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Li S, Zhu P, Cai G, Li J, Huang T, Tang W. Application of machine learning models in predicting insomnia severity: an integrative approach with constitution of traditional Chinese medicine. Front Med (Lausanne) 2023; 10:1292761. [PMID: 37928471 PMCID: PMC10625410 DOI: 10.3389/fmed.2023.1292761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/06/2023] [Indexed: 11/07/2023] Open
Abstract
Objective This study sought to explore the utility of machine learning models in predicting insomnia severity based on Traditional Chinese Medicine (TCM) constitution classifications, with an aim to discuss the potential applications of such models in the treatment and prevention of insomnia. Methods We analyzed a dataset of 165 insomnia patients from the Shanghai Minhang District Integrated Traditional Chinese and Western Medicine Hospital. TCM constitution was assessed using a standardized Constitution in Chinese Medicine (CCM) scale. Sleep quality, or insomnia severity, was evaluated using the Spiegel Sleep Questionnaire (SSQ). Machine learning models, including Random Forest Classifier (RFC), Support Vector Classifier (SVC), and K-Nearest Neighbors (KNN), were utilized. These models were optimized using Grid Search algorithm and were trained and tested on stratified patient data, with the TCM constitution classifications serving as primary predictors. Results The RFC outperformed others, achieving a weighted average accuracy, precision, recall, and F1-score of 0.91, 0.94, 0.92, and 0.92 respectively, it also effectively classified the severity of insomnia with high area under receiver operating characteristic curve (AUC-ROC) values. Feature importance analysis demonstrated the Damp-heat constitution as the most influential predictor, followed by Yang-deficiency, Qi-depression, Qi-deficiency, and Blood-stasis constitutions. Conclusion The results demonstrate the potent utility of machine learning, specifically RFC, coupled with TCM constitution classifications in predicting insomnia severity. Notably, the constitution classifications such as Damp-heat and Yang-deficiency emerged as crucial determinants, emphasizing its potential in guiding targeted insomnia treatments. This approach enables the development of more personalized and efficient interventions, thereby enhancing patient outcomes.
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Affiliation(s)
- Shenguang Li
- Shanghai Minhang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
| | - Po Zhu
- Shanghai Minhang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
| | - Guoying Cai
- Shanghai Minhang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
| | - Jing Li
- Shanghai Minhang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
| | - Tao Huang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenchao Tang
- School of Acupuncture-Moxibustion and Tuina, Shanhgai University of Traditional Chinese Medicine, Shanghai, China
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Feng W, Yang Z, Liu Y, Chen R, Song Z, Pan G, Zhang Y, Guo Z, Ding X, Chen L, Wang Y. Gut microbiota: A new target of traditional Chinese medicine for insomnia. Biomed Pharmacother 2023; 160:114344. [PMID: 36738504 DOI: 10.1016/j.biopha.2023.114344] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/20/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
All species have a physiological need for sleep, and sleep is crucial for the preservation and restoration of many physiological processes in the body. Recent research on the effects of gut microbiota on brain function has produced essential data on the relationship between them. It has been discovered that dysregulation of the gut-brain axis is related to insomnia. Certain metabolites of gut microbiota have been linked to insomnia, and disturbances in gut microbiota can worsen insomnia. Traditional Chinese medicine (TCM) has unique advantages for the treatment of insomnia. Taking the gut microbiota as the target and determining the scientific relevance of TCM to the prevention and treatment of insomnia may lead to new concepts for the treatment of sleep disorders and improve the therapeutic effect of sleep. Taking the gut microbiota as an entry point, this paper reviews the relationship between gut microbiota and TCM, the relationship between gut microbiota and insomnia, the mechanism by which gut microbiota regulate sleep, and the mechanism by which TCM regulates gut microbiota for insomnia prevention and treatment. This review provides new ideas for the prevention and treatment of insomnia through TCM and new ideas for drug development.
