【摘要】 目的:观察针刺对2型糖尿病模型大鼠胰岛素抵抗的作用。方法:实验于2003-02/2004-05在新疆医科大学第一附属医院内分泌科完成。①制备2型糖尿病大鼠模型,取造模成功的2型糖尿病大鼠30只,采用随机数字表方法分为3组,另设正常对照组(对照组),每组10只。糖尿病模型针刺组(针刺组):用电针刺激单侧脾俞、膈俞、足三里、内庭穴;糖尿病模型药物组(药物组):将盐酸二甲双胍片按100mg/(kg·d)灌胃;糖尿病模型对照组(模型组)、对照组:灌服等量的生理盐水。②治疗40d后,检测大鼠空腹血糖、空腹血清胰岛素、三酰甘油、胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇,并用ELASA法测定白细胞介素6、肿瘤坏死因子α、C-反应蛋白、血浆纤溶酶原激活物抑制因子。结果:对照组大鼠死亡1只。进入结果分析39只。①各组大鼠糖代谢相关指标的比较:与模型组比较,针刺组、药物组的空腹血糖、空腹血清胰岛素、稳态模式胰岛素抵抗指数均明显降低(P<0.01,P<0.05),胰岛素敏感指数则明显增高(P<0.05);针刺组除空腹血糖高于对照组外,余指标与对照组、药物组两两比较,差异无统计学意义(P>0.05);3组糖尿大鼠的稳态模式β细胞功能指数均显著低于对照组(P<0.01)。②各组大鼠血脂的比较:针刺组、药物组的三酰甘油、胆固醇、低密度脂蛋白胆固醇明显低于模型组(P<0.01,P<0.05),与对照组两两比较差异无显著性(P>0.05),针刺组的高密度脂蛋白胆固醇则明显高于模型组、药物组(P<0.01,P<0.05),与对照组之间无统计学差异(P>0.05)。③各组大鼠前炎症介质和凝血因子的比较:针刺组、药物组的肿瘤坏死因子α、白细胞介素6、C-反应蛋白、血浆纤溶酶原激活物抑制因子均明显低于模型组(P<0.01,P<0.05),与对照组无统计学差异(P>0.05)。④稳态模式胰岛素抵抗指数影响因素的相关分析结果:单因素分析提示稳态模式胰岛素抵抗指数与肿瘤坏死因子α、白细胞介素6、C-反应蛋白、血浆纤溶酶原激活物抑制因子、胆固醇、三酰甘油、低密度脂蛋白胆固醇均成正相关(P<0.01,P<0.05),且炎症因子之间也呈正相关(P<0.01,P<0.05)。结论:①针刺可明显降低血糖、血清胰岛素,改善胰岛素抵抗,作用与盐酸二甲双胍相近。②针刺改善胰岛素抵抗可能与降低炎症因子有关。③针刺可明显改善脂质代谢紊乱,在升高高密度脂蛋白胆固醇方面,优于盐酸二甲双胍。更多还原

【Abstract】 AIM: To study the effect of acupuncture on insulin resistance (IR) in type 2 diabetic rats. METHODS: The experiment was performed at the Department of Endocrinology, First Affiliated Hