Is adjunctive treatment with medication of liver-soothing-oriented method beneficial for depression after cerebrovascular accident?: A PRISMA-compliant meta-analysis.

BACKGROUND: Adjunctive treatment with medication of liver-soothing-oriented method (MLSM) is one of the most commonly used approaches for subjects with depression after cerebrovascular accident (DCVA) in China. The purpose of this meta-analysis was to evaluate the outcome of MLSM treatment in subjects with DCVA using relevant published literature. METHODS: The PubMed, Cochrane Library, Embase, Chinese databases of China National Knowledge Infrastructure, WanFang, Sinomed, and VIP were used to collect all publications until March 2016. Randomized controlled trials comparing treatments with and without MLSM for subjects with DCVA were included. The quality of each publication was assessed based on the recent Handbook (5.1 version) for Cochrane Reviewers. Cochrane Collaboration's software RevMan 5.3 software was applied for data analysis. RESULTS: Thirty studies, including 2599 cases, were identified and collected. Adjunctive treatment with MLSM noticeably enhanced total effective rates (odds ratio 3.76; 95% confidence interval [CI] 2.92-4.85, I = 0%, P = 0.96) in comparison to non-MLSM conventional pharmacotherapy. Compared to non-MLSM treatment, the changes of Hamilton Depression Scale in adjunctive treatment with MLSM, respectively, decreased and showed beneficial effects after 3 weeks (weighted mean difference [WMD] -4.83; 95% CI -6.82 to -2.83; I = 86%, P < 0.001), 4 weeks (WMD -4.20; 95% CI -5.06 to -3.33; I = 78%, P < 0.001), 6 weeks (WMD -3.36; 95% CI -4.05 to -2.68; I = 54%, P = 0.02), 8 weeks (WMD -4.83; 95% CI -5.62 to -4.04; I = 73%, P < 0.001), and 12 weeks (WMD -2.88; 95% CI -4.09 to -1.67; I = 58%, P = 0.09). As for changes in inflammatory cytokine levels, adjunctive treatment with MLSM was associated with a significant decrease in tumor necrosis factor-α, IL-6, and interleukin-1ß levels in comparison to non-MLSM treatment. Moreover, there were positive effects on score changes for National Institute of Health Stroke Scale, activities of daily living, Hamilton Anxiety Scale, Modified Edinburgh Scandinavian Stroke Scale, and Self-Rating Anxiety Scale. No serious adverse events were reported. CONCLUSION: MLSM appears to improve symptoms of depressive disorders, enhance immediate responses, and the quality of life in subjects with DCVA. The positive action of MLSM might be potentially connected with its immunoregulating effects. More prospective trials with strict design and larger sample sizes are warranted to clarify its effectiveness and safety.

Depressive neurosis treated by acupuncture for regulating the liver--a report of 176 cases.

OBJECTIVE: To observe therapeutic effect of acupuncture for regulating the liver on depressive neurosis. METHODS: In a multi-center randomized controlled trial, 440 patients were divided into 3 groups: Acupuncture group for regulating the liver (Acup., 176 cases) was treated by acupuncture at Siguan Points, i.e., bilateral Hegu (LI 4) and Taichong (LR 3), Baihui (GV 20) and Yintang (EX-HN3) plus ear-acupuncture, Prozac group (P., 176 cases) by oral administration of Prozac, and Non-acupoint needling group (NAN, 88 cases) by acupuncture at non-acupoints as acupuncture placebo. Self-rating Depression Scale (SDS) was examined before treatment, and one month, two and three months after treatment respectively to evaluate therapeutic effect, and Rating Scale for Side Effects (SERS) was used to evaluate the safety. RESULTS: After one month of treatment, SDS scores in Acup. Group were significantly lower than that in P. Group (P < 0.05) and than that in NAN Group (P < 0.01), and SDS scores in P. Group were lower than that in NAN Group (P < 0.05), showing the SDS scores in Acup. Group < P. Group < NAN Group. After 2 months of treatment, SDS scores in Acup. Group were also significantly lower than that in P. Group (P < 0.01) and than that in NAN Group (P < 0.01), and SDS scores in P. Group were also lower than that in NAN Group (P < 0.05), showing the SDS scores in Acup. Group 0.05), showing the SERS scores in Acup. Group < NAN Group < P. Group. No side effect was found in Acup. and NAN groups. CONCLUSION: The therapeutic effect of acupuncture on depressive neurosis is better than or similar to that of Prozac but with less side effect.

