Effect of Jin-3-needling therapy on plasma corticosteroid, adrenocorticotrophic hormone and platelet 5-HT levels in patients with generalized anxiety disorder

Abstract

To observe the therapeutic efficacy of Jin-3-needling therapy (J3N) on generalized anxiety disorder (GAD) through clinical global impression scale (CGI), and to explore the mechanism by measuring the plasma levels of corticosteroid (CS), adrenocorticotrophic hormone (ACTH), and platelet 5-hydroxytryptamine (5-HT) before and after treatment. Eighty-six GAD patients with the diagnosis agreeing with the inclusion criteria were assigned, according to the sequence of visiting time, to three groups. The 29 patients in the Western medicine group were treated mainly with fluoxetine or paroxetine, Alprazolam might be given additionally in severe conditions if necessary; the 29 patients in the needling group received J3N therapy with Sishenzhen, Dingshenzhen, Neiguan (PC6), Shenmen (HT7) and Sanyinjiao (SP6) as the chief acupoints selected; and the 28 patients in the combined treatment group were treated with both drugs and needling in the same way as applied in the above two groups. The therapeutic course for all was 6 weeks. Conditions of patients were evaluated before and after treatment with CGI, and levels of CS, ACTH as well as 5-HT were measured by high performance liquid chromatography-electrochemistry. By CGI scoring, the scores of severity index and the general index were not different significantly in the three groups, but the efficacy index proved to be the highest in the needling group, the second in the combined trentment group, and the lowest in the drug group. Plasma level of ACTH and platelet content of 5-HT were lowered in all the three groups after treatment, showing statistical significance (P<0.05), but no significant change was found in CS level (P>0.05). The therapeutic efficacy of J3N in treating GAD is equivalent to, but with the efficacy index significantly higher than, that of conventional treatment. Moreover, when combined with drugs, needling might effectively prevent the side effect of the routinely used Western drugs. The regulatory action of needling on platelet 5-HT and plasma ACTH is probably one of the acting pathways for J3N treatment on GAD.