| Objective:To study the effects of 7-day flexible fasting technology on psychological status,drug craving,addiction-related physiological index and gut flora of the detoxification trainees in the compulsory isolation drug rehabilitation center in order to evaluate the effect of flexible fasting technology on the psychological status and drug craving of drug addicts and study the relationship between gut flora and drug's psychological dependence for researching a new clue for further study of the correlation between military psychology and gut flora.Methods:(1)30 drug addicts were recruited as volunteers from a compulsory isolation drug treatment center.SCL-90,SAS,willpower scale and drug craving scale were used to evaluate the mental and psychological status of drug addicts before intervention.During the 7-day intervention,volunteers' daily subjective experience informations(hunger,fatigue,mental state,sleep quality and defecation frequency)were recorded.30 volunteers were treated with 7-day flexible fasting.At the end of the intervention,30 volunteers who completed the intervention were assessed with the same psychological scales.The mental symptoms,anxiety,willpower level and drug craving before and after the intervention were analyzed.At the same time,volunteers' fecal samples were collected at 3 time points(before,after intervention and after one-week resumption of diet)and 16 s rDNA sequencing analysis was carried out.(2)Totally 44 heroin addicts,28 methamphetamine addicts and 30 normal people without addiction were recruited seperately as heroin group,methamphetamine group and normal control group.7-day flexible fasting was arranged for heroin addicts and methamphetamine addicts.At 3 time points(before intervention,after intervention and after one-week resumption of diet),the psychological scale(drug craving scale,SDS,SAS,willpower scale,social adaptability scale)examination,collection of blood and fecal samples were arranged.The blood and fecal samples of normal control group were collected too.The concentration of DA,5-HT,BDNF and GLU in serum was detected,and the 16 S rDNA sequencing of fecal samples was carried out(still in progress).The results of psychological scales of heroin group and methamphetamine group before intervention were compared,and the scale score changes of two groups at 3 time points were analyzed.The differences of concentration of DA,5-HT,BDNF and GLU in serum between heroin group(pre-intervention),methamphetamine group(before intervention)and normal control group were compared,and the changes of concentration of DA,5-HT,BDNF and GLU in serum from heroin group and methamphetamine group at 3 time points.The results of 16 S rDNA sequencing were analyzed in the same way.Results:(1)Totally 25 drug addicts completed 7-day flexible fasting operation.Before and after the intervention,there was no significant difference in the total average score of SCL-90,the total average score of positive items and the score of each factor(p>0.05).There was also no significant difference in the scores of SAS and willpower scale(p>0.05).After intervention,the total score of drug craving scale decreased significantly(p<0.05).The total score and the score of "drug impact " in heroin group decreased significantly(p<0.05),but the total score and scores of three factors in methamphetamine group didn't change significantly(p>0.05).The scores of "drug out of control" in both groups didn't show significant change(p>0.05).The richness and diversity of gut flora were significantly improved after a week of diet-resumption(p<0.001).At the phylum classification level,the relative abundance of Actinobacteria,Firmicutes decreased and the relative abundance of Bacteroidetes increased after oneweek resumption of diet(p<0.05)and the relative abundance of Bacteroidetes increased(p< 0.001).At the genus classification level,the relative abundance of Blautia,Collinsella,Dorea decreased and Alistipes,Bacteroides,Parabacteroides increased after one-week resumption of diet(p< 0.05).(2)At the second study,forty drug addicts(25 in heroin group and 15 in meth group)completed 7 days' flexible fasting intervention.Before intervention,the scores of drug craving scale,“drug impact” and “craving frequency” of heroin group were significantly higher than those of methamphetamine group(p<0.01),and there was no significant difference between the two groups' scores of "drug out of control"(p>0.05).The scores of SDS and SAS of heroin group were also significantly higher than those of methamphetamine group(p<0.05).The average scores of the two groups' SDS(50.763 ±13.194,43.731 ±9.962)were higher than the gross score of the national norm(the reference value 41).The average score of heroin group's SAS(40.325±7.901)was higher than the gross score of the national norm(the reference value 40).There was no significant difference in the two groups' scores of willpower and social adaptability scales(p>0.05).After intervention and after one-week resumption of diet,the total score of drug craving scale and the score of "drug impact" of two groups both decreased(p<0.05).The heroin group's score of "craving frequency" decreased(p<0.05),but the change of methamphetamine group was