| Objective: 1. To look for metabolites closely associated with psychological sub-optimal health state of the Yin deficiency type through exploring preliminary the difference of metabolites in the blood between the crowd suffering from the state and healthy crowd in a small sample. 2. To evaluate the intervention effect of Baihe Dihuang decoction to the state through observing its clinical effect and the metabolites’ changes before and after intervention.Methods: Through SCL-90 scale and the diagnostic criteria of different syndrome types of TCM to screen the Yin deficiency type psychological sub-optimal health crowd. Give them the Baihe Dihuang decoction, a daily dose, treatment of 4 weeks. According to the test results of SCL-90 scale to evaluate its intervention effect from the angle of clinical. Gather blood samples of all subjects before and after the intervention, in healthy people as control. Use NMR detection instrument to test the samples and gather metabolomics data. Apply SIMCA- P13.0 software to analysis these data. Search for the metabolites which have obvious difference between the groups through establishing PLS – DA model and OPLS-DA model, combined with the VIP(variable importance in the the projection) value and t test results. Then according to the area under receiver-operating curves(ROC) to evaluate their diagnostic capacity. Through analyzing the relevant metabolic pathways to clarify preliminary the pathophysiology of Yin deficiency type psychological sub-optimal health state. According to the changes of these special metabolites before and after the intervention to evaluate the intervention effect of Baihe Dihuang decoction.Results: 1. After full course of treatment, the improvement situation of 24 cases is: 0 cases were cured, 8 cases were markedly improved, 15 cases were improved, and 1 case had no effect, the total effective rate was 95.83%. The change of each factor of SCL- 90 scale as follows: in addition to the paranoid factor, there were statistically significant difference in the rest of the factors before and after intervention(P < 0.01), especially in somatization, other(reflecting sleep and diet), depression, hostility and anxiety factors. 2. There were 22 samples after eliminating clinical invalid and unqualified blood sample. We identified 32 kinds of metabolites from NMR maps of all samples, including amino acids, sugars, choline and other substances. PLS- DA scatterplot displays that these samples from different groups(the intervention group before and after intervention and the healthy group) were obviously divided into three clusters and Showed the gathered trend in each group. The scatterplot also displays that the intervention group after intervention had a tendency towards the healthy group. 3. Compared with the healthy group, there are six metabolites increasing significantly and three metabolites decreasing significantly in the blood metabolites of the intervention group before intervention. The former are glutamine, citrate, N-acetyl-glycoproteins, TMAO, tyrosine and phenylalanine. The latter are valine, isoleucine and glucose. 4. In the above 9 kinds of potential biomarkers, the area under the ROC curve of valine, isoleucine and glucose are all below 0.5, which suggests that they have no diagnostic ability to the Yin deficiency type psychological sub-optimal health state. And the area under the ROC curve of the other 6 kinds of metabolites are all between 0.7 ~ 0.9, which suggests that their diagnostic ability is medium. 5. After intervented, the level of these potential biomarkers of the intervention group have some changes: the level of valine, isoleucine, glutamine, citrate, tyrosine and phenylalanine have no significant difference between the intervention group and the healthy group, which show that they have returned to normal levels.Conclusion: The Baihe Dihuang decoction has an integral improving effect to the Yin deficiency type psychological sub-optimal health state, especially in the following aspects: Somatization symptoms including acid, numb, swell, pain and weakness of the limbs and some uncomfortable feeling in the stomach, the lower quality status of diet and sleep, some bad mood and psychology including hostility, depression and anxiety. But the Baihe Dihuang decoction has almost no improving effect to paranoid. The research results of the blood metabolomics showed that the Yin deficiency type psychological sub-optimal health population have metabolism disorder, and the disorder can be regulated by the Baihe Dihuang decoction. |
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