Abstracted & Translated by
Bob Flaws, L.Ac., FNAAOM (), FRCHM

On pages 115-116 of issue #4, 2008 of Si Chuan Zhong Yi (Sichuan Chinese Medicine), Lin Gui-ji and Sun Peng-fei published an article titled “Observations on the Clinical Therapeutic Effects of Acupuncture-moxibustion in the Treatmeent of Perimenopausal Depression.” A summary of this article is presented below.

Cohort description:

Eighty women with perimenopausal depression were randomly divided into two groups – a treatment group and a comparison group. All these women met the diagnostic criteria for unipolar depression found in the CCMD-2 (the Chinese equivalent of the DSM-IV). They also all met the criteria for menopausal syndrome found in Zhong Yao Xin Yao Lin Chuang Yan Jiu Zhi Dao Yuan Ze (Reference Principles for the Clinical Research of Chinese Medicinals & New Medicines). All had a menopausal syndrome score of three points or more, all were 45-55 years of age, and all had a Hamilton Depression Rating (HAMD) score of 20 points or more and a Hamilton Anxiety Rating (HAMA) score of seven points or more. Exclusion criteria included such things as gynecological malignant tumors, secondary depression, and having taken allergy-type medicines, psychiatric medicines, or cardiovascular medicine within the last half year.

Treatment method:

All members of the comparison group were administered 20 milligrams of Prozac once per day for six continuous weeks. All members of the treatment group were administered a combination of acupuncture and moxibustion also for six weeks. In terms of the acupuncture, the points chosen consisted of:

Bai Hui (GV 20)
Yin Tang (M-HN-3)
Nei Guan (Per 6)
Shen Men (Ht 7)
He Gu (LI 4)
Tai Chong (Liv 3)
San Yin Jiao (Sp 6)
Tai Xi (Ki 3)

All these points were needled bilaterally. After disinfection of the skin in the areas of these points, 1.5 inch needles were inserted into the above points. Bai Hui was needled transversely to a depth of 0.5 inches and then was stimulated with small amplitude twisting and turning. Yin Tang was needled with the tip of the needle pointing downward along with small amplitude twisting and turning. The rest of the points were needled perpendicularly to a depth of approximately one inch. Twisting and turning hand technique was also used to stimulate these points with even supplementing-even draining hand technique. Strong stimulation was applied and the needle sensations induced included soreness, tingling, and distention. The needles were all retained for 20 minutes per treatment and were restimulated 2-3 times during this period.

Indirect moxubstion on top of salt was also performed at Shen Que (CV 8). Approximately three cones were burned each time during the time that the needles were retained. Acupuncture-moxibustion was doen once per day with five days equaling one course of treatment. Then a two day rest was given followed by the next course of treatment for a total of six courses in six weeks. In other words, treatment was given Monday-Friday each week for six weeks.

Study outcomes:

Study outcomes were based on changes in HAMD scores. A decrease in the HAMD score of 75% or more was considered a cure. A decrease of 50% or more was considered a marked effect, and a decrease of 25% or more was considered some effect. A decrease of less than 25% was considered as no effect. The following table shows the outcomes of the two groups based on these criteria.

Basically there was no significant statistical difference in the outcomes in these two groups. Thus the above acupuncture-moxibustion regime was as effective as the Prozac for treating perimenopausal depression.

Discussion:

While there was no significant difference in therapeutic outcomes between the Prozac and the acupuncture-moxibustion, Prozac can cause nausea, vomiting, and heart rhythm irregularities. In addition, Prozac can cause disturbance of the sex hormones, with long-term administration possibly leading to uterine cancer, breast cancer, and ovarian cancer as well as venous thrombosis. Acupuncture-moxibustion, on the other hand, is essentially without adverse reactions. Therefore, although both achieve the same therapeutic effects, acupuncture-moxibustion is preferable since it is without side effects.

Basically, the Chinese authors of this article say that their acupuncture-moxibustion protocol works by balancing yin and yang, nourishing and supplementing the liver and kidneys, coursing and freeing the flow of the qi mechanism, quieting the spirit and resolving depression.

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