Liver Depression-Spleen Vacuity & Metabonomics

abstracted & translated by
Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)

Keywords: Chinese medicine, pattern discrimination, liver depression-spleen vacuity, metabonomics

A liver depression with concomitant spleen qi vacuity is one of the most commonly presenting patterns in adults in Chinese medicine. It is so commonly seen that it even has an abbreviation within the Chinese medical literature, a liver-spleen disharmony (gan pi bu he). Because this pattern is so common, especially in stressed-out adults in developed countries, it is important to be able to quickly and accurately diagnosis it so that effective treatment for it may be initiated. While the traditional signs and symptoms of this two-part pattern are clinically valid and accurate, there is no reason not to also want more objective criteria for its identification – for instance, criteria based on blood analysis. Certainly in China, great efforts are underway to try to establish Western biomedical indicators of traditional Chinese patterns. As an example of this movement, on pages 307-313 of issue #3, 2007 of the Zhong Xi Yi Jie He Xue Bao (Academic Journal of Integrated Chinese-Western Medicine), Luo He-gu et al. published an article titled “Metabonomic Research on Rat Liver Depression-Spleen Vacuity.” In this study, the authors attempt to identify a pattern of occurrence of various chemicals in the blood that a present in those with liver depression-spleen vacuity. A summary of this article is presented below.

Study methodology:

Twenty-four male Sprague-Dawley rats were randomly divided into four groups of six rats each. Group A were identified as the seven-day normal control group, group B were identified as the 21-day normal control group, group C were identified as the seven-day stress group, and group D were identified as the 21-day stress group. Chronioc restarint was used to induce stress in the rats in groups C and D. Blood was then collected from the heart ventricle under anesthesia on day 8 in groups A and C and on day 22 in groups B and D and analyzed using a Fourier variable superconducting nuclear magnetic resonance (NMR) spectrometer (Varivia Unitylnova 600 M). Free induction decay signals were transferred into one-dimensional NMR spectrograms via 32k Fourier transformation. Next, segmental integral calculus (0.004 ppm per segment) was performed from 4.5-0.5 ppm (Carr-Purcell-Meiboom-Gill, CPMG) or 6.0-0 ppm (logitudinal eddy-delay, LED) as default ¹H spectra values using the VNMR software. Date were saved as text or Excel files after normalization and then used for pattern recognition analyses. All the data were analyzed by principal component analysis (PCA) using the SIMCA-P 10.0 software (Umetrics AB, Umea, Sweden).

Study outcomes:

The PCA analysis of rat plasma ¹H NMR spectra revealed different metabolic spectra between the stressed and control groups which were consistent with alterations of in vivo metabolisms in rats under stress. Compared with the normal control groups, the rats which experienced repeated stress displayed significant changes in spectral peak shapes of acetate, lactate, tyrosine, low-density lipid (LDL) cholesterol, and other unknown compounds (3.44 ppm).

Conclusions:

Therefore, the authors of this study conclude that the ¹H NMR spectra of metabolites the rat blood are differentially altered after chronic stress, and, further, these the pattern of occurrence of these altered metabolites may be used as a biomarker of the pattern of liver depression-spleen vacuity in further studies. More generally, it was the authors’ opinion that, based on the outcomes of this study, specific, characteristic metabolic products can be identified by metabonomic analysis as relating to specific Chinese medical patterns, thus leading to the objective, biological identification of such other patterns. Hence they believe that more of this type of research should be carried out in the future.

Discussion:

In the past, many Chinese researchers have looked for a one-to-one relationship between specific individual chemical markers in the body and particular Chinese medical patterns. However, such one-to-one correspondences have failed to achieve anything more than generally a 70% statistical probability. However, as this and similar metabonomic studies show, there is a growing perception in China that, instead of looking at a single chemical marker per pattern, they should be looking at patterns of biomarkers. If one considers that a Chinese medical pattern is not typically identified by a single sign or symptom alone, it makes sense that, on a chemical level, we should not be looking for a significant change in a single chemical but rather a patterned shift in several chemicals. It is my opinion that Western students and practitioners of Chinese medicine be aware of these kinds of developments in China. Otherwise we run the risk of being shut out of the inevitable integration of Chinese and Western medicines facilitated by this kind of research.

Copyright © Blue Poppy Press, 2007. All rights reserved.