基于情感环路探讨摩腹法治疗广泛性焦虑症的作用机制

Generalized anxiety disorder(GAD) is a kind of neurosis with anxiety-based ,which is Clinical common and frequently-occurring disease. Abdominal massage is a method to cure this disease ,which has a good clinical effect.Basing on the earlier period research foundation, taking "Rubbing abdomen" which is as the intervention method as the intervention method ,the study team proposes the hypothesis: when "Rubbing abdomen" acting on the abdomen ,by means of brain-gut axis neural pathways, it could affect mood ring role.The study will detect the changes in the intestinal tissue and emotional loop GAS, NPY, CGRP levels of neuropeptide of rats model of GAD,and observe sensitive areas of rat GAD emotional loop morphology,using HRP tracer techniqueto observe the the neurons of Emotional loop,function and changes in the organizational structure of each nucleus before and after intervention,and based on the above analysis of the results to be compared. Determining the role of a bridge of neural pathways of brain-gut axis,and Observing the action of "Rubbing abdomen" on Emotional loop , so the central regulatory mechanisms would be figured out.After arrange and analyse indexes, this project has the important practical significance for abdominal-Tuina in the treatment of functional gastrointestinal disease theory and clinical practice and provide the scientific basis for the system of abdominal-Tuina mechanism in this project.

广泛性焦虑症(Generalized Anxiety Disorder，GAD)是临床常见病以及多发病。腹部推拿作为其治疗手段之一，具有良好的临床疗效。本研究基于前期研究基础，以腹部推拿核心手法"摩腹法"为干预手段，提出"摩腹法作用于腹部，影响情感环路，通过对情感环路多个核团整体调节，达到治疗GAD作用"的理论假说，拟以慢性情绪应激法建立模型，检测GAD大鼠肠组织及情感环路中GAS、NPY、CGRP神经肽含量变化、应用fMRI技术探索摩腹干预情感环路的敏感区、运用HRP示踪技术观察情感环路各核团HRP标记细胞表达、采用HE、MRS技术检测摩腹法干预前后情绪环路形态、功能以及各核团结构变化，综合以上研究结果加以对比分析。揭示情绪环路在GAD调节中的作用，以及摩腹法调节情绪环路干预GAD的中枢机制。该项目将进一步深化腹部推拿基础研究，对促进推拿学科发展具有重要意义，为腹部推拿临床推广提供依据。

本项目作为前期研究延续与扩展，以“摩腹法”为干预手段，以调控情感环路为突破口，观察摩腹法干预前后情感环路形态、功能、以及各核团组织结构变化，阐释摩腹法干预情感环路作用GAD的中枢调节机制。采用广泛性焦虑大鼠模型制作方法——慢性情绪应激法，并以高架十字迷宫试验对其进行评价。通过放免技术，检查摩腹法干预前后，GAD大鼠模型肠组织以及情感环路中GAS、NPY、CGRP神经肽的含量变化，证实脑肠通路的桥梁作用；采用fMRI成像技术，观测摩腹作用后的GAD大鼠模型情感环路多个核团的效应靶点；应用HRP逆行追踪标记技术，检测摩腹干预后GAD大鼠情感环路中标记细胞的表达，验证摩腹法干预情感环路假说的真实性；通过液相-质谱联用的方法进行绝对定量分析，观察情感环路各核团组织结构的变化情况和各核团神经元代谢物NAA、Glu、Cho和Cr的浓度等指标的变化，揭示摩腹法作用于腹部干预情感环路治疗GAD的中枢调节机制。验证了“摩腹法作用于腹部，借助脑肠轴神经通路，影响情感环路，通过对情感环路为重点的多个核团整体调节，从而达到调衡GAD的作用机制”假说的真实性。