not significant(p>0.05).There was no significant change in both two groups' scores of "drug out of control"(p>0.05).After intervention and after oneweek resumption of diet,the SDS score of heroin group decreased(p<0.05),and its scores of willpower and social adaptability scales increased(p<0.05).There was no significant changes in heroin group's SAS scores(p>0.05).The methamphetamine group's scores of SDS,SAS,willpower and social adaptability scales adaptation didn't change significantly(p>0.05).Before intervention,there was no significant difference between the DA concentration of heroin group and normal control group(p>0.05).DA concentrations of the both groups were significantly higher than that of methamphetamine group(p<0.01).The 5-HT concentrations of heroin and methamphetamine group were significantly lower than that of normal control group(p<0.001),but there was no significant difference between the two groups(p>0.05).The BDNF concentrations of heroin group and methamphetamine group were significantly higher than that of normal control group(p<0.001),and the BDNF concentration of heroin group was significantly lower than that of methamphetamine group(p<0.05).There was no significant difference in GLU concentrations between the three groups(p>0.05).After intervention,DA concentrations in serum of heroin group and methamphetamine group increased(p<0.05),and showed no significant change after one-week resumption of diet(p>0.05).After intervention,the 5-HT concentration in heroin group was significantly higher than that before intervention(p<0.01).There was no significant change in 5-HT concentration of methamphetamine group after intervention and after one-week resumption of diet(p>0.05).The BDNF concentration in heroin group after intervention and after one-week resumption of diet decreased(p<0.05).The changes of BDNF concentration in methamphetamine group was not significant(p>0.05).There was no significant change in GLU concentration in heroin group after intervention and after oneweek resumption of diet(p>0.05).In the methamphetamine group,the GLU concentration decreased after one-week resumption of diet(p<0.05).Before the intervention,there was no significant difference between the three groups(p>0.05).The heroin group's Chao1 index increased(p<0.05)after one-week resumption of diet,and the change of Simpson index was not significant after intervention and after one-week resumption of diet(p>0.05).The changes of methamphetamine group's Chao1 and Simpson index were not significant after the intervention and after one-week resumption of diet(p>0.05).At the phylum classification level,the relative abundance of Proteobacteria in heroin group was higher than that in control group(p<0.05),and the relative abundance of Bacteroidetes in heroin group was lower(p<0.001).After a week of diet-resumption,the relative abundance of Proteobacteria in heroin group decreased and Bacteroidetes increased(p<0.05).The relative abundance of Bacteroidetes in the methamphetamine group was lower than that in the control group(p<0.001),and the relative abundance of Bacteroidetes in the methamphetamine group increased after a week of diet-resumption(p<0.05).At the genus classification level,the relative abundance of Blautia,Terrisporobacter in heroin group was higher than that in control group(p<0.05),and the relative abundance of Bacteroides,Faecalibacterium in heroin group was significantly lower than that in control group(p<0.05).After a week of dietresumption,the relative abundance of Blautia,Terrisporobacter in heroin group decreased and Bacteroidetes,Faecalibacterium increased(p<0.05).The relative abundance of Blautia,[Eubacterium]_hallii_group,Dorea in methamphetamine group was higher than that in control group(p<0.05),and the relative abundance of Faecalibacterium in methamphetamine group was significantly lower than that in control group(p<0.05).After a week of dietresumption,the relative abundance of Blautia,[Eubacterium]_hallii_group,Dorea in methamphetamine group decreased and Faecalibacterium increased(p<0.05).Conclusion:The psychological drug craving with depression and anxiety in heroin group are more obvious than those in methamphetamine group,but methamphetamine shows more serious effect on the concentration of addictionrelated neurotransmitters in the serum of drug addicts.The flexible fasting can help drug addicts to reduce drug craving,relieve depressive symptoms,improve willpower and social adaptability.At the same time,the abnormity of serum indexes related to addiction could be improved.The improvement effect of flexible fasting on heroin psychological dependence is better than that of methamphetamine.Flexible fasting can help heroin and methamphetamine addicts to improve the composition of gut flora,which may be related to the alleviation of drug craving.This study not only laid a foundation for improving the prevention and control efficiency of drug psychological dependence from the point of view of gut flora regulation,but also provided a reference for the further study of military psychological evaluation and intervention based on gut flora and psychological dependence. |
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