Clinical research on abdominal acupuncture plus conventional acupuncture for knee osteoarthritis.

OBJECTIVE: To probe the therapeutic effect of abdominal acupuncture plus conventional acupuncture on knee osteoarthritis. METHODS: PEMS3.1 software was used. The 105 patients with knee osteoarthritis were randomly divided into an abdominal acupuncture group, a conventional acupuncture group and a combined group (abdominal acupuncture plus conventional acupuncture). For the abdominal acupuncture group, the abdominal acupuncture was performed at Zhongwan (CV 12), Guanyuan (CV 4), Wailing (ST 26), Daheng (SP 15), Lower Rheumatism point and Qipang with needles retained for 30 minutes. For the conventional acupuncture group, the acupuncture was practiced at Neixiyan (EX-LE4) and Dubi (ST 35) of the affected limb, Yanglingquan (GB 34), Liangqiu (ST 34), Xuehai (SP 10) and Xiyangguan (GB 33). For the combined group, both methods were applied. Treatment was given once a day, 6 times a week, for 4 weeks. Lysholm knee scoring scale was used to score the functions of knee before and after treatment. RESULTS: Of 35 cases in the abdominal acupuncture group, 8 cases were remarkably relieved, 10 cases relieved, 14 cases improved, and 3 cases failed, the total effective rate was 91.4%. Of 35 cases in the conventional acupuncture group, 7 cases were remarkably relieved, 8 cases relieved, 16 cases improved, and 4 cases failed, the total effective rate was 88.6%. Of 35 cases in the combined group, 13 cases were remarkably relieved, 16 cases relieved, 5 cases improved, and 1 cases failed, the total effective rate was 97.1%. There was a remarkable difference in the effect among 3 groups (P < 0.05). The difference in scores of Lysholm knee scoring scale for knee joint after treatment among 3 groups was very significant (P < 0.01). CONCLUSION: Abdominal acupuncture has reliable effect for knee osteoarthritis and it has the synergized function when combined with conventional acupuncture.

[Acupuncture for treatment of depressive neurosis: a multi-center randomized controlled study].

OBJECTIVE: To observe the clinical therapeutic effect of acupuncture on depressive neurosis. METHODS: With a multi-center randomized controlled study, 440 cases were randomly divided into an acupuncture group, a prozac group, a non-acupoint needling group. In the acupuncture group, Hegu (LI 4) and Taichong (LR 3) were selected, and the Prozac group were treated with administration of 20 mg/d and the non-acupoint needling group were treated with needling the points deviating from the acupoints. The therapeutic effect was evaluated by HAMD score reduction rate, and Asberg's anti-depressant side-effect rating scale (SERS) and severe adverse reaction were used for safety evaluation, and the data were analyzed with ITT. RESULTS: The total effective rate was 86. 4% in the acupuncture group, which was better than 59.1% in the non-acupoint needling group and 72.7% in the prozac group; HAMD score in the acupuncture group was similar to that in the Prozac group, which was better than that in the non-acupoint needling group; the SERS scores in the acupuncture group and the non-acupoint needling group were significantly lower than that in the Prozac group, with no severe side-effects found for acupuncture. CONCLUSION: Acupuncture is an effective and safe therapy for depressive neurosis; therapeutic effect of acupuncture on depressive neurosis possibly is better than or similar to that of Prozac, but with less side-effects.

[Randomized controlled study on picking therapy for treatment of cervical spondylosis].

OBJECTIVE: To use randomized controlled clinical research method to assess therapeutic effect of picking therapy on cervical spondylosis. METHODS: One hundred and fifty-eight cases were randomly divided into a picking therapy group (n=56), a routine acupuncture group (n=55) and a local anesthesia group (n=47). They were treated respectively with picking therapy, routine acupuncture and local anesthesia at Jing bailao (EX HN 15), Dazhui (GV 14), Jianjing (GB 21), etc. Brief McGill Pain Questionaire was used for score, which was combined with clinical symptoms and signs to analyze the therapeutic effect. RESULTS: The cured rate was 57.1% in the picking therapy group, better than 23.6% in the acupuncture group and 14.9% in the local anesthesia group (P < 0.01), and adverse reaction was basically not found in the picking therapy group. CONCLUSION: Picking therapy is a highly effective and safe therapy for cervical spondylosis.