166 Journal of Traditional Chinese Medicine 2007; 27(3): 166-169

A Controlled Study on Treatment of Mental Depression by

Acupuncture plus TCM Medication
He Qingyong 何庆勇, Zhang Ji 张吉 & Tang Yuxiu 唐玉秀
Beijing University of Traditional Chinese Medicine, Beijing 100029, China

Objective: To evaluate the therapeutic effect and safety of acupuncture plus TCM medication for
treatment of mental depression. Method: 61 cases of mental depression were randomly divided into a
treatment group of 30 cases and a control group of 31 cases. The former group was treated by
acupuncture plus TCM medication, and the latter with TCM medication alone. The Hamilton Mental
Depression (HAMD) scoring system was adopted to evaluate the therapeutic effects, and the Treatment
Emergent Symptom Scale (TESS) was used to evaluate the adverse reactions. Results: The treatment
group was superior to the control group in the total effective effect (P<0.05), with a significant
difference in the HAMD score before and after treatment between the 2 groups (P<0.01). There were
marked differences in the reducing rate of HAMD score at the end of the second and sixth week of the
treatment between the 2 groups (P<0.05) and the difference was very obvious at the end of the fourth
week (P<0.01). No remarkable difference was found in adverse reactions between the 2 groups (P>0.05).
Conclusion: Acupuncture plus TCM medication may show satisfactory results for mental depression,
indicating that a synergic action may exist between acupuncture and TCM medication.

Mental depression is manifested by constant
hypoemotivity, less or no interest, lassitude,
distraction, declined thinking ability, insomnia,
early awaking, and with a suicidal tendency in
severe cases. There are 340 million mental
depression patients in the world with an incidence
about 5.6%. 1 Mental depression is caused by social
and psychological factors. It can be treated with
antidepressants, with good prognosis in some
patients, but no cure and with serious toxic side
effects for the others. We have treated the disorder
in the period from 2004-2006 with acupuncture plus
TCM medication, with satisfactory results reported
as follows.
General Data
61 cases of mental depression were randomly
divided into a treatment group and a control group.
Among the 30 cases in the treatment group were 14
males and 16 females, aged 19-63 years, 34.5±5.6
on the average, with the illness course from 7
months to 6 years, 3.25±1.78 on the average, and
the Hamilton Mental Depression (HAMD) score
23.57±3.21. Among the 31 cases in the control
group were 16 males and 15 females, aged 18-67
years, 32.1±6.9 on the average, with the illness
course from 6 months to 5 years, 3.19±1.53 on the
average, and the HAMD score 23.61±3.63. There
were no remarkable differences in age, sex, illness
course and HAMD score between the 2 groups
(P>0.05).
Diagnostic Criteria:
The Criteria for Diagnosing and Classifying
Psychonosema in China (revised version of the third
edition) (CCMD) was adopted. 2
Criteria for Inclusion:
The patients with hypoemotivity for over two weeks
and with 4 or more of the following 9 symptoms
were included: 1) loss of interest, 2) lassitude, 3)
psychonosema, 4) self underestimation, 5) declined
Journal of Traditional Chinese Medicine 2007; 27(3): 166-169
thinking ability, 6) suicidal tendency, 7) insomnia,
early awaking, or excessive sleep, 8) poor appetite,
obvious loss of weight, and 9) hyposexuality.
Criteria for Exclusion:
The patients with organic psychonosema or with
mental depression caused by psychological active
substance and non-addictive materials were
excluded.
Method of Treatment
1. For the control group: This group of patients took
only the Chinese herbal decoction. The recipe
consisted of Suan Zao Ren (酸枣仁 Semen Ziziphi
Spinosae) 12g, Yu Li Ren （郁李仁 Semen Pruni）
12g, Yuan Zhi (远志 Radix Polygalae) 12g, Bai Zi
Ren (柏子仁 Semen Biotae) 12g, Xiang Fu (香附
Rhizoma Cyperi) 12g, Yu Jin ( 郁 金 Radix
Curcumae) 12g, Long Gu (龙骨 Os Draconis) 30g,
Mu Li ( 牡 蛎 Concha Ostreae) 30g, Hu Po ( 琥 珀
Succinum) 25g, Chai Hu (柴胡 Radix Bupleuri) 12g,
Sheng Di Huang (生地黄 Radix Rehmanniae) 12g,
Huang Qin (黄芩 Radix Scutellariae) 12g, and Zhi
Gan Cao (炙甘草 Radix Glycyrrhizae Preparata) 6g.
Zhi Zi (栀子 Fructus Gardeniae) 12g and Long Dan
Cao (龙胆草 Radix Gentianae) 10g were added for
the patients with excessive liver fire, anxiety and
anger. Sheng Shi Gao (生石膏 Gypsum Fibrosum)
30g and Zhi Mu (知母 Rhizoma Anemarrhenae) 15g
were added for those with excessive heat in the
Yangming Channel, thirst, and vexation. Qing Pi
(青皮 Pericarpium Citri Reticulatae Viride) 12g and
Zhi Qiao ( 枳 壳 Fructus Aurantii) 12g were added
for those with abdominal distension and fullness
sensation. Yi Yi Ren ( 薏 苡 仁 Semen Coicis) 12g
and Gou Ji (狗脊 Rhizoma Cibotii) 12g were added
for lassitude. Mang Xiao ( 芒 硝 Natrii Sulfas) 12g
and Tao Ren (桃仁 Semen Persicae) 10g were added
for dry stool. Chao Yi Yi Ren ( 炒 薏 苡 仁 Semen
Coicis Preparata) 15g and Cang Zhu (苍术 Rhizoma
Score before treatment - score after treatment
The HAMD score-reducing rate =
Score before treatment
167
Atractylodis) 15g were added for loose stool. Zhen
Zhu Mu ( 珍 珠 母 Concha Margaritifera Usta) 12g
was added with the dosage of Suan Zao Ren 酸枣
仁（Semen Ziziphi Spinosae）increased to 20g for
insomnia. Fu ling (茯苓 Poria) 10g, Bai Zhu (白术
Rhizoma Atractylodis Macrocephalae) 10g and
Shan Yao ( 山 药 Rhizoma Dioscoreae) 10g were
added for poor appetite. Yin Yang Huo （淫羊藿
Herba Epimedii） 12g, Tu Si Zi (菟丝子 Semen
Cuscutae) 12g and Gou Qi Zi (枸杞子 Fructus Lycii)
10g were added for hyposexuality. One dose of the
decoction was orally taken in twice a day, each in
the morning and evening, for 6 weeks before
evaluation of the therapeutic effects.
2. For the treatment group: The patients in this
group were treated by acupuncture and TCM
mediation. Acupuncture was performed at the points
of Baihui (GV 20), Shenting (GV 24), Yintang
(EX-HN3), Renzhong (GV-26), Anmian (Extra),
Shanzhong (CV 17), Neiguan (PC 6), Daling (PC 7),
Shenmen (HT 7), and Taichong (LR 3). After
routine sterilization, the filiform needles (0.3mm ×
40mm) were rapidly inserted into the points, with
the uniform reinforcing-reducing manipulation
given after the needling sensation was induced. The
needles were retained for 20 minutes, during which
the manipulation was performed once every 10
minutes mainly with the twirling method. The
treatment was given once every other day. Oral
administration of the Chinese herbal decoction was
the same as that in the control group. The
therapeutic effects were evaluated after a 6-week
treatment.
Evaluation of the Effects:
The HAMD scoring system was adopted to evaluate
the effect at the end of the first, second, fourth and
sixth week of treatment with the following formula:
×100%
168 Journal of Traditional Chinese Medicine 2007; 27(3): 166-169

