TREND AND ISSUE IN COMPLEMENTARY CARE (ACUPUNCTURE)

“Effect of Acupuncture on Chronic Pain with Depression: A Systematic Review”

MEMBERS OF GROUP : 6

I MADE WIDHI ANTARA 18.321.2870

NI KADEK DINDA PUTRI MARICHI 18.321.2880
NI KADEK RISKI DWIYANTI 18.321.2883
NI KOMANG SURYANTINI 18.321.2890
WAHIDAH SHENNY RUSLIANA 18.321.2899

A12-B
PROGRAM STUDI KEPERAWATAN PROGRAM SARJANA
STIKES WIRA MEDIKA BALI
DENPASAR
2020
 Effect of Acupuncture on Chronic Painwith Depression: A Systematic Review

Background :

Numerous studies suggested that chronic pain and depression were closely related and
widespread in the population. When patients have symptoms of chronic pain and depression,
the corresponding treatment will become difficult. Acupuncture, a unique therapeutic method
of traditional Chinese medicine, has been reported to potentially serve as an alternative
treatment for patients with comorbid chronic pain and depression by many research studies.

1. P (Population/ Patient Problem): Patients diagnosed with chronic pain combined with
depression or depression combined with chronic pain will be included. The main concern
of studies cited must be chronic pain and depression, that is to say, the author must
explain the definition or diagnostic criteria for chronic pain and depression. There will be
no limits on the age, sex, and source of cases.
2. I (Intervension) : Patients in the experimental group were treated with acupuncture alone
or in combination with other therapy, while those in the control group were subjected to
other therapy without acupuncture for chronic pain with depression.
3. C (Comparison) :
- Comparison of the Pain-Related Score. A total of 6 studies assessed pain [51–56],
and 5 of them used the VAS score [51, 53–56], while the other one used the
comprehensive headache score [52]. ,e evaluation time point of each study was
different, and most studies chose pretreatment and 4 weeks after treatment as time
points for pain assessment (Table 4). ,ere was no significant difference in VAS
between the two groups before therapy. After 4 weeks of treatment, VAS decreased
significantly in both groups, and the experimental group was more significant than the
control group (MD = −0.68 (−1.24, −0.12), P = 0.02, I2 = 85%) (Figure 2). However,
there was a high degree of heterogeneity in the study (I2 = 85%). Sensitivity analysis
reduced heterogeneity (I2 = 20%) (Figure 3) after deleting a study whose data were
apparently different from the others.
- Comparison of the Depression-Related Score. In the eligible RCTs, all trials
conducted the depression-related assessments, and HAMD was used in 6 of them [51,
53–57]. Similar to the VAS, most studies included the time point of pretreatment and 4
 weeks after treatment (Table 5). ,ere was no significant difference in HAMD between
the two groups before therapy. After 4 weeks of treatment, HAMD decreased
significantly in both groups, especially in the experimental group, which indicates that
there was a significant difference between the two groups (MD = −2.18 (−3.09,
−1.26), P < 0.00001, I2 = 52%) (Figure 4). Similarly, because of the high
heterogeneity, after removing a research, the heterogeneity was significantly declined
(Figure 5).
4. O (Outcome) : the primary outcomes of interest were the pain scores and depression
severity, i.e., Visual Analog Scale (VAS): higher scores indicate more severe pain, and
Hamilton Depression Scale (HAMD): higher scores indicate a greater degree of
depression, and to observe the changes of indicators before and after intervention. The
secondary outcomes included any adverse events, i.e., Treatment Emergent Symptom
Scale (TESS) or Rating Scale for Side Effects (SERS).
5. T (Time) : . The following electronic databases were searched from inception to March
17, 2020.

Conclusion :

Acupuncture has a promising application prospect due to its unique advantages for the treatment
of chronic pain with depression comorbidity, which can be used in patients suffering from some
certain chronic pain with depression comorbidity with poorer response to the conventional
medication or suffering from serious side effects. High-quality RCTs are needed to support the
current clinical application of acupuncture for the treatment of chronic pain with depression
comorbidity and to broaden the clinical application.
 Reference

Bin Yan, Shibai Zhu, Yu Wang, Gula Da, Guoqing Tian, “Effect of Acupuncture on Chronic
Paint With Depression : A Systematic Review”, Evidence-Based Complementary and Alternative
Medicine, vol. 2020, Article ID 7479459, 10 pages, 2020. https://doi.org/10.1155/2020/7479459
 ROLE PLAY

In Tonja Village, there are complementary clinics, especially the acupuncture clinic, which was
recently established by a nursing graduate of STIKes Wira Medika Bali. In the morning, Ners
Nida, the owner of that clinic, she had a patient who complained about his back pain that often
recurred. Therefore, the patient decided to visit the Ners Nida clinic. The patient named Mrs. Eny.

Mrs. Eny: Excuse me, good morning (knock the door)

Ns. Nida: Morning (opening the door), Morning, Mrs. Eny, can I help you? Please come in

Mrs. Eny went into the room with Ns. Nida

Mrs. Eny: Ners, recently my back pain has recurred, especially if I move too much

Ns. Nida: How long has it been since you had your relapse?

Mrs. Eny: It's been almost a month, Ners, my activities have become limited

Ns. Nida: Did you check with the doctor before?

Mrs. Eny: Yes Ners, I got pain relievers

Ns. Nida: When was the last check up, Ma'am?

Mrs. Eny: Last month, the medicine almost ran out too

Ns. Nida: Then Mrs. Eny, can I do a brief examination? Later you can lie on the bed.

Mrs. Eny: Oh of course Ners (Mrs. Eny was lying down)

After the examination, Ns. Nida offered Ms. Eny to do acupuncture as a non-pharmacological
therapy without having to delay or stop pharmacological treatment.

Ns. Nida: Alright, the examination has been completed and it does need regular treatment so that the pain
is gradually reduced. Mrs. Eny, apart from taking medication, your pain can also be relieved by
acupuncture.

Mrs. Eny: Is it true, Ners? I want to try it then

Ns. Nida: If you are willing, maybe you can fill in the consent form first, and there was available
procedures for what to do. If the mother agrees, it can be signed.

Ibu Eny: OK, I'll read it first.

After Mrs. Eny's read the form, she agreed and signed it.

Mrs. Eny: I have signed this, when can I do the acupuncture?

Ns. Nida: you can now if you want.

Mrs. Eny: okay Ners.

Ns. Nida: Fine ma'am, because you agreed so we can start now. You can lie on the bed again.

Mrs. Eny was lying on the bed as well as Ms. Eny and Ns. Nida immediately set up the acupuncture
equipment and immediately took the action, slowly and carefully. 30 minutes passed, the procedure
was completed then.

Ns. Nida: O.K Mrs., the action is over. How did you feel after that?

Ibu Eny: wow I feel better, could it be fully recover?

Ns. Nida: It could be Ma’am, but there is a possibility for recurrence. From now on, Mrs. Eny may pay
more attention to activity patterns and control their health more frequently.

Mrs. Eny: I see, okay then. So, when can I visit again?

Ns. Nida: about 1-2 weeks again, to prevent infection at your acupuncture points and when the pain starts
to come back.

Mrs. Eny: okay, hopefully it doesn't come back again and stay healthy like this.

Ns. Nida: I hope you will get well soon

After finishing the administration, Mrs. Eny's went to his home and followed Ners directions to pay
more attention to health control.

That's all, thank you.