ACUPUNCTURE AS A COMPLEMENTARY ALTERNATIVE IN THE TREATMENT OF ANXIETY: A LITERATURE REVIEW

The present work consists of the study of Traditional Chinese Medicine (TCM), with the objective of reporting the use of acupuncture as an alternative in the treatment of anxiety contextualizing it with public health, through a literature review in which articles from the last ten years were selected in reliable websites. Acupuncture and proved effective in all selected articles, avoiding the prolonged use of medications that may cause dependence, this practice allows the pharmaceutical professional to apply his area of activity to the patient so that they can use such therapy in their treatment.


INTRODUCTION
Anxiety is an intolerable emotional state, it is related to traumas caused in daily life by environmental, sociological, financial, and personal resources factors (LAZARUS; FOLKMAN, 1986.) v.1, n.2, 2022 The person feels distressed and apprehensive, may evolve to Anxiety Disorder (AD) and the individual feeling threatened or with the feeling that he is being persecuted, presenting indirect factors such as eating disorders, consequently the non-treatment of AD will lead to a future depression (MEDINA-GÓMEZ et al, 2019).
The AT is something common today starting adolescence, especially in people from 22 to 45 years of age, mostly female, who has a prevalence of 3.6% of the world population with AD, there is an increase in these proportions of 5.65% in Latin America and Brazil has stood out as the country with the highest number of anxiety cases in the world with 9.3% of its population, in this sense, an interest arose through a literature review discussing a non-drug alternative in the treatment of AD, through complementary practices such as acupuncture (FERNANDES et al., 2017).
Acupuncture has been present in the world for almost 5,000 years, it is a Traditional Chinese Method that originates in the East, based on theories: (GIRÃO, 2008).

i)
Yin Yang, which are energies in perfect harmony and can bring the well-being of the body, ii) Theory of the five movements (fire, earth, metal, water and wood), which is part of the elements of generation and mastery that govern the organs of meaning and Zang iii) Fu (organs and viscera) related to the flow of Qi (energy) in the blood Its arrival in Brazil is about 90 years old, developing in areas such as pharmacy, nursing and medicine, its main purpose and treating diseases through specific points known as acupoints, with the beneficial of reducing intoxications caused by conventional treatment through medicines (YAMAMURA, 2001).
Individuals who have resistance to conventional treatment based on anxiolytic drugs can adhere to this complementary practice, which has been effective by promoting an improvement in the patient's mental health and well-being, reducing risks of intoxications and adverse drug reactions, but not ruling out the rational use of acupuncture (PIGNONE; MARTINE, 2011). And has a low theoretical framework and little knowledge of the population and health professionals, acupuncture shows its effectiveness in the treatment of psychic diseases such as depression and anxiety, at specific points in the body to regularize the balance of Qi, which can flow in perfect harmony in the blood, and brings the improvement of symptoms of AD (SNIEZEK; SIDDIQUI, 2013). According to Tu et al. (2019), even though studies are variable, it is suggested that patients resistant to conventional interventions join acupuncture treatment, demonstrating positive effects by decreasing anxiety symptoms.
Thus, the present article aims to report the use of acupuncture as an alternative in the treatment of anxiety contextualizing it with public health and the question of whether acupuncture can be used as an alternative in non-drug treatment in cases of anxiety. These drugs play a large role acting in the limbic system, being classified action potential, such as alprazolam for a short half-life of 12 hours, has a better hypnotic effect and those that have a longer lasting action are preferred to treat anxiety, both clonazepam and diazepam have a half-life of 24 hours (BRAGA et al., 2016).
Prolonged use of BZDs can lead to addiction and withdrawal crises, and their rational use is indicated for a period of four months, having their ideal functionality and not bringing risks and allowing patients undergoing treatment to cope with day-to-day traumas. victims of abuse, family members  Clonazepam is effective in the treatment of panic syndrome and anxiety related to it, as it is a benzodiazepine of high affinity of central receptors having non panic effect due to its action on the serotonergic system (VALENÇA et al., 2003). Diazepam is a GABA-positive allosteric modulator because is the CNS depressor agent (AZEVEDO; ARAUJO; FERREIRA, 2016).
Selective serotonin reuptake inhibitors (SSIs), Figure 2, currently considered one of the classes of drugs for the first choice of social anxiety disorder (ATT), showing to be effective with a good tolerance and low side effects, effective drugs: sertraline, escitalopram, fluoxetine and paroxetine, are highly selective for serotonin uptake (5-HT), the well-known SSRIs (Selective serotonin reuptake inhibitors) being well absorbed orally with a half-life of 15 to 24 hours (RANG et al., 2016). Sertraline being an SSRIs has the benefit of having few medicamentosa interactions and has been shown to be safe in people who have psychological diseases related to melancholy but has an indispensable factor that is    and thoughts; and decreased flow of Qi from the heart and liver, the accumulation of phlegm leading to emotional states that can cause TA (ROSS, 2003).
The strengthening of the heart calms the mind by nourishing the blood, toned through acupuncture with the use of specific acupoints, capable of acting intensely on severe causes of anxiety, such as: B-44 (Shentang) Figure 5, which relieve anxiety symptoms that may be related to Yin deficiency of the heart (RAMOS, 2015).    (CARNEVALE et al., 2017). In countries such as Denmark and Norway, 25 to 40% of hospitals have adopted acupuncture treatment services, the most accepted among ICP (SALOMONSEN et al., 2011).

METHODOLOGICAL PROCEDURES
The present work consists of a bibliographic review where scientific articles from the last ten years were selected, using the databases of Scielo, Pubmed, Lilacs, Bireme, ProQuest, Web of Science and Science Direct. The time frame of documents of historical relevance was not considered. The following words were used as descriptors: acupuncture, anxiety, ansioltics, TCM.   A study with rats that were submitted to alcohol withdrawal and then evaluated the anxiety of these rats after ethanol withdrawal,

PRESENTATION AND ANALYSIS OF DATA
showing signs of anxiety. The results showed improvement and decrease in their anxiety after being treated with acupuncture.

Source: Author's, 2022
It can be observed that TCM has been shown to be beneficial in the treatment of anxiety both in patients suffering from this condition due to personal problems, family, social and even economic, and in the preoperative period where patients are anxious for the surgery that will be affected, acts in reducing pain and improving the quality of sleep related to anxiety (BONTEMPO et al., 2016), in order to reduce the risks of drug poisoning, or even the association to obtain a satisfactory result for the patient (MASCARENHAS et al., 2019). Although acupuncture has been shown to be significantly effective in the treatment of ED, through specific acupoints, further studies are needed to precisely explain its mechanism of action (VALIANI et al, 2018).
According to Spence et al. (2004), acupuncture significantly improved insomnia, anxiety, fatigue and depression levels because of excretion of 6-sulfateximelatonin, a metabolite of melatonin, which was normalized. Anxiety can be treated with the aid of acupuncture in a promising way of therapy when compared to pharmacotherapy and can lead to a reduction in health costs (CHAO et al., 2019).
Acupuncture therapy is an alternative of complementary therapy in neuropsychiatric disorders, including anxiety, thus parameters have been investigated on its efficacy, having significant effects, but not ruling out a possible placebo effect because it does not have the precise explanation of its mechanism of action (MEDEIROS; SAAD, 2009).