), Nigun (内关 PC 6) and Shnmn (神门 HT 7) were used in the group B; and the group C was treated with oral administration of Fluoxetine. The scores of Hamilton Depression Scale (HAMD) were tested and the level of serum interleukin 1(IL-1), interleukin 6 (IL-6), and tumor necrosis factor (TNF-) w
6、ere measured by Enzyme Linked Immunosorbent Assay （ELISA）before and after treatment. Results Their scores of HAMD were obviously decreased after treatment in three groups(all P0.05), indicating comparability. METHODSEA observation group Selection of points: Bihu (百会 GV 20) and Zsnl (足三里 ST 36). Oper
7、ation: after routine sterilization, Hwato brand sterile needle, 0.30 mm40 mm, was used to puncture Bihu (百会 GV 20) World Journal of Acupuncture-Moxibustion (WJAM),Vol.20,No.4,30th Dec.20104transversely and manipulated with rotation technique. Another needle was inserted 3 mm lateral to Bihu (百会 GV 2
8、0) obliquely toward Bihu (百会 GV 20). After arrival of qi, Full-function Electric Pulsating Apparatus of Great Wall Brand (KWD-808) was used, 3 Hz in frequency, continuous wave, tolerable intensity. Zsnl (足三里 ST 36) was punctured bilaterally and stimulated with electric pulsating apparatus. The needl
9、es were retained for 30 min. The treatment was given once daily for 5 days a week and free for 2 days in weekend.EA control groupSelection of points: Tichng (太冲 LR 3), Snynjio (三阴交 SP 6), Nigun (内关 PC 6) and Shnmn (神门 HT 7). Operation: after routine sterilization, Hwato brand sterile needle, 0.30 mm
10、40 mm, was used to puncture conventionally. After arrival of qi, Full-function Electric Pulsating Apparatus of Great Wall Brand (KWD-808 ) was used at Tichng (太冲 LR 3) and Snynjio (三阴交 SP 6), 3 Hz in frequency, continuous wave, tolerable intensity. The needles were retained for 30 min. The treatment
11、 was given once daily for 5 days a week and free for 2 days in weekend.Medication control group Oral administration of Fluoxetine (Eli Lilly and Company, USA, 20 mg each tablet), 20 mg, once a day.The efficacy was observed after continuous treatment of 6 weeks among 3 groups.Indices and methods of d
12、etectionFor all the patients, from 8:00 am to 9:00 am, 5 mL blood was collected from elbow vein and the serum was centrifuged with centrifuge at low temperature, 4, 2 000 r/min for 20 min. After packing separately, the sample was stored in freezing at -80. ELISA was adopted to detect the levels of I
13、L-1, IL-6 and TNF- in serum before treatment and at the endpoint of trial (the end of 6-week treatment) separately.Criteria of efficacy judgment HAMD of edition 24 items was adopted for the detection before treatment, after 2 and 4 weeks treatment as well as at the endpoint of trial (the end of 6-we
14、ek treatment) separately and the statistical management was performed. Meanwhile, the efficacy assessment of HAMD score reducing rate was applied. The score reducing rate = (total score before treatment total score after treatment) total score before treatment 100%, the result was expressed with per
15、centage. Cured: HAMD score reducing rate 75%. Markedly effective: HAMD score reducing rate50% and 0.05), indicating comparability. Compared with the value before treatment and after 2-week treatment, HADM total scores in EA observation group (t=11.01), EA control group (t=6.95) and medication contro
16、l group (t=4.09) decreased significantly (all P0.05). Moreover, there were no statistical differences in IL-1, IL-6 and TNF- levels after treatment in comparison Table 2 Comparison of efficacy among three groups of depression patients Cases (%)GroupsPatientsCuredMarkedly effectiveEffectiveFailedEA observation 282 (7.1)19 (67.9)5 (17.9)2 (7.1)EA control 280 (0)16 (57.1)12