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Affiliation(s)
- Wanying Feng
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Zhihua Yang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Yangxi Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China.
| | - Rui Chen
- College of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Zhihui Song
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Guiyun Pan
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Yuhang Zhang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Zehui Guo
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Xinya Ding
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China.
| | - Lu Chen
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Yi Wang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
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Yu H, Zhang F, Wen Y, Zheng Z, Chen G, Pan Y, Wu P, Ye Q, Han J, Chen X, Liu C, Shen T. Mechanism of interventional effect and targets of Zhuyu pill in regulating and suppressing colitis and cholestasis. Front Pharmacol 2022; 13:1038188. [PMID: 36408242 PMCID: PMC9666482 DOI: 10.3389/fphar.2022.1038188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/24/2022] [Indexed: 11/23/2022] Open
Abstract
Zhuyu pill (ZYP) is a traditional Chinese medicine prescription composed of two drugs, Coptis chinensis Franch. and Tetradium ruticarpum (A. Jussieu) T. G. Hartley, and is commonly used in the clinical treatment of diseases of the digestive system. However, the mechanism underlying the effect of ZYP on colitis remains unclear. In this study, a colitis rat model was induced with 2,4,6-trinitro-benzenesulfonic acid (TNBS, 100 mg/kg) and treated with ZYP (low dose: 0.6 g/kg, high dose: 1.2 g/kg). Disease activity index, colonic weight index, and weight change ratio were used to evaluate the model and efficacy. LC-MS and 16S rRNA gene sequencing were used to measure differences in fecal metabolism and microorganism population among the control, model, low-dose ZYP, and high-dose ZYP groups. To elucidate the mechanism of interventional effect of ZYP, Spearman correlation analysis was used to analyze the correlation between fecal metabolism and fecal microbial number. High-dose and low-dose ZYP both exhibited significant interventional effects on colitis rat models, and high-dose ZYP produced a better interventional effect compared with low-dose ZYP. Based on a metabolomics test of fecal samples, significantly altered metabolites in the model and high-dose ZYP treatment groups were identified. In total, 492 metabolites were differentially expressed. Additionally, sequencing of the 16S rRNA gene in fecal samples revealed that the high-dose ZYP could improve TNBS-induced fecal microbiota dysbiosis. Ultimately, changes in tryptophan metabolism and Firmicutes and Gammaproteobacteria populations were detected after ZYP treatment in both colitis and cholestasis. Therefore, we conclude that tryptophan metabolism and Firmicutes and Gammaproteobacteria populations are the core targets of the anti-inflammatory effect of ZYP. These findings provide a scientific basis for further investigation of the anti-inflammatory mechanism of ZYP in the future.
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Affiliation(s)
- Han Yu
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fenghua Zhang
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yueqiang Wen
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China,Department of Pediatrics, Guang’an Hospital of Traditional Chinese Medicine, Guang’an, China
| | - Zhili Zheng
- Department of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Gaoyang Chen
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yingying Pan
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Peijie Wu
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qiaobo Ye
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jun Han
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaofeng Chen
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China,*Correspondence: Xiaofeng Chen, ; Chao Liu, ; Tao Shen,
| | - Chao Liu
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China,*Correspondence: Xiaofeng Chen, ; Chao Liu, ; Tao Shen,
| | - Tao Shen
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China,*Correspondence: Xiaofeng Chen, ; Chao Liu, ; Tao Shen,
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Cheng B, Liu Y, Tian J, Gao R, Liu Y. Complementary and Alternative Medicine for the Treatment of Insomnia: An Overview of Scientific Evidence from 2008 to 2018. Curr Vasc Pharmacol 2019; 18:307-321. [PMID: 31057109 DOI: 10.2174/1570161117666190506111239] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 04/11/2019] [Accepted: 04/11/2019] [Indexed: 11/22/2022]
Abstract
Insomnia is a widespread sleep disorder in the general population, and it is a risk factor for impaired function, the development of other medical and mental disorders, and causes an increase in health care costs. In view of the health hazards of insomnia and the shortcomings of western medicine, Complementary and Alternative Medicine (CAM) should be considered in the management of insomnia. The present overview reports the potential role of herbal medicine and non-pharmacological therapies in the treatment of insomnia and summarizes the scientific evidence reported from 2008 to 2018. PubMed and Web of Science databases were searched for studies published from 2008 to 2018. 17 randomized controlled trials and 22 non-pharmacological therapies were included in this review, and the results showed that CAM had certain advantages in the treatment of insomnia. The safety of CAM for insomnia was acceptable. Meanwhile, based on pre-clinical trial, the possible mechanisms of CAM for insomnia were modulation of circadian rhythm, GABA receptor activation, antagonisms of 5-HT receptors, inhibition of glutamate-mediated pathways, and attenuation of inflammation. CAM for insomnia has made some progress, but high quality evidence-based medical evidence is still needed to provide guidance for clinical application.
