A~1H NMR-based Metabonomics Study Of Acupuncture At ST25for Treating Functional Constipation

Objective:To investigate whether metabolic difference exists between acupuncture at ST25(Tianshu) and non-acupoint. In this study, A NMR-based metabonomics approach is applied to study the metabolic effects of acupuncture for functional constipation (FC) to elucidate the complex physiological effects of acupuncture.Methods:Seventy-four participants were recruited, including forty-nine FC patients and twenty-five healthy volunteers. FC patients were randomly divided into acupuncture at ST25group (group A) or sham acupuncture group (group B), and receive10sessions of acupuncture treatment over2weeks. Fasting blood samples of FC patients and healthy control subjects were collected for NMR-based metabonomics analysis. The samples were analyzed by1H NMR spectroscopy, and the segments of each NMR spectrum were optimal normalized for pre-processing the integrated area of each spectrum. The integral data were imported into the SIMCA-P+10.0software as variables for the multivariate pattern recognition analysis. Principal component analysis (PCA) and partial least squares discriminate analysis (PLS-DA) were applied for data analysis with the results of scatter plots and loading plots. To explore the regulation effects of acupuncture at ST25compared the FC patients and healthy volunteers in metabolic difference.Results:1. After two periods of acupuncture treatment, the Constipation Scoring System (CSS) of FC patients was significantly decreased with acupuncture treatment at ST25and non-acupoint over2weeks (P<0.05), and the CSS between two groups was not statistically significant (P>0.05). The SF-36scale scores of two groups was not statistically significant (P>0.05), however, the SF-36scale scores of some dimensions in groups had a significant difference (P<0.05).2. Compared to healthy subjects, the levels of a series compounds including alanine, lactate and proline were significantly decreased (P<0.05), and glutamate, valine, tyrosine, choline,3-hydroxybutyrate, a-glucose and β-galactose were significantly increased (P<0.05).3. The levels of glycine, arginine,3-hydroxybutyrate and a-glucose were decreased after needling ST25in two periods of treatment, however,3-hydroxybutyrate and a-glucose were significantly decreased (P<0.05). In addition, the levels of VLDL, alanine and proline were not obviously increased except alanine (P<0.05). The levels of glycine and a-glucose were significantly decreased on needling non-acupiont (P<0.05).Conclusion:1. The levels of metabolic profiles including alanine, lactate, glutamate, valine, tyrosine, choline,3-hydroxybutyrate, a-glucose, proline and P-galactose were significantly changed on FC patients.2. The key metabolites of alanine,3-hydroxybutyrate and a-glucose were obviously regulated by acupuncture at ST25for FC patients. Acupuncture at ST25was more effective than non-acupiont in regulating the content of metabolites in FC patients.3. Acupuncture at ST25and non-acupiont could both change the levels of amino acid and glucose for improving intestinal peristalsis.