Clinical And Mechanism Study Of Auricular Point Comprehensive Therapy Based On Omics In The Treatment Of Migraine With Liver-yang Hyperactive

Objective: The study aims to explore the clinical effect of auricular point comprehensive therapy in the treatment of liver-yang hyperactive migraine without aura,and to study the molecular biological mechanism of the therapy in the treatment using transcriptomics and proteomics technology.We hope to further improve the mechanism study of this therapy.Methods: 84 patients with liver-yang hyperactive migraine without aura were randomly divided into auricular point comprehensive therapy group(observation group)and common acupuncture group(control group)to observe the changes of migraine scores and VAS、SAS、SDS、WHOQOL-BREF scores after treatment and follow-up.And then we comprehensively analyzed and evaluated the clinical efficacy.Transcriptomics and proteomics studies were performed using RNA sequencing and TMT techniques.Results :1.Clinical research:(1)In the efficacy scale scores,the two groups had significant improvement in the headache degree,duration,attack frequency,accompanying symptoms,VAS,SAS,WHOQOL-BREF scores than before treatment(P<0.05).Compared with the control group,the effect of the observation group was more obvious in improving headache degree,VAS and WHOQOL-BREF scores(P<0.05),and there were no significant differences in improving headache duration,attack frequency,accompanying symptoms and SAS scores between the two groups(P>0.05).In terms of improving SDS scores,the short-term effect of the observation group was not obvious(P>0.05)and the long-term effect was obvious(P<0.05),while the short-term and long-term effects of the control group were not obvious(P>0.05).(2)In terms of clinical effective rate,the short-term effective rate was 95% and the long-term effective rate was 90% in the observation group,while the short-term effective rate was 90% and the long-term effective rate was 82.5%in the control group.There was no statistical difference in the short-term and long-term effective rate between the two groups(P>0.05).(3)In terms of safety and compliance,there were no statistical differences in ADR and compliance rate between the two groups(P>0.05).2.Transcriptomics studies had found that IL1R1、TNFAIP2、LRP1、NRP1、VEGFA、NOTCH1、PELI1 genes were differentially expressed between healthy people and liver-yang hyperactive migraine patients without aura.After auricular point comprehensive therapy treatment,IL1R1、TNFAIP2、NOTCH1、PELI1 genes were differentially expressed.The differential genes enrichment pathway mainly included NF-κB signaling pathway,MAPK signaling pathway,cytokine-cytokine receptor interaction pathway,NOD-like receptor signaling pathway,Notch signaling pathway and so on.3.Proteomics study found that the differential proteins after auricular point comprehensive therapy treatment were mainly PF4、PBP、TIMP1、ALDOC、LDHA、YWHAE、THBS1、APOC3、APOA2,and the differential proteins enrichment pathway mainly included cytokine-cytokine receptor interaction pathway,chemokine signaling pathway,HIF-1 signaling pathway,PI3K-AKT signaling pathway,PPAR signaling pathway and so on.Conclusions: Auricular point comprehensive therapy has good short-term and long-term efficacy,safety and compliance in treating liver-yang hyperactive migraine without aura.And it has some advantages over common acupuncture in relieving pain,regulating emotion and improving quality of life.The mechanism may be related to IL1R1、TNFAIP2、NOTCH1、PELI1 genes and PF4、PBP、TIMP1、YWHAE proteins,involved in cytokine-cytokine receptor interaction pathway,chemokine signaling pathway,NOD-like receptor signaling pathway,Notch signaling pathway,HIF-1 signaling pathway,PI3K-AKT signaling pathway,PPAR signaling pathway,etc.This therapy can regulate the above genes,proteins and the corresponding signaling pathways,and then regulate interleukin,tumor necrosis factor,nuclear factor,vascular endothelial growth factor and other cytokines and inflammatory factors,reduce the neurovascular inflammatory response,protect the cerebrovascular and nerve,and then relieve migraine.It provides a reference for the study of other types of migraine treated with auricular point comprehensive therapy.