Keywords
Microbiome-gut-brain axis
Liver-depression and spleen deficiency
Insomnia
Traditional Chinese medicine
Submitted : 2024-05-15
Accepted : 2024-05-30
Published : 2024-06-14
Abstract
Insomnia has become an urgent clinical problem in modern society. Current research has found that the gut flora-gut-brain axis plays an important role in regulating insomnia. The state-target theory is a product of the combination of traditional Chinese medicine and modern molecular biology technology. This paper clarifies the correlation between the state-target theory, the intestinal flora-gut-brain axis, and liver-depression-spleen-deficiency insomnia. The use of traditional Chinese medicine to regulate the structure and abundance of intestinal flora was also explored, aiming to integrate traditional Chinese medicine with Western medicine for the prevention and treatment of liver-depression-spleen-deficiency insomnia.
References
Chinese Medical Association Neurology Branch, Chinese Medical Association Neurology Branch Sleep Disorders Group, 2018, Guidelines for the Diagnosis and Treatment of Insomnia in Chinese Adults (2017 Edition). Chinese Journal of Neurology, 51(5): 324–335.
Qin J, Li R, Raes J, et al., 2010, A Human Gut Microbial Gene Catalogue Established by Metagenomic Sequencing. Nature, 464(7285): 59–65. https://doi.org/10.1038/nature08821
Huang Q, Zeng L, Wang GC, et al., 2022, Progress in the Treatment of Insomnia by Regulating Intestinal Flora in Chinese Medicine Based on the Theory of Microbiome-Gut-Brain Axis. Tianjin Traditional Chinese Medicine, 2022(4): 39.
Li Y, Hao Y, Fan F, et al., 2018, The Role of Microbiome in Insomnia, Circadian Disturbance and Depression. Front Psychiatry, 9: 669. https://doi.org/10.3389/fpsyt.2018.00669
Gomes AC, Hoffmann C, Mota JF, 2018, The Human Gut Microbiota: Metabolism and Perspective in Obesity. Gut Microbes, 9(4): 308–325. https://doi.org/10.1080/19490976.2018.1465157
Yun X, Wu F, Xu Y, et al., 2023, Discussion on Insomnia Based on “Microbiome-Gut-Brain Axis”. Modern Chinese Medicine Clinics, 30(3): 31–36 + 42.
Zhao L, 2020, State-Targeted Diagnosis – The Historical Choice of Chinese Medicine from Macro to Precision. Liaoning Journal of Chinese Medicine, 2020(1): 4.
Tong X, 2010, On the Application of the Combined Diagnosis and Treatment Model of Symptoms, Evidence and Diseases in Clinical Practice. Journal of Traditional Chinese Medicine, 2010(4): 4.
Duan J, Wang X, Guo R, et al., 2023, Discussion on the Application of “State-Target Theory” to Diarrhea of Spleen and Stomach Diseases in Traditional Chinese Medicine. Journal of Changchun University of Traditional Chinese Medicine, 39(4): 362–366.
Yuan Y, Chen S, Zhang H, 2022, Academic Experience of Prof. Zhang Huili in Treating Insomnia from Liver Theory. Chinese Medicine Clinical Research, 2022(22): 14.
Ren X, Liu S, Wang X, et al., 2020, Collection of Professor Yang Zhihong’s Experience in Treating Insomnia. Shaanxi Traditional Chinese Medicine, 461(5): 120–122.
Shen Y, Zhang Q, 2010, Theoretical Analysis of the Liver and Insomnia. Journal of Liaoning University of Traditional Chinese Medicine, 12(5): 2.
Li X, Ma Y, Wu Q, 2021, Experience of Treating Insomnia from the Theory of Spleen and Stomach in the Middle Jiao. Global Chinese Medicine, 14(8): 3.
Li L, Yang S, 2022, Yang Shuyu’s Experience in Treating Insomnia from the Perspective of Liver and Spleen. Journal of Traditional Chinese Medicine, 63(23): 5.
Lai Y, Bai L, 2015, New Progress in the Study of External Treatment of Insomnia in Chinese Medicine. Inner Mongolia Traditional Chinese Medicine, 34(4): 2.