Statistical Analysis: score was reduced by ≥50%. Improved: The HAMD

The data in the present study were expressed as
mean ± standard difference with the SAS6. 12
software used for data-processing. χ2 test was done
for comparing the therapeutic effects, and t test for
the measurement data.
Criteria for Therapeutic Effects
Cured: The HAMD score was reduced by ≥75% or
the score was <7. Markedly effective: The HAMD
score-reducing rate was ≥25%. Failed: The HAMD
score-reducing rate was <25%.
Results of Treatment
1. Comparison of the therapeutic effects between
the two groups (see Table 1):
2. Comparison of the HAMD score before and after
treatment between the two groups (see Table 2 and
Table 3):

Table 1. The therapeutic results in the 2 groups.

Group n Cured Markedly effective Improved Failed Total effective rate(%)

Treatment group 30 9(30.0%) 11(36.7%) 6(20.0%) 4(13.3%) 86.7*
Control group 31 4(12.9%) 7(22.6%) 13(41.9%) 7(22.6%) 77.4
Note: As compared with the control group, * χ 2=4.79, P=0.03, with an obvious difference in the total
effective rate between the 2 groups (P<0.05).

Table 2. Comparison of the HAMD score before and after treatment in the 2 groups.

After treatment
Group n Before treatment
First week Second week Fourth week Sixth week
Treatment group 30 23.57±3.21 19.90±3.93** 15.93±4.07** 12.37±4.18** 10.30±4.38**
Control group 31 23.61±3.63 21.23±3.51** 17.65±4.22** 15.23±4.41** 12.68±4.88**

Table 3. Comparison of the HAMD score-reducing rate after treatment between the 2 groups.

