SERUM METABOLOMICS ANALYSIS OF DANGGUI LIUHUANG TANG FOR MANAGING NIGHT SWEATS AFTER LUMBAR SPINE SURGERY: IMPLICATIONS FOR RECOVERY AND PHYSICAL ACTIVITY IN PATIENTS WITH YIN DEFICIENCY AND EFFULGENT FIRE

Abstract

Objective: This study explores the mechanism of action of Danggui Liuhuang Tang (DGLHT) in managing night sweats of Yin deficiency and fire exuberance type following lumbar spine surgery, using serum metabolomics analysis. Methods: From November 2022 to November 2023, six patients experiencing post-surgical night sweats after open lumbar discectomy with spinal canal decompression were selected as the treatment group. Six age- and gender-matched healthy individuals from the Physical Examination Center were included as the control group after providing informed consent. The treatment group received oral DGLHT (150 mL twice daily) for one week. Venous blood samples (3 mL) were drawn from the median elbow vein before and after treatment in the treatment group, while a single venous blood sample was taken from the control group. Serum metabolomics analysis was performed using ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS). Results: Before treatment, 117 differential metabolites were identified between the treatment and control groups, including 66 up-regulated and 51 down-regulated metabolites. After treatment, 44 differential metabolites were detected in the treatment group, with 21 up-regulated and 23 down-regulated. Comparative analysis revealed 29 overlapping metabolites, such as 2-hydroxybutyric acid, ornithine, and lysine, involving key metabolic pathways related to amino acids and peptides, carboxylic acids, TCA cycle intermediates, fatty acids, and their conjugates. Additionally, 19 shared metabolic pathways were identified, including the tricarboxylic acid cycle, amino acid synthesis and metabolism, lipid metabolism, and glycolysis. Conclusion: The therapeutic effect of DGLHT in treating night sweats after lumbar spine surgery appears to be related to the regulation of glycolipid metabolism, lipid balance, and correction of energy metabolism disorders. These findings suggest potential applications for improving metabolic recovery and supporting physical rehabilitation in sports medicine and orthopedic recovery contexts.