Efficacy and adverse reactions of moxibustion combined with repetitive transcranial magnetic stimulation for depressive episodes

ZHANG Jie; HE Hao; WU Wenyu; HUANG Wenyan; YANG Zhao; ZHANG Yanling

doi:10.3969/j.issn.1002-266X.2025.07.002

Abstract：Objective To observe the efficacy and adverse reactions of moxibustion combined with repetitive tran-scranial magnetic stimulation(rTMS)in the treatment of depressive episodes,and to provide theoretical basis and practi-cal guidance for the clinical treatment of depressive episodes.Methods A total of 134 patients with depressive episodes were divided into four groups using a four-arm randomized controlled trial,including the conventional treatment group of 34 cases,the moxibustion group of 34 cases,the rTMS group of 33 cases,and the combined treatment group of 33 cases.Patients in the conventional treatment group only took escitalopram oxalate tablets.Patients in the moxibustion group re-ceived moxibustion treatment in addition to taking escitalopram oxalate tablets.Patients in the rTMS group received rTMS treatment in addition to taking escitalopram oxalate tablets.Patients in the combined treatment group received both moxi-bustion and rTMS treatment in addition to taking escitalopram oxalate tablets.The treatment lasted for 4 consecutive weeks.Before treatment and 4 weeks after treatment,the Hamilton rating scale for depression(HAMD-24)and the Zung Self-Rating Depression Scale(SDS)were used to evaluate the depressive episodes of patients.The Clinical Global Impres-sion-Severity of Illness(CGI-S)was used to evaluate the severity of the patients'condition,and the clinical response rate was calculated based on the HAMD-24 score.Before treatment and 4 weeks after treatment,the Treatment Emergent Symp-tom Scale(TESS)was used to evaluate the occurrence of adverse reactions in patients,including nausea and vomiting,drowsiness,headache,insomnia,etc.,and the total incidence of adverse reactions was calculated.Results Compared with those before treatment,the scores of HAMD-24,SDS,and CGI-S in the four groups decreased after 4 weeks of treat-ment(all P<0.05).After 4 weeks of treatment,the HAMD-24 and CGI-S scores in the rTMS group were lower than those in the conventional treatment group and the moxibustion group,and the SDS score was lower than that in the moxibustion group(all P<0.05).After 4 weeks of treatment,the HAMD-24,SDS,and CGI-S scores in the combined treatment group were lower than those in the conventional treatment group and the moxibustion group,and the CGI-S score was lower than that in the rTMS group(all P<0.05).The clinical response rates of the conventional treatment group,moxibustion group,rTMS group,and combined treatment group were 20.59%,23.53%,57.58%,and 72.73%respectively.The clinical re-sponse rate was higher in the rTMS group than in the conventional treatment group and the moxibustion group(all P<0.05),and the clinical response rate was higher in the combined treatment group than in the conventional treatment group,moxibustion group,and rTMS group(all P<0.05).There was no significant difference in the total incidence of ad-verse reactions among the groups(all P>0.05).Conclusion The combined therapy of moxibustion and rTMS can effec-tively reduce the HAMD,SDS,and CGI-S scores of patients with depressive episodes,improve the clinical response rate,and does not increase the incidence of adverse reactions.