125. Intervention study of oral traditional chinese medicine combined with acupuncture for depression IN empty-nest elderly

Abstract Background With the rapid aging of China’s population, the proportion of empty-nest elderly is increasing, and insufficient social support and emotional deprivation make them more susceptible to depressive symptoms. Depression in older adults commonly presents as sleep disorders, loss of interest, memory decline, and diminished self-worth. Although conventional antidepressants can relieve symptoms, long-term use may lead to tolerance, gastrointestinal discomfort, and dependence. Traditional Chinese Medicine (TCM), based on the principle of “internal–external combined regulation,” aims to soothe the liver, alleviate depression, and harmonize qi, blood, and organ function. Based on this, the study conducted an evaluation of the efficacy and safety of oral Chinese medicine combined with acupuncture in improving depression in elderly people living alone. Methods A total of 150 elderly patients with mild to moderate depression who met the empty-nest criteria were enrolled and randomly assigned to the experimental group (n = 75) or control group (n = 75). The experimental group received oral TCM decoction (including Radix Bupleuri, Angelica Sinensis, Curcuma aromatica, and Poria cocos) twice daily, and acupuncture at Baihui (GV20), Shenmen (HT7), and Taichong (LR3) three times per week for 12 weeks. The control group received Paroxetine Hydrochloride 10 mg/day combined with psychological counseling. Assessments were conducted at baseline, week 6, and week 12 using the Hamilton Depression Rating Scale (HAMD-17) and Pittsburgh Sleep Quality Index (PSQI). Adverse reactions and functional ability were monitored. Statistical analysis was performed using repeated measures analysis of variance (ANOVA), with p<.05 considered statistically significant. Results After 12 weeks, HAMD scores in the experimental group decreased from 19.7 ± 2.4 to 10.2 ± 2.1 (≈48.2% improvement), significantly better than the control group (from 19.5 ± 2.3 to 14.8 ± 2.6, ≈24.1%, p=.003). PSQI scores improved from 13.8 ± 2.7 to 7.1 ± 2.4 (≈48.6%), compared with 10.5 ± 2.5 in the control group (≈23.9%, p=.006). Social withdrawal incidence declined from 42.7% to 21.3% (≈50.1%) in the experimental group, higher than the ≈18.4% reduction in controls (p=.01). Functional decline was approximately 28.6% slower, and emotional fluctuation decreased by 41.8%, outperforming the 20.5% improvement in the control group. Compliance was high; only mild soreness and transient fatigue were reported after acupuncture, with no serious adverse events. Discussion The findings indicate that oral TCM combined with acupuncture significantly alleviates depressive symptoms in empty-nest elderly and improves sleep quality and functional stability, demonstrating its feasibility as an intervention for mild to moderate depression. The therapeutic mechanism may involve the modulation of central neurotransmitter balance, enhancement of qi and blood circulation, and regulation of neural emotional pathways. External acupuncture additionally promotes autonomic nervous system equilibrium and stress adaptation, offering a holistic regulatory advantage over single-path pharmacological approaches. The results suggest that multidimensional combined intervention facilitates early emotional recovery in empty-nest elderly. Future studies may integrate brain imaging techniques to explore neural modulation mechanisms and investigate synergy with music therapy or behavioral activation strategies, providing new directions for elderly depression treatment.