延年九转法干预慢性疲劳综合征的脑肠轴调控机制研究

Chronic fatigue syndrome (CFS) has a high incidence and complex symptoms, Which has the significant negative effects on human health and economic development. CFS etiology and pathogenesis is not clear, which poses a serious challenge to clinical workers..The Previous research have shown that Exercises can alleviate physical and mental fatigue and improve gastrointestinal function of CFS patients. The method of Yan nian jiu zhuan is a classic combination of exercises and abdominal tuina in traditional Chinese medicine. Therefore, it has a therapeutic advantage.There may be a close association between the theory of CFS on the spleen and the theory of "brain-gut axis abnormalities". Our preliminary research also found that CFS patients with hypothalamic PVN, VMH and other functional areas of abnormal signal may be associated with gastrointestinal activity and neuroendocrine-related abnormalities..On the basis of previous research, we hypothesized that there was abnormal nerve - endocrine network in the CFS patients. Abdominal manipulation and exercises can regulate brain-gut axis of the patient's, Which has an effect of improving gastrointestinal function and relieving fatigue symptoms. We will use the technology of gastrointestinal dynamics, immunology and fMRI to observe the correlation of clinical symptoms - neurotransmitter / peptide - brain function - gastrointestinal function. The research will explore some of the characteristic changes in the pathogenesis and progression of CFS and will discuss the effect and mechanism of traditional Chinese medicine,Which will be conducive to reveal the mystery of the traditional exercises, and provide scientific basis and new research ideas of prevention and control for CFS.

CFS发生率高、症状复杂，已对人类健康产生严重的负面影响。因其病因及发病机制不明确，对临床工作者提出了严峻挑战。前期研究表明导引功法能改善CFS的疲劳、失眠和胃肠功能。延年九转法将导引功法和腹部推拿融为一体，具有治疗学上的优势。中医学从脾论治CFS的理论和“脑-肠轴异常”学说之间存在密切关联。课题组前期研究发现CFS患者下丘脑PVN、VMH等功能区信号异常，可能与胃肠功能及神经-内分泌异常相关。本课题在此基础上，提出假说“CFS存在神经内分泌网络异常，导引功法和腹部推拿干预CFS的慢性疲劳状态、改善睡眠质量和胃肠功能是通过脑肠轴调控实现的”。拟采用胃肠动力学、免疫学、fMRI等技术，研究CFS临床症状-神经递质/肽-脑功能活动-胃肠功能的关联。探讨CFS在疾病发生和发展过程中的特征性改变及中医传统疗法的效应与机制。将有利于揭开传统功法效应的神秘面纱，为CFS的防治提供科学依据和新思路。

慢性疲劳综合征（CFS）发生率高、症状复杂，已对人类健康产生严重的负面影响。前期临床实践和研究表明，传统导引功法和腹部推拿对CFS患者躯体、精神症状和胃肠功能具有较好的临床疗效。本项目基于脑肠轴(BGA)调控理论研究特色传统功法干预 CFS 的作用机制，观察患者胃肠功能、睡眠质量和疲劳症状，检测与CFS 密切相关的BGA，分析CFS患者的脑内信息响应特征，探讨CFS患者在疾病发生和治疗过程中的一些特征性改变及中医特色导引功法干预效应与机制。.本研究发现延年九转法对CFS的疲劳、失眠和胃肠功能临床疗效显著；研究发现CFS患者胃肠功能存在异常，肠道菌群、脑肠肽也出现较大差异，但尚未证实延年九转法能够改善患者肠道菌群；运用fMRI技术发现延年九转法激活患者左侧尾状核、左侧额上回、左侧中央前回神经元活动，降低右侧枕中回、左侧枕上回、左侧角回、左侧顶上回、右侧角回、右侧顶上回神经元活动；患者功能连接在左侧枕中回与右侧枕中回，右侧枕上回与左侧枕中回和左侧枕上回增强；与教育组相比，延年九转法激活前扣带回、内侧扣带回、中央后回、内侧额上回等脑区，显著降低左右枕中回、右侧角回、左侧颞中回、右侧枕上回脑区功能。本研究为从脑功能、胃肠功能角度对延年九转法治疗CFS效应机制做进一步阐释，为CFS 的防治提供了部分实验依据，持续的研究将有助于明确中医非药物疗法“外治内应”的作用机制。.本项目按照既定研究方案完成了相应的研究内容，达到预期研究成果。 项目已发表学术论文多篇，主编、副主编十三五推拿学规划教材，培养了多位研究生。通过慢性疲劳综合征推拿门诊，海报以及微信公众号平台等多种形式和渠道宣传推广CFS的防治和中医传统非药物疗法。

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