An Acupuncture Treatment for Depression

abstracted & translated by
Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)

Keywords: Chinese medicine, acupuncture, psychiatry, depression

On pages 41-42 of issue #6, 2006 of Hei Long Jiang Zhong Yi Yao (Heilongjiang Chinese Medicine & Pharmacology), Huang Jing-xuan published an article titled, “Clinical Observations on the Acupuncture Treatment of 35 Cases of Depression.” A summary of this study is presented below.

Cohort description:

All cases enrolled in this study met the diagnostic criteria for depression given in the ICD-10PHC. Among these 35 cases, there were eight males and 27 females 18-59 years of age. However, most of the patients were 33-50 years old. These patients had suffered from depression for from one month to seven years. Eighteen cases presented a pattern of liver depression qi stagnation, seven presented with heart-spleen dual vacuity, five presented with liver-kidney yin vacuity, and five presented with yin vacuity fire effulgence.

Treatment method:

The basic acupuncture prescription consisted of:

Bai Hui (GV 20)
Yin Tang (M-HN-3)
An Mian (N-HN-54)
Nei Guan (Per 6)
Zhong Wan (CV 12)
San Yin Jiao (Sp 6)
Tai Chong (Liv 3)
Feng Long (St 40)

If there was liver depression qi stagnation, Qi Men (Liv 14), Yang Ling Quan (GB 34), Zhi Gou (TB 6), and Tai Chong (Liv 3) [sic] were added.

If there was heart-spleen dual vacuity, Shen Men (Ht 7), Nei Guan (Per 6) [sic], San Yin Jiao (Sp 6) [sic], Zu San Li (St 36), Yin Ling Quan (Sp 9), Pi Shu (Bl 20), and Xin Shu (Bl 15) were added.

If there was liver-kidney yin vacuity, Tai Chong (Liv 3) [sic], Tai Xi (Kid 3), Zu San Li (St 36), Gan Shu (Bl 18), and Shen Shu (Bl 23) were added.

If there was yin vacuity fire effulgence, San Yin Jiao (Sp 6) [sic], Tai Xi (Kid 3), Xin Shu (Bl 15), and Shen Shu (Bl 23) were added.

One to 1.5 inch fine needles were used. After disinfection and obtaining the qi, twisting and turning supplementing and draining technique was used at appropriate points depending on the presence of vacuity and repletion. The needles were retained for 20 minutes each time, and treatment was given once per day. Ten treatments equaled one course, and 1-3 courses were administered.

Study outcomes:

Outcomes criteria were based on the criteria promulgated by the Psychiatric Branch of the Chinese National Medical Association. Therefore, there were four possible outcomes: cure, marked effect, improvement, and no effect. Based on these criteria, out of the total of 35 patients, eight patients were judged cured, 14 experienced a marked effect, seven improved, and six got no effect. Therefore, the total effectiveness rate was published as 82.85%. The following table shows these four outcomes broke down by pattern presentation.

This shows that the best effects were obtained in the liver depression qi stagnation group or those who presented a pure repletion pattern. The total effectiveness of the three vacuity patterns was only 76.47% in comparison.

Discussion:

According to Dr. Huang, internal damage by the seven affects cause upbearing and downbearing, entering and exiting of the qi to suffer blockage and obstruction. Hence the liver loses its coursing and discharging and the qi mechanism loses its regulation, thus resulting in the qi not being able to spread externally. Instead, it binds and gathers internally. If the liver qi counterflows horizontally to assail the spleen, the spleen loses its movement and transformation. Therefore, phlegm rheum collects internally and results in phlegm dampness brewing and binding. If qi depression endures for days, it consumes the qi and damages yin, and the source of the engenderment and transformation of qi and blood loses its source. This results in heart-spleen dual vacuity. If enduring disease damages and reaches kidney yin, water will not sprinkle and moisten the liver and thus there will be liver-kidney yin vacuity. Further, if yin vacuity fails to control yang, yang may become hyperactive and engender effulgent fire.

Based on this vision of the disease mechanisms of this condition, Dr, Huang believes that the basic treatment principles to remedy it should be to course the liver and resolve depression, quiet the spirit and stabilize the mind, fortify the spleen and transform phlegm. Therefore, within the above formula, Bai Hui, Yin Tang, and An Mian are all meant to clear and disinhibit the head and eyes, quiet the spirit and stabilize the mind. In particular, Bai Hui is on the governing vessel which “enters the network vessels of the brain.” It is also the meeting point point of the governing vessel and all the yang channels. Nei Guan is the network point of the hand jue yin pericardium channel from which the qi flows freely to the three burners. The three burners or triple burner rules the qi. Therefore, stimulating this point can calm the heart and also regulate the qi. Tai Chong is a transport point on the foot jue yin liver channel. It has the ability to soothe the liver, rectify the qi, and regulate and harmonize yin and yang. Zu San Li is the uniting point of the stomach, and the spleen and stomach are the source of the engenderment and transformation of the qi and blood. They are also the pivot of the upbearing and downbearing of the qi mechanism. Supplementing this point fortifies the spleen and nourishes the heart. Shen Men is a transport and source point on the hand shao yin heart channel. Supplementing it calms the heart and quiets the spirit. San Yin Jiao a meeting point of the foot three yin channels. Therefore, it can fortify the spleen and transform phlegm as well as regulate the blood and nourish the liver. Zhong Wan and Feng Long fortify the spleen and transform phlegm. When all these points are used together, their effect is to course the liver and resolve depression, quiet the spirit and stabilize the mind, fortify the spleen and transform phlegm.

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