Perimenopausal insomnia adversely affects women's health. Western medicine primarily employs hormone replacement therapy (HRT) and sedative-hypnotic drugs for its treatment. However, HRT is associated with a high recurrence rate and carries increased risks of thrombosis and carcinogenesis, while sedative-hypnotics often lead to issues of dependence and addiction. Therefore, exploring safe and effective non-pharmacological treatments holds significant clinical importance.

To investigate the potential mechanism of action of dynamic moxibustion in treating perimenopausal insomnia.

Forty SPF-grade adult female SD rats were randomly divided into a sham-operated group, a model group, a dynamic moxibustion group, a suspended moxibustion group, and a positive control group using a block randomization method, with 8 rats per group. A rat model of perimenopausal insomnia was established. Rats in the sham-operated and model groups received intragastric administration of 0.9% NaCl solution (10 mL/kg). The dynamic moxibustion group received treatment with dynamic moxibustion. The suspended moxibustion group received intervention with circling moxibustion. The positive control group received intragastric administration of 0.1 mg/L estazolam solution (10 mL/kg), once daily. All interventions lasted for 15 consecutive days. One week after ovariectomy, vaginal exfoliated cells were collected for Giemsa staining. After the intervention period, a pentobarbital sodium cooperative sleep test was conducted to evaluate sleep duration. The Morris water maze test was used to assess learning and memory abilities in the perimenopausal rat model. After the completion of the Morris water maze and pentobarbital sodium tests, rats were anesthetized and sacrificed, and hypothalamic and colon tissues were collected. Hematoxylin-eosin (HE) staining was performed to observe pathological changes in colon tissue. Immunohistochemical staining was used to detect the protein expression of substance P (SP) and neuropeptide Y (NPY) in the hypothalamus and colon tissues. Western blot analysis was used to detect SP and NPY protein expression in thalamic tissue. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum levels of SP, NPY, 5-hydroxytryptamine (5-HT), norepinephrine (NE) and estradiol (E2).

Giemsa staining results showed that rats in the sham-operated group maintained a regular estrous cycle, while the modeling success rate, indicated by loss of the estrous cycle, was 100% in the model group, suggesting the rats entered a perimenopausal state. Compared with the sham-operated group, the model group exhibited prolonged sleep latency and shortened sleep duration. Compared with the model group, all treatment groups showed shortened sleep latency and prolonged sleep duration. Compared with the suspended moxibustion group, the dynamic moxibustion group demonstrated shortened sleep latency and significantly prolonged sleep duration (P<0.05). Morris water maze results indicated that compared with the sham-operated group, the model group showed decreased platform crossings, prolonged escape latency, and increased total path length. Compared with the model group, all intervention groups exhibited a shortened total path length, decreased escape latency, and increased platform crossings (P<0.05). HE staining revealed that the sham-operated group had regular, intact, and orderly arranged colonic tissue structure with abundant neurons. The model group showed irregular colonic tissue surfaces, structural changes, and a decreased number of neuronal cells. Compared with the model group, all intervention groups demonstrated more uniformly and orderly arranged colonic crypts and an increased number of neuronal cells, with the abdominal dynamic moxibustion group showing marked improvement. Immunohistochemical staining results showed that compared with the sham-operated group, the model group had decreased protein expression of SP and NPY in the colon and thalamic tissues (P<0.05). Compared with the model group, all intervention groups showed increased protein expression of SP and NPY in the colon and thalamic tissues (P<0.05). Compared with the suspended moxibustion group, the dynamic moxibustion and positive control groups exhibited increased protein expression of SP and NPY in the colon and thalamic tissues (P<0.05). Western blot results indicated that compared with the sham-operated group, the model group had increased protein expression of SP and NPY in the thalamic tissue (P<0.05). Compared with the model group, all intervention groups showed decreased protein expression of SP and NPY in the thalamic tissue (P<0.05). Compared with the suspended moxibustion group, the dynamic moxibustion and positive control groups exhibited increased SP protein expression (P<0.05). ELISA results demonstrated that compared with the sham-operated group, the model group had significantly decreased serum levels of SP, NPY, 5-HT, and E2, and significantly increased NE levels. Compared with the model group, all intervention groups showed significantly increased serum levels of SP, NPY, and 5-HT, and decreased NE levels. Compared with the suspended moxibustion group, the dynamic moxibustion group showed significantly increased serum SP and 5-HT levels, and decreased NE levels (P<0.05).

