Integrative therapy with moxibustion and repetitive transcranial magnetic stimulation enhances outcomes in patients with post-stroke depression.

BACKGROUND: Post-stroke depression (PSD) affects 30-60 % of stroke survivors and significantly impairs rehabilitation outcomes. While selective serotonin reuptake inhibitors remain standard treatment, they often have limited efficacy and notable side effects. This study investigated whether combining Governor Vessel-regulating and depression-relieving moxibustion with repetitive transcranial magnetic stimulation (rTMS) could enhance treatment outcomes compared to escitalopram alone. METHODS: In this prospective comparative study, 120 PSD patients treated at our hospital from December 2021 to December 2023 were enrolled and assigned to control (n = 60) or study groups (n = 60) based on treatment allocation. The control group received escitalopram oxalate (Lexapro) 10 mg daily. The study group received escitalopram plus Governor Vessel-regulating and depression-relieving moxibustion (30 min daily) and 1 Hz rTMS (20 min, 5 times weekly) for 4 weeks. Primary outcomes included Hamilton Depression Rating Scale (HAMD) scores and treatment effectiveness. RESULTS: The study group demonstrated significantly greater improvements than controls across all measures: lower post-treatment HAMD scores (p < 0.05), higher total effectiveness rate (96.67 % vs 80.00 %, p < 0.05), reduced inflammatory markers (TNF-α and IL-6, both p < 0.05), improved neurological function (lower NIHSS scores, p < 0.05), better daily living activities (higher Barthel Index, p < 0.05), and fewer adverse reactions (3.33 % vs 15.00 %, p < 0.05). CONCLUSION: The combination of Governor Vessel-regulating and depression-relieving moxibustion with rTMS and escitalopram significantly outperformed escitalopram monotherapy for PSD, offering enhanced antidepressant effects, reduced inflammation, improved neurological recovery, and better tolerability. This integrative approach represents a promising therapeutic strategy for post-stroke depression management.