针刺改善原发性失眠代谢组学研究

Metabonomics Study on Acupuncture Improving Primary Insomnia

目的:观察针刺治疗原发性失眠的临床疗效及治疗前后受试者尿液代谢产物的改变,探究针刺治疗失眠可能的作用途径。方法:将40例原发性失眠患者随机分为针刺组与假针刺组,两组疗程均为2周,观察两组临床疗效;并同时纳入1组健康受试者作鉴定对照,分别于第0天和第14天留取各组的尿液标本,通过非靶向代谢组学检测,探究与针刺治疗失眠可能相关的代谢标志物。结果:①针刺组的失眠严重指数量表(ISI)、睡眠质量、睡眠时间、日间功能障碍评分及总分治疗前后差异均具有统计学意义(P<0.05),并较假针刺组具有统计学差异(P<0.05)。②与原发性失眠相关的潜在差异代谢物有27种,与针刺治疗失眠相关的潜在差异代谢物有1种:Eletriptan N-oxide。结论:①针刺治疗能改善原发性失眠患者的睡眠质量、睡眠时间与日间功能,对原发性失眠具有疗效。②针刺疗法改善原发性失眠的作用可能与调控5-HT代谢相关。

Objective:To observe the clinical efficacy of acupuncture and the urine metabolites in primary insomnia patients,and explore the potential mechanism.Methods:40 patients with primary insomnia were randomly divided into an acupuncture group and a sham acupuncture group.The clinical effects of both groups were observed for 2 weeks,and a group of healthy subjects were included as identification control.The urine samples of each group were taken on the 0th day and 14th day,and the metabolic markers which may be related to acupuncture treatment of insomnia were explored by non-targeted metabonomics detection.Result:①There were significant differences in insomnia severity index (ISI),sleep quality,sleep time,daytime dysfunction score and total score in acupuncture group before and after treatment (P<0.05),and there was statistical difference between the sham acupuncture group and the sham acupuncture group (P<0.05).②27 potential metabolites were detected related to primary insomnia and one related to acupuncture.Conclusion:①Acupuncture therapy can improve the sleep quality,and daytime function,and has curative effect on primary insomnia.②The underlying mechanism may related with 5-HT metabolism.