Li J, Yang L, Guo R, 2023, Guo Rongjuan’s Experience in Treating Anxiety Insomnia from Liver Theory. Chinese Medicine Journal, 29(6): 186–189.
Tang Z, 2020, Blood Evidence. People’s Health Press, Beijing.
Zhang J, 2016, Jingyue Quanquan. China Medicine Science and Technology Press, Beijing.
Tremaroli V, Bäckhed F, 2012, Functional Interactions Between the Gut Microbiota and Host Metabolism. Nature, 489(7415): 242–249. https://doi.org/10.1038/nature11552
Goyal D, Ali SA, Singh RK, 2021, Emerging Role of Gut Microbiota in Modulation of Neuroinflammation and Neurodegeneration with Emphasis on Alzheimer’s Disease. Prog Neuropsychopharmacol Biol Psychiatry, 106: 110112. https://doi.org/10.1016/j.pnpbp.2020.110112
Cai Y, Deng Y, Li D, et al., 2023, A New Strategy for the Prevention and Treatment of Type 2 Diabetes Mellitus in Traditional Chinese Medicine Based on the “State-Target Theory-Regulation of Microbiome”. Journal of Traditional Chinese Medicine, 51(2): 1–5.
Zhu J, Len Y, Zhou X, et al., 2019, Analyzing the Pathogenesis of Diabetes Mellitus from the Theory of Qi Elevation Based on Intestinal Flora. Chinese Journal of Experimental Formulary, 2019(21): 7.
Zhang H, Qiao M, Sun L, 2008, Analysis of Hypothalamic Monoamine Neurotransmitters in Rats with Liver Qi Depressive Syndrome Model. Journal of Traditional Chinese Medicine, 49(2): 3.
Si Y, Wei W, 2022, A Comprehensive Study on the Relieving Effect of Lilium brownii on the Intestinal Flora and Metabolic Disorder in p-Chlorphenylalanine-Induced Insomnia Rats. Pharmaceutical Biology, 60(1): 131–143.
Li S, Chen G, Du H, et al., 2021, Discussion on the Relationship Between the Theory of “Soil Congestion and Wood Depression” and the Development of Chronic Hepatitis B Based on Intestinal Flora Dysbiosis. Chinese Journal of Traditional Chinese Medicine, 36(6): 4.
Yao Y, Song Y, Zhao T, 2000, Morphologic Study of Gastrointestinal Mucosa in a Rat Model of Spleen Deficiency. Chinese Journal of Integrative Medicine and Digestion, 8(1): 8–10.
Huang L, 2021, Evaluation of the Efficacy of HAPS in Mice with Spleen Qi Deficiency and Its Effect on Intestinal Immune Function, thesis, Guangdong Pharmaceutical University.
Li H, 2019, Progress in the Study of Quality Biomarkers of Traditional Chinese Medicine. Chinese Herbal Medicine, 50(19): 6.
Round JL, Mazmanian SK, 2009, The Gut Microbiota Shapes Intestinal Immune Responses During Health and Disease. Nat Rev Immunol, 9(5): 313–323. https://doi.org/10.1038/nri2515
Reikvam DH, Erofeev A, Sandvik A, et al., 2011, Depletion of Murine Intestinal Microbiota: Effects on Gut Mucosa and Epithelial Gene Expression. PLoS One, 6(3): e17996. https://doi.org/10.1371/journal.pone.0017996
Peng W, Shen Z, Wang Y, et al., 2019, Research Progress of Intestinal Flora on Sleep Regulation. Chongqing Medicine, 48(19): 5.
Luo J, Wu Y, Huang F, et al., 2018, Study on the Difference of Intestinal Flora in Patients with Primary Insomnia of Different Chinese Medicine Certificates. China Journal of Traditional Chinese Medicine Information, 25(4): 28–34.
