Synergistic Effect of Integrated Embedding Acupuncture and Psychotherapy on HPA Axis Modulation in Patients with Panic and Depressive Disorders: A Randomized Controlled Trial

Background: Panic and depressive disorders are highly prevalent psychiatric conditions often characterized by dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Conventional pharmacological treatments have limitations, including adverse effects and high relapse rates. This study aims to evaluate the synergistic effect of integrated embedding acupuncture (ACE) and psychotherapy on HPA axis modulation and clinical symptoms in patients with these disorders. Methods: A randomized controlled trial and meta-analysis approach was employed, synthesizing data from recent studies (۲۰۲۰-۲۰۲۵) across global and Persian databases (e.g., Google Scholar, PubMed, Civilica). We analyzed clinical outcomes (HAM-D, HAM-A) and biological markers (salivary cortisol, ACTH). Results: The integrated approach demonstrated a significant reduction in depressive symptoms (HAM-D mean difference: -۴.۲, ۹۵% CI: -۵.۵ to -۲.۹) and panic symptoms compared to monotherapies. Furthermore, HPA axis biomarkers showed substantial normalization, with cortisol levels decreasing significantly (Standardized Mean Difference: -۱.۹, ۹۵% CI: -۲.۶ to -۱.۲). Forest plots confirmed the consistency of these findings across multiple trials. Conclusion: The combination of embedding acupuncture and psychotherapy offers a potent, synergistic intervention for panic and depressive disorders, effectively modulating the HPA axis and improving clinical outcomes with minimal adverse effects.

کلیدواژه ها:

Embedding Acupuncture ، Psychotherapy ، HPA Axis ، Panic Disorder ، Major Depressive Disorder ، Cortisol ، Meta-analysis