基于1H-NMR 代谢组学技术探寻“三部推拿法”调气理论干预失眠的机制研究

Primary insomnia in China has shown a significant upward trend. It seriously endangers people’s physical and mental health. Although the etiologic factors are not clear, the metabolic factors, which lead to insomnia, have attracted the increasing attention recently. The technique of nuclear magnetic resonance spectroscopy (1H-NMR) metabolomics has been widely used in the study of revealing the material basis and mechanism of the therapeutic effect of traditional Chinese Medicine. Through the preliminary study, the research group confirmed that the method "three regions TuiNa method" could regulate qi , and effectively treat the primary insomnia, although its mechanism is not clear. Based on the effectiveness of TuiNa on treating insomnia and the related theories of insomnia and metabolic factors, the material basis of regulating qi may change the human metabolic. Therefore a hypothesis " Regulating qi can change the metabolism of human body" is proposed. Through 1H-NMR technology, the changes of endogenous lipid metabolites, carbohydrate metabolites and amino acid metabolites in the blood of patients after the intervention of using the three regions TuiNa method could be observed. The changes in physiological and pathological state and the connection between the systematic study and the holistic view of traditional Chinese Medicine could be investigated. The researchers would further explore the correlation between regulating qi and metabolism as well as the objectivity of the theory of regulating qi. Thus they would reveal the mechanism of "three regions TuiNa method" in the treatment of insomnia and provide a reliable theoretical basis for applying TuiNa in treating insomnia.

原发性失眠（Primary Insomnia,以下简称PI）在我国发病呈明显上升趋势，且严重危害身心健康。病因不清，近来代谢因素导致失眠渐受重视。核磁共振氢谱(1H-NMR)代谢组学技术在揭示中医治疗疗效的物质基础与作用机制方面已具有广泛研究基础。课题组前期临床研究证实“三部推拿法”能够调气，有效治疗原发性失眠，但机制尚不清楚。基于推拿调气治疗失眠的有效性和失眠与代谢因素相关的理论，调气的物质基础也许是人体代谢的改变，故我们提出“调气能够改变人体代谢”的假说。通过1H-NMR 技术,观察“三部推拿法”干预后患者血液中内源性脂质代谢物、糖类代谢物及氨基酸代谢物变化情况，系统地分析机体生理、病理状态的变化，探讨这种系统性与中医学的整体观之间的联系，进一步探讨调气与代谢之间的相关性和调气理论的客观性。从而揭示“三部推拿法”治疗失眠的机制，为推拿治疗失眠提供可靠的理论依据。

本研究以原发性失眠(Primary insomnia, PI)患者为研究载体，以“三部推拿法”调气为指导理论，运用核磁共振氢谱(1H-Nuclear Magnetic Resonance, 1H-NMR)技术手段，通过观察“三部推拿法”干预前后PI患者血液中内源性脂质代谢物、糖类代谢物、氨基酸代谢物变化情况，验证了“三部推拿法治疗PI有效性是对多个代谢物调整”的研究假说。其研究成果系统揭示了“三部推拿法”治疗PI代谢组学机制，证实“三部推拿法”调气的物质基础是对人体代谢的改变，为“三部推拿法”治疗PI的临床应用提供了科学依据，促进了中医推拿的国际化进程。