Abdominal dynamic moxibustion can improve sleep and spatial cognitive ability in a rat model of perimenopausal insomnia. Its mechanism of action may be associated with the regulation of brain-gut peptide and monoamine neurotransmitter expression.

围绝经期失眠对女性健康带来了不利影响，西医治疗围绝经期失眠主要采用激素替代疗法和镇静安眠药物，但激素替代疗法复发率高，同时存在较高的血栓和癌变风险，镇静催眠药物容易造成依赖性等问题。因此探索安全有效的非药物治疗方法具有重要的临床意义。

探讨动力灸治疗围绝经期失眠大鼠的可能作用机制。

采用区组随机化法将40只SPF级成年雌性SD大鼠分为假手术组、模型组、动力灸组、悬灸组和阳性对照组，每组8只，制作大鼠围绝经期失眠模型。假手术组和模型组大鼠予10 mL/kg 0.9%NaCl溶液灌胃；动力灸组采用动力灸治疗；悬灸组采用回旋灸进行干预；阳性对照组予0.1 mg/L艾司唑仑溶液10 mL/kg灌胃，1次/d，干预连续15 d。大鼠摘除卵巢1周后采集阴道脱落细胞Giemsa染色；成模后戊巴比妥钠协同睡眠实验评估大鼠睡眠潜伏期和睡眠时间；Morris水迷宫实验评估围绝经期大鼠模型的学习能力和记忆能力。Morris水迷宫实验和戊巴比妥钠协同睡眠实验结束，处死大鼠，留置下丘脑和结肠组织。苏木素-伊红（HE）染色观察大鼠结肠组织病理变化。免疫组化染色检测下丘脑、结肠组织P物质（SP）、神经肽Y（NPY）蛋白表达情况。免疫印迹（Western blot）检测大鼠丘脑组织SP、NPY蛋白表达情况。酶联免疫吸附试验（ELISA）检测大鼠血清SP、NPY、5-羟色胺（5-HT）、去甲肾上腺素（NE）、雌二醇（E2）水平。

Giemsa染色结果显示，假手术组大鼠保持规律动情周期，造模大鼠失去动情周期率为100%，提示大鼠进入围绝经期。与假手术组大鼠比较，模型组入睡潜伏期延长、睡眠持续时间缩短；与模型组大鼠比较，各治疗组入睡潜伏期缩短、睡眠持续时间延长；与悬灸组比较，动力灸组入睡潜伏期缩短，睡眠持续时间显著延长（P<0.05）。Morris水迷宫实验结果显示，与假手术组比较，模型组大鼠穿越平台次数减少，逃避潜伏期延长、总路程增加；与模型组相比，各干预组大鼠总路程缩短、逃避潜伏期缩短、穿越平台次数增加（P<0.05）。HE染色显示，假手术组大鼠结肠组织切片结构规则完整，排列有序，神经元数量较多；模型组大鼠结肠组织表面不规则，结构变化，神经元细胞数量减少；与模型组比较，各干预组大鼠结肠组织隐窝排列较均匀有序，神经元细胞数量增加，腹部动力灸组改善明显。免疫组化染色结果显示，与假手术组比较，模型组大鼠结肠、丘脑组织SP、NPY蛋白表达降低（P<0.05）；与模型组比较，各干预组大鼠结肠、丘脑组织SP、NPY蛋白表达升高（P<0.05）；与悬灸组相比，动力灸组和阳性对照组结肠、丘脑组织SP、NPY蛋白表达升高（P<0.05）。Western blot结果显示，与假手术组比较，模型组大鼠丘脑组织SP、NPY蛋白表达升高（P<0.05）；与模型组比较，各干预组丘脑组织SP、NPY蛋白表达降低（P<0.05）；与悬灸组相比，动力灸组和阳性对照组SP蛋白表达升高（P<0.05）。ELISA结果显示，与假手术组比较，模型组大鼠血清SP、NPY、5-HT、E2水平降低，NE水平升高；与模型组比较，各干预组大鼠血清SP、NPY、5-HT水平增加，NE水平降低；与悬灸组比较，动力灸组血清SP、5-HT增加，NE水平降低（P<0.05）。

腹部动力灸可改善围绝经期失眠模型大鼠的睡眠和空间认知能力，其作用机制可能与调节脑肠肽和单胺类神经递质表达相关。