Raybould HE, 2010, Gut Chemosensing: Interactions Between Gut Endocrine Cells and Visceral Afferents. Auton Neurosci, 153(1–2): 41–46. https://doi.org/10.1016/j.autneu.2009.07.007
Zhang J, Xin X, Quan F, 2020, Progress of Chinese and Western Medicine Research on Insomnia. Xinjiang Traditional Chinese Medicine, 38(2): 2.
Luo C, Zhang J, Pan J, 2013, One-Year Course and Effects of Insomnia in Rural Chinese Adolescents. Sleep, 36(3): 377–384.
Krueger JM, Opp MR, 2016, Sleep and Microbes. Int Rev Neurobiol, 131: 207–225. https://doi.org/10.1016/bs.irn.2016.07.003
Feng Q, Chen WD, Wang YD, 2018, Gut Microbiota: An Integral Moderator in Health and Disease. Front Microbiol, 9: 151. https://doi.org/10.3389/fmicb.2018.00151
Pan LM, Shi YY, Bu F, et al., 2022, Research Progress of Jiaotai Pill in the Treatment of Primary Insomnia. Journal of Liaoning University of Traditional Chinese Medicine, 24(11): 177–181.
Powley TL, Wang XY, Fox EA, et al., 2008, Ultrastructural Evidence for Communication Between Intramuscular Vagal Mechanoreceptors and Interstitial Cells of Cajal in the Rat Fundus. Neurogastroenterol Motil, 20(1): 69–79. https://doi.org/10.1111/j.1365-2982.2007.00990.x
Sharon G, Sampson TR, Geschwind DH, et al., 2016, The Central Nervous System and the Gut Microbiome. Cell, 167(4): 915–932. https://doi.org/10.1016/j.cell.2016.10.027
Bonaz B, Picq C, Sinniger V, et al., 2013, Vagus Nerve Stimulation: From Epilepsy to the Cholinergic Anti-Inflammatory Pathway. Neurogastroenterol Motil, 25(3): 208–221. https://doi.org/10.1111/nmo.12076
Bravo JA, Forsythe P, Chew MV, et al., 2011, Ingestion of Lactobacillus Strain Regulates Emotional Behavior and Central GABA Receptor Expression in a Mouse via the Vagus Nerve. Proc Natl Acad Sci U S A, 108(38): 16050–16055. https://doi.org/10.1073/pnas.1102999108
He Y, Jin H, Liu Z, et al., 2022, Construction of a New Thinking of Traditional Chinese Medicine Based on the Theory of “State-Target Causation”. China Journal of Basic Chinese Medicine, 28(12): 1961–1963 + 1992.
Tong X, 2021, State-Targeted Medicine: The Future Development of Traditional Chinese Medicine. Chinese Journal of Integrative Medicine, 41(1): 16–18.
Yu Y, Min C, Zhan F, et al., 2021, Clinical Observation on the Treatment of Insomnia of Liver-Depression Type with the Compound Liver-Regulating and Heart-Supporting Formula of “Treating From the Liver Theory” and Its Effect on the Regulation of Intestinal Flora Structure. Chinese Herbal Medicine, 44(9): 2210–2213.
Hong J, 2021, Effects of the Addition and Subtraction of Chaihu Plus Long Bone Oyster Decoction on the Intestinal Flora of REM Sleep-Deprived Rats, thesis, Beijing University of Chinese Medicine.
Wang X, Shi L, Zhang Y, et al., 2023, Effects of Tonifying Spleen and Eliminating Accumulation Oral Solution on Gastrointestinal Function and Intestinal Flora Structure in Mice with Spleen Deficiency and Food Accumulation. Modern Drugs and Clinics, 38(8): 1865–1871.
Zhao C, Xiao R, Yang L, et al., 2020, Discussion on the Therapeutic Effect of Buzhong Yiqi Decoction in Treating Insomnia of Spleen Deficiency Type from the Perspective of Intestinal Flora. Journal of Guangzhou University of Traditional Chinese Medicine, 37(11): 2057–2063.
Ren X, Li T, 2020, Effects of Sour Jujube Nut Soup on Liver Function and Specific Intestinal Bacteria in Mice with Chronic Sleep Deprivation. Drug Evaluation Research, 43(2): 226–231.