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Affiliation(s)
- Bingli Cheng
- Beijing Handian Pharmaceutical Co, Ltd, Beijing 100020, China.,West China School of Pharmacy, Sichuan University, Chengdu 610041, China
| | - Yanfei Liu
- Graduate School of Beijing, University of Chinese Medicine, Beijing 100029, China.,Institute of Clinical Pharmacology of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Jinfan Tian
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Rui Gao
- Institute of Clinical Pharmacology of Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Yue Liu
- Cardiovascular Diseases Center, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing 100091, China
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An innovative method to evaluate the severe level of general Qi deficiency. J TRADIT CHIN MED 2018. [DOI: 10.1016/s0254-6272(18)30891-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
OBJECTIVE To evaluate the effect of Guizhi Gancao Longgu Muli Tang (GGLMT), a decoction prepared
with herbal medicine of Traditional Chinese Medicine, on sleep disturbances in women with
menopause. METHODS Totally 162 participants were recruited for the treatment of sleep difficulty from February,
2012 to December, 2014. Decoction of 200 mL was taken by every participant twice daily in half an
hour after lunch and dinner during two weeks. Sleep quality was assessed by Pittsburg sleep quality index (PSQI) and menopausal symptoms and quality of life were evaluated by the menopause
rating scale (MRS) and the Chinese version of World Health Organization quality of life-BREF at the final
fellow-up in the fourth weekend after beginning. RESULTS The average scores of PSQI had reduced from (13.82 ± 4.97) to (8.14 ± 3.19), 95% CI
(- 4.87, - 3.05) after 2-week GGLMT treatment in the fourth week. GGLMT improved symptoms in patients
with more severe conditions (MRS ≥ 16). Three adverse drug reaction, mouth ulcer, constipation,
and folliculitis, might be related with GGLMT and disappeared after withdrawals of the treatment. CONCLUSION For menopausal women suffering from chronic sleep disturbances, our findings suggest
that two weeks treatment of GGLMT was safe and effective.
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Singh A, Zhao K. Treatment of Insomnia With Traditional Chinese Herbal Medicine. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 135:97-115. [PMID: 28807167 DOI: 10.1016/bs.irn.2017.02.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Insomnia is a condition with sleep problems and many people suffered from it. Chronic insomnia can last for long time and it will severely affect people's health and the quality of life. In conventional medicine, the most commonly used the medicine is benzodiazepine. It is effective but also has significant side effects. Patients try to use some kinds of alternative medicines. Chinese medicinal herbs and formulas have been used in the treatment of insomnia for more than 2000 years in China. In recent decades, Chinese herbal medicine has been widely used in the Western countries. Many clinical studies including randomized controlled clinical trials and research on pharmacological action mechanisms of the herbs for treatment of insomnia have been conducted. It is very important and very helpful to review the published research papers to gather the available information for a critical analysis. This chapter evaluated the data from both of clinical studies and pharmacological researches on the therapeutic formulas and on some key herbs used in the treatment of insomnia. Clinical studies showed a very wide spectrum of herbs that were used in clinical treatment of insomnia. This was due to different syndrome patterns happened with insomnia. This brought complexity and difficulties to identify which are the essential key herbs or formulas. It was found Suanzaoren decoction (Ziziphus spinose decoction ) is the most frequently used formula for the treatment of insomnia. Based on the clinical data, several herbs were identified as most frequently used sedative and hypnotic herbs in Chinese herbal medicine including Suanzaoren (Ziziphus spinose ), Fuling (Poria cocos ), and Gancao (Glycyrrhiza uralensis ). The underlying pharmacological action mechanisms discovered in the studies on some key herbs used in the treatment of insomnia were evaluated. The major pharmacological action mechanisms shared by most of the sedative herbs are to act through the neurotransmitter gamma-aminobutyric acid (GABA) or via stimulation of GABAAA receptor. Some herbs exert sedative activities via inhibition of 5-hydroxytryptamine 1A receptor. Another mechanism shown by some herbs is to upregulate the expression of orexin-A, leptin, orexin receptor-1, and leptin receptor in the brain, reducing insomnia-induced negative consequences, and thus indirectly help improvement of insomnia.
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Affiliation(s)
- Amrinder Singh
- Traditional Chinese Herbal Medicine Programme, Middlesex University, The Borough, Hendon, London, United Kingdom
| | - Kaicun Zhao
- Traditional Chinese Herbal Medicine Programme, Middlesex University, The Borough, Hendon, London, United Kingdom.
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