After treatment (the HAMD score-reducing rate,%)

Group n
First week Second week Fourth week Sixth week
Treatment group 30 15.69±10.72 32.74±13.32* 47.47±15.29** 56.07±16.93*
Control group 31 13.41±16.81 24.11±17.41 34.15±18.23 46.03±18.97

As shown in Table 2, all the HAMD scores at the
end of the first, second, fourth and sixth week of
treatment differ greatly from that before treatment
in the 2 groups ( ** P<0.001). Table 3 showed that
the mean HAMD score-reducing rate was >25%
(improved) at the end of the second week of
treatment in the treatment group and at the end of
the fourth week in both the two groups; and that it
was >50% (markedly effective) at the end of the
sixth week in the treatment group. There was an
obvious difference in the mean HAMD
score-reducing rate at the end of the second week of
treatment between the two groups (* P<0.05), with
a very obvious difference at the end of the fourth
week (** P<0.01) and with an obvious difference at
the end of the sixth week (* P<0.05).
3. Analysis of the adverse reactions (see Table 4):

Table 4. Comparison of the incidence of the adverse reactions between the 2 groups.
Journal of Traditional Chinese Medicine 2007; 27(3): 166-169 169

Dry Gastrointestinal
Group n mouth Dizziness Constipation Blurred vision discomfort Lethargy
Treatment group 30 3(10%) 1(3.3%) 1(3.3%) 1(3.3%) 2(6.7%) 3(10%)
Control group 31 4(12.9%) 1(3.2%) 2(6.5%) 2(6.5%) 3(9.7%) 2(6.5%)
As compared with the control group, there was no obvious difference in the incidence of adverse reactions
between the 2 groups (P>0.05).

Discussion difference in the HAMD score-reducing rate at the

end of the second and sixth week of treatment
We have used acupuncture plus TCM medication to
between the 2 groups (P<0.05), with a very obvious
treat mental depression. Acupuncture at Baihui (GV
difference at the end of the fourth week (P<0.01),
20) and Shenting (GV 24) can regulate qi in the Du
indicating that acupuncture plus TCM medication
channel, restore consciousness, induce resuscitation,
was superior to TCM medication alone in
activate heart-yang and improve intelligence.
improving the clinical symptoms of mental
Acupuncture at Yintang (EX-HN3) can regulate yin
depression. Both the two groups showed less
and yang. Acupuncture at Renzhong (GV26) can
adverse reactions with no obvious difference
activate mentality and regulate the internal organs.
(P>0.05). The present study also indicated that a
Acupuncture at Neiguan (PC 6), Daling (PC 7) and
synergic action may exist between acupuncture and
Shenmen (HT 7) can regulate and improve
TCM medication, that is, 1) acupuncture can
functional activities of the heart. Acupuncture at
regulate qi and blood in internal organs and
Taichong (LR 3), Anmian (Extra) and Shanzhong
strengthen the spleen, thus possibly enabling the
(CV 17) can relieve the depressed liver-qi and
body to enhance the absorption and utilization of
tranquilize the mind. Xiang Fu ( 香 附 Rhizoma
the Chinese drugs, and 2) Oral administration of the
Cyperi), Yu Jin ( 郁 金 Radix Curcumae) and Chai
Chinese drugs can replenish qi and balance yin and
Hu ( 柴 胡 Radix Bupleuri) of the medication can
yang, thus possibly enabling the body to enhance
soothe the liver and promote qi flow. Suan Zao Ren
the active reaction to acupuncture. Nevertheless, the
(酸枣仁 Semen Ziziphi Spinosae), Yu Li Ren （郁
mechanism needs to be further studied so as to
李 仁 Semen Pruni ） , Yuan Zhi ( 远 志 Radix
provide a scientific basis for the treatment of mental
Polygalae), Bai Zi Ren ( 柏 子 仁 Semen Biotae),
depression with acupuncture plus TCM mediation
Long Gu (龙骨 Os Draconis), Mu Li (牡蛎 Concha
and for the enhancement of therapeutic effects.
Ostreae) and Hu Po ( 琥 珀 Succinum) can
tranquilize the mind and relieve mental depression.
References
The present study showed that there was an obvious
1. 罗和春, 孙玉国. 抑郁症. 北京: 农村读物出版社
difference in the total effective rate between the 2
2000; 56.
groups (P<0.05), indicating that the effect in the
2. 中华医学会精神科分会. CCMD-3 中国精神障碍分类
treatment group was superior to that in the control
与诊断标准. 第 3 版. 济南: 山东科学技术出版社
group. Both the two groups differed greatly in
2001; 4.
HAMD score before and after treatment (P<0.001),
3. 汪向东, 王希林, 马弘. 心理卫生评定量表手册(增
indicating that both the therapies can remarkably
订版). 北京: 中国心理卫生杂志社 1999; 220~223.
improved the clinical symptoms of mental
depression. However, there was an obvious (Translated by Duan Shumin 段树民)