Acupuncture for Depression and Myalgia in Patients with Hepatitis: An Observational Study

Abstract

Background Depressive symptoms and myalgia are commonly seen in patients with chronic hepatitis B and chronic hepatitis C. Objective To investigate the effi cacy of acupuncture treatment on depressive symptoms and myalgia in patients with hepatitis. Methods Of 44 patients with hepatitis screened for depression and myalgia, 28 were enrolled and included in the study. The main outcome measure for depressive symptoms was Beck's Depression Inventory (BDI). For pain/myalgia, patients rated their pain on a scale from 0 to 10. Patients with a score greater than the cut-off point in either score were allocated to acupuncture treatment. The Chinese method of acupuncture was used. Treatment continued for 6 weeks. Results At baseline, 17/44 patients (39%) had a BDI score ≥17 and 24 (55%) had a pain score ≥5. A total of 28 patients were allocated to acupuncture treatment, forming three groups: group 1, 13 patients with high BDI and high myalgia scores; group 2, 11 patients with low BDI score but high myalgia score; group 3, 4 patients with high BDI score but low myalgia score. Adherence to treatment was good; all patients completed the sessions and there were no drop-outs. Signifi cant improvements in end-treatment BDI and in myalgia scores compared with baseline levels was found. Conclusion Acupuncture seems to be a promising treatment for patients with hepatitis. Further studies are warranted in large populations to establish the therapeutic role of acupuncture. INTRODUCTIONThe estimated numbers of patients with chronic hepatitis C (CHC) and B (CHB) viral infections in the world are 2.7 million and 350 million, respectively. 1 2 Depressive symptoms are common in these patient groups. Increased expression of specifi c proinfl ammatory cytokines has been shown to cause depressive symptoms in patients with hepatitis C virus. Additionally, treatment of the disease with interferon (IFN) may also cause or exacerbate depression.3 4 Reports suggest that depression in patients with CHB develops less frequently than in patients with CHC during treatment with IFN. However, a Turkish study found a Acupuncture for depression and myalgia in patients with hepatitis: an observational study high rate of psychiatric disorders and no signifi cant difference between the two groups. 5Psychotherapy and antidepressant drugs are known to be useful but high rates of dropout, lack of effect in some patients, intolerable adverse effects and relapse all reduce their effectiveness and patient compliance. [6][7][8] In consequence, patients with depression may seek alternative treatments.Acupuncture has long been used to treat emotional and psychological disorders, including anxiety, insomnia and depression. It may also be an alternative treatment of depressive symptoms in patients with CHB or CHC. In our patients with hepatitis, we have found that in addition to depression, myalgia is also common. Therefore, the objective of this study was to determine the prevalence of depressive symptoms and myalgia among patients with chronic hepatitis and ...

Feasibility and Acceptability of Group Acupuncture in Veterans with Hepatitis C: A Pilot Study

“…19 Similarly, Turfan et al also reported 100% adherence in 28 individuals with hepatitis who received acupuncture twice weekly for 6 weeks. 16 …”

“…These researchers did not, however, report whether the acupuncture was administered in an individual or in a group setting. 16 Another study showed that acupuncture, administered in a group setting, reduced fatigue, muscle aches, irritability, and nausea experienced by 14 Veterans during antiviral therapy. 17 Group acupuncture, if acceptable and feasible, could potentially provide a safe therapy alone or as an adjunct with pharmacologic therapy for treating symptoms experienced by individuals with HCV.…”

Effects of electroacupuncture on liver function in mice with chronic alcoholic liver injury: visual display by in vivo fluorescence imaging

“…Acupuncture can improve LF; it has been reported that electroacupuncture (EA) and manual acupuncture can downregulate the expression of cytokines in serum and liver tissue, improve immune function, and inhibit liver injury. [7][8][9] Acupuncture can decrease the yellow gangrene index, promote the recovery of LF, and relieve clinical symptoms. 10,11 In addition, the World Health Organization (WHO) released a review and analysis of clinical acupuncture trials in 2002, which included evidence for the treatment of alcohol dependence and detoxification.…”

The Effects of Acupuncture on Insomnia, Anxiety, and Depression in Women with Chronic Liver Disease: A Randomized Controlled Trial

“…and hepatocellular carcinoma (HCC) [5] has been reported to cause psychiatric problems. Chronic liver disease is associated with impaired health-related quality of life (HRQOL), depression, anxiety, and other psychological impairments [6,7]. In cases where these chronic conditions stigmatize the patient, psychological impairment becomes more pronounced.…”

“…A few articles reported that acupuncture alleviated depression related to chronic hepatitis or otherwise impaired liver function. One observational study showed the improvement of depression after acupuncture in 28 patients with chronic hepatitis [7,15,16]. There were acupuncture studies with negative turnover of hepatitis B virus versus control group via examination of physiological parameters [14,15].…”