Congqi Shoushen Tuina Method for generalized anxiety disorder: Clinical outcomes and serum metabolomic profiles

BACKGROUND Generalized anxiety disorder (GAD) is a common emotional disorder in clinical practice, with a high incidence rate, and it can seriously affect people’s work and life. The Congqi Shoushen Tuina Method can be used to treat the head and abdomen simultaneously, and can also regulate the body’s energy and spirit; meanwhile, the clinical treatment of GAD is significant. AIM To assess clinical outcomes of the Congqi Shoushen Tuina Method in GAD and to examine related serum metabolomic profiles. METHODS This experiment enrolled 20 GAD patients as the GAD group, who received Congqi Shoushen Tuina Method (40 minutes per session, once daily, 5 times weekly, for 2 consecutive weeks). The primary outcome was the Hamilton Anxiety Scale; secondary outcomes included the Self-Rating Anxiety Scale and Pittsburgh Sleep Quality Index. Meanwhile, 20 healthy volunteers served as the control group to explore serum metabolomics profile alterations in the GAD group before and after intervention, compared with the control group. RESULTS After a 2-week intervention, the GAD group’s Hamilton Anxiety Scale scores dropped significantly, along with notable decreases in Self-Rating Anxiety Scale and Pittsburgh Sleep Quality Index scores. Serum untargeted metabolomics revealed distinct metabolites in GAD patients vs healthy controls, dominated by lipids and lipid-like molecules (19.86%), followed by organic heterocyclic compounds (15.87%) and others; lipid molecules (e.g. , phosphatidylcholine, lysophosphatidylcholine, Lysophosphatidylethanolamine) showed the most prominent differences. Congqi Shoushen Tuina Method reversed levels of some metabolites, especially lipids. This suggests that therapy alleviates GAD symptoms by regulating metabolite expression, particularly lipids metabolism. Exploratory biomarker identification also pinpointed 5 key differential metabolites: Levulinic acid, Corypalline, sphingomyelin (d18: 1/20:0), lysine-valine, and cucurbitin. CONCLUSION Congqi Shoushen Tuina Method modulates serum metabolites in GAD patients, especially lipid metabolism, alleviating anxiety symptoms and improving sleep quality. Identified metabolites may support future prediction and diagnosis of GAD.