Objective To investigate the profile of metabolites of gastric mucosa involving the effectiveness of moxibustion in the treatment of syndromes of stomach heat(SH) and stomach cold(SC) by

1

H-nuclear magnetic resonance(1H-nuclear magnetic resonance(

1

H-NMR) spectroscopy in rats

so as to reveal its mechanisms underlying improvement of gastric disorders.Methods Male SD rats were randomly divided into control

SH-model

SC-model

SH-moxibustion and SC-moxibustion groups(n=6 rats/group). The SH-model and SC-model were established by gavage of pepper liquid plus ethanol

and ice water plus NaOH

respectively. Moxibustion was applied to bilateral "Zusanli"(ST36) and "Liangmen"(ST21) for 20 min

once daily for 7 days. Histopathological changes of the gastric tissue were observed by H.E. staining. Differential metabolites in the gastric mucosal tissue were detected and the relevant metabolic pathways analyzed by using 1H-NMR) spectroscopy in rats

so as to reveal its mechanisms underlying improvement of gastric disorders.Methods Male SD rats were randomly divided into control

SH-model

SC-model

SH-moxibustion and SC-moxibustion groups(n=6 rats/group). The SH-model and SC-model were established by gavage of pepper liquid plus ethanol

and ice water plus NaOH

respectively. Moxibustion was applied to bilateral "Zusanli"(ST36) and "Liangmen"(ST21) for 20 min

once daily for 7 days. Histopathological changes of the gastric tissue were observed by H.E. staining. Differential metabolites in the gastric mucosal tissue were detected and the relevant metabolic pathways analyzed by using

1

H-NMR

pattern recognition method

and online MetPA(http://www.metaboanalyst.ca). Results Compared with the control group

the body mass was decreased significantly from the 41H-NMR

pattern recognition method

and online MetPA(http://www.metaboanalyst.ca). Results Compared with the control group

the body mass was decreased significantly from the 4

(th)

to 14(th) to 14

(th)

day after modeling(P

<

0.05

P

<

0.01). After the treatment

the body mass was obviously increased from the 10(th) day after modeling(P

<

0.05

P

<

0.01). After the treatment

the body mass was obviously increased from the 10

(th)

day on in both SH-EA and SC-EA groups relevant to the SH and SC model group

respectively(P

<

0.05

P

<

0.01). H.E. staining showed severe damage of the columnar epithelial structure of the gastric mucosa and inflammatory cell infiltration in the SH group

and inflammatory cell infiltration in the SC model group

which were relatively milder in both moxibustion groups. (th) day on in both SH-EA and SC-EA groups relevant to the SH and SC model group

respectively(P

<

0.05

P

<

0.01). H.E. staining showed severe damage of the columnar epithelial structure of the gastric mucosa and inflammatory cell infiltration in the SH group

and inflammatory cell infiltration in the SC model group

which were relatively milder in both moxibustion groups.

1

H-NMR analysis displayed a total of 16 potential biomarkers in the injured gastric mucosa of SH syndrome and 14 biomarkers for the SC syndrome after mode-ling

and 13 metabolites related to SH moxibustion and 8 metabolites related to SC moxibustion after moxibustion interventions

respectively. After moxibustion

among the 13 differential metabolites of the SH syndrome

the effectively up-regulated candidates were isoleucine

creatinine

choline and lactate(P

<

0.05)

and the down-regulated ones were choline phosphate

glycine

alanine

urine pyrimidine

tyrosine

phenylalanine

hypoxanthine

adenosine and nicotinamide(P

<

0.05). Among the 8 metabolites related to the SC syndrome

creatinine

ethanolamine

choline

adenosine and nicotinamide were markedly increased(P

<

0.05)

and glycine

creatine phosphate and tyrosine remarkably decreased in their levels after moxibustion(P

<

0.05). MetPA showed that moxibustion could regulate 10 metabolic pathways for SH syndrome and 7 metabolic pathways for SC syndrome. Metabolites and metabolic pathways are mainly involved in functions of amino acid metabolism

energy metabolism and inflammatory response.Conclusion The idea of "moxibustion could be used for heat syndrome" has metabolic substance basis

and its efficacy in repairing the injured gastric mucosa involves regulation of amino acid metabolism

energy balance and inflammation response

and moxibustion for SH and SC syndromes has both generality and specificity in regulating metabolic activities.