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Year : 2019  |  Volume : 3  |  Issue : 2  |  Page : 44-47

Effect of acupuncture and moxibustion on serum brain-derived neurotropic factor level, C-reactive protein, and zinc level in patients with depression

Department of Medicine, Xinjiang Medical University, 393 Xinyi Rd, Xinshi, Urumqi, Xinjiang, China

Date of Submission17-Jun-2019
Date of Acceptance19-Sep-2019
Date of Web Publication3-Feb-2020

Correspondence Address:
Dr. Y Zhi
TCM College of Xinjiang Medical University, Urumqi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/MTSM.MTSM_18_19

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Objectives: To apply the acupuncture and moxibustion to the treatment of patients with depression and study the serum brain-derived neurotropic factor (BDNF) level, C-reactive protein (CRP), and zinc level in the patients. Methods: Thirty-five patients with depression treated in our hospital were selected as the research individuals, and they were randomly divided into the control group and the observation group. Seventeen patients in the control group were treated with head massage and 18 patients in the observation group were treated with acupuncture. The levels of BDNF, CRP, and zinc were measured and recorded by enzyme-linked immunosorbent assay. Results: The levels of BDNF in serum BDNF in the control group were significantly higher than those in the control group, and there was a significant difference between the two groups in serum BDNF levels (P < 0.05). Compared with the control group, the CRP decreased significantly in the observation group, and there was significant difference in the CRP between the two groups (P < 0.05). The level of zinc in the observation group was significantly lower than that of the control group, and there was a significant difference in the level of zinc in the two groups (P < 0.05). Conclusions: The treatment of acupuncture and moxibustion can effectively reduce the level of serum BDNF in patients, the level of zinc, and CRP, which has a certain value of research.

Keywords: Acupuncture, C-reactive protein and zinc, moxibustion

How to cite this article:
Zhi Y, Wu J X, Guo S J, Xie S S, Zhou X T. Effect of acupuncture and moxibustion on serum brain-derived neurotropic factor level, C-reactive protein, and zinc level in patients with depression. Matrix Sci Med 2019;3:44-7

How to cite this URL:
Zhi Y, Wu J X, Guo S J, Xie S S, Zhou X T. Effect of acupuncture and moxibustion on serum brain-derived neurotropic factor level, C-reactive protein, and zinc level in patients with depression. Matrix Sci Med [serial online] 2019 [cited 2022 Jan 26];3:44-7. Available from: https://www.matrixscimed.org/text.asp?2019/3/2/44/277512

  Introduction Top

Depression is a common psychological disorder after stroke. Although the prevalence of poststroke depression (PSD) varies greatly among the literature, the overall incidence is high, reaching 55%. PSD can occur in the acute period after stroke rehabilitation. A significant increase in morbidity and mortality in patients with cerebral apoplexy will reduce the patients' cognitive function and quality of life which affects the patients with functional recovery and independent risk factor for stroke recurrence. Previous studies have mostly focused on the relationship between stroke foci and PSD and gradually focused on the social and psychological factors of patients.[1] Research has confirmed that Type A behavior is an independent factor affecting the occurrence of hypertension development “1, and high blood pressure is the key of brain stroke risk factors.[2] Type A behavior of hostile factors can trigger depression alone H1, so the research on Type A behavior and PSD helps to reveal the relationship between behavior types in patients with stroke occurrence of PSD was susceptible to sex. Research has confirmed ischemic stroke can lead to brain-derived neurotropic factor (BDNF) content of low J, and the study found that BDNF level with the onset of depressive disorder have close L6J, has clearly serum BDNF levels in a certain extent, and can reflect the cerebrospinal fluid of BDNF levels.[3] At present, PSD and Type A are divided into type factor and serum BDNF and high-sensitivity (HS).[4] The research of the behavior of the patients with PSD types and risk factors, analysis of the psychosomatic status, and to explore serum BDNF and HS-CRP level possible role in the pathogenesis of PSD and the behavior type and the relationship of the cognitive function for the PSD of early prevention and drug, psychological and behavior provides the theory basis for targeted therapy.[5],[6]


Object 1

Stroke patients randomly selected from xi'an Jiao Tong university first-affiliated hospital neurology from February 2018 to May 2018 in hospital during the period of 116 cases of patients with acute cerebral apoplexy, among which 77 were male, female 39 cases, aged 39–80, the average age (65). All the selected patients met the diagnostic criteria for stroke formulated by the fourth national academic conference on cerebrovascular diseases and were accompanied by head magnetic resonance imaging to identify the responsible lesions. The admission time was within 7 d after the onset of acute stroke, and the informed consent of the subjects was obtained, ranging from 18 to 80 years of age.

Exclusion criteria

(1) severe stroke, significant aphasia or severe cognitive impairment (MMSE < 10), severe functional disability (modified Rankin scale [MRS] = 5), and inability to complete the score; (2) transient ischemic attack, cerebral hemorrhage, and subarachnoid hemorrhage; (3) patients with depressive disorder, schizophrenia, and other mental diseases and suicidal tendencies before stroke onset; (4) patients with malignant tumors or other critical diseases (heart failure, respiratory failure, etc.), Parkinson's disease, and epilepsy. Normal control group: a total of 31 patients, 19 males and 12 females, aged 46–73 years, with an average age of 63, were randomly selected for health examination in our hospital during the same period. 1–7 age, normal clinical physical examination and mental examination. No history of mental illness, gender, and age were matched with the PSD group. This study by southeast university affiliated Zhongda hospital, clinical research ethics committee approval is audited by university first affiliated hospital ethics committee for the record, and into the group, all patients signed the informed consent.

  Methods Top

(1) General clinical data: demographic data, history of stroke, hypertension, diabetes, coronary heart disease (CHD), and atrial fibrillation were collected in the patient group. (2) Evaluation: depression after stroke by trained two psychiatrists in stroke patients into the group of 14 day independently assess, with reference to the diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV) depression diagnosis criterion, conform to the standard group PSD into the brain, and USES the 17 Hamilton depressive scale (HAMD. 17) assess the severity of depressive symptoms, with a total score of <7 for no depressive symptoms, 7–17 for mild depression and 18–24 for moderate depression and >24 are classified as severe depressive disorder. The remainder was in the nonstroke depression group (NPSD group). (3) Social psychology evaluation: (1) a behavior pattern scale (TABP): review behavior type, A total of 60 items, including time urgency scale (TH) 25 items, hostile competition scale (CH) 25 items and hide scale (L) 10 entries, answered by “yes” and “no” rating, L 7 points that authenticity is not enough, or invalid questionnaire, L <7 points, that test is valid, then calculate the score TH, CH. If the total score of TH + CH is >28 points, it is included into the Type A behavior group, and the remaining is classified into the nontype behavior group, assessed within 3 days of group entry. (2) Social support assessment scale: a total of 10 items including objective support, subjective support, and utilization of social support were assessed in the social support assessment scale. The total score of the three dimensions is 66 points, the total score <22 points is low level, 23–44 points is medium level, 45–66 points is high level, assessed within 3 days of the group. (3) scale simple mental state examination (MMSE): assess the patient's cognitive function, a total of 30 entries, including time place orientation, immediate and short memory, attention, and computing power, retelling, and object naming, language understanding and expression, reading comprehension, and graphic description, assessment at group 14 days. (4) Neurologic evaluation: in one group of 14 days by the national institutes of health stroke scale (NIHSS), MRS, Barthes index (BI) respectively to assess the patient's nerve function defect degree, neural function recovery, daily life ability.

  Results Top

The incidence of acute PSD after stroke was 36 of 116 patients in this study (31). PSD occurred in the acute phase of ischemic stroke, including 16 cases of mild depression, 13 cases of moderate depression, and 7 cases of severe depression. PSD with NPSD group asked for age, sex, body mass index, level of education, diabetes, CHD, and/or atrial fibrillation, the constitution of the history of previous stroke, then there was no statistical difference of FL learning significance (P > 0. 05). The composition ratio of hypertension in the PSD group was significantly higher than that in the NPSD group, and the difference was statistically significant (97): 22% versus 76. 25%. T =0. 653, P = 0. 006.

With the social psychology and neural function assessment scores of the PSD group and the NPSD group, the composition ratio of Type A behavior in the PSD group was significantly higher than that of the NPSD group, and the score of TH, CH, and TH + CH factors were significantly higher than that of the NPSD group (P < 0.01); social support score of PSD group was significantly lower than that of NPSD group (P < 0.01); MMSE score of PSD group was significantly lower than that of NPSD group (P < 0.05). The NIHSS and MRS scores of PSD group were significantly higher than those of NPSD group (P < 0.01); BI score was significantly lower than that of NPSD group (P < 0.01) [Table 1] and [Table 2].
Table 1: Type A behavior pattern score of poststroke depression group and nonpoststroke depression group

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Table 2: Social support, mini-mental state examination score, and neurologic function score of poststroke depression group and nonpoststroke depression group

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Compared with the serum BDNF and HS-CRP levels in the PSD group, NPSD group, and NC group, the serum BDNF levels in the PSD group were significantly lower than those in the NPSD group and NC group (P < 0.01). Compared with NC group, NPSD group significantly decreased (P < 0.01). The CRP level was significantly higher than that of NPSD group and NC group (P < 0.01). The NPSD group was significantly higher than NC group (P < 0.01) as shown in [Table 3].
Table 3: Serum brain-derived neurotropic factor and high sensitivity C-reactive protein levels in poststroke depression group, nonpost stroke depression group, and NC group were compared

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HAMD 17 score, TABP factors, social support, MMSE, NIHSS, MRS, BI score and serum BDNF and HS score of PSD group. The correlation analysis results of CRP showed that HAMD in PSD group. The score was positively correlated with CH, TH, and CH factors (P < 0.01); CH factor score was negatively correlated with social support (P < 0.05), which was positively correlated with serum HS-CRP level (P < 0.05); none of the rest were related to | (corpse > 0.05) [Table 4].
Table 4: Correlation of hamd-17 score, Type A behavior pattern factors, social support, mms score and serum brain-derived neurotropic factor and high-sensitivity C-reactive protein level (R)

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  Conclusions Top

There are many limitations in this study. The correlation between each factor is only studied in the PSD group, and the sample size is small. Only depression in the acute phase of stroke was studied, and various risk factors of PSD during follow-up were not statistically analyzed. The dynamic changes of serum BDNF and HS-CRP could not be understood by measuring the level of serum BDNF and HS-CRP at one time point. Therefore, in the future, we should expand the sample size, strengthen follow-up, dynamically observe and explore the mechanism of biological single-minded social perspective of PSD. To sum up, stroke Type A behaviour is particularly a hostile competition factor, under internal and external stress under high arousal, inflammation because of HS-CRP serum levels increased significantly, and low social support, easy to suffer from PSD. Hence, in the future, we can through the psychosomatic intervention, line for therapy hostile competition factors, make the choice when facing stress more reasonable way to deal with to reduce stress related to psychosomatic disease.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Xia Y, Wang HD, Ding Y, Kang B, Liu WG. Parkinson's disease combined with depression treated with electroacupuncture and medication and its effect on serum BDNF. Zhongguo Zhen Jiu 2012;32:1071-4.  Back to cited text no. 1
Ren Y, Yang X, Zhang Y, Wang Y, Li X. Effects and mechanisms of acupuncture and moxibustion on reproductive endocrine function in male rats with partial androgen deficiency. Acupunct Med 2016;34:136-43.  Back to cited text no. 2
Bao C, Wang D, Liu P, Shi Y, Jin X, Wu L, et al. Effect of electro-acupuncture and moxibustion on brain connectivity in patients with Crohn's disease: A resting-state fMRI study. Front Hum Neurosci 2017;11:559.  Back to cited text no. 3
Zhenzhong L, Xiaojun Y, Weijun T, Yuehua C, Jie S, Jimeng Z, et al. Comparative effect of electroacupuncture and moxibustion on the expression of substance P and vasoactive intestinal peptide in patients with irritable bowel syndrome. J Tradit Chin Med 2015;35:402-10.  Back to cited text no. 4
Fan L, Fu W, Chen Z, Xu N, Liu J, Lü A, et al. Curative effect of acupuncture on quality of life in patient with depression: A clinical randomized single-blind placebo-controlled study. J Tradit Chin Med 2016;36:151-9.  Back to cited text no. 5
Zhao JM, Li L, Chen L, Shi Y, Li YW, Shang HX, et al. Comparison of the analgesic effects between electro-acupuncture and moxibustion with visceral hypersensitivity rats in irritable bowel syndrome. World J Gastroenterol 2017;23:2928-39.  Back to cited text no. 6


  [Table 1], [Table 2], [Table 3], [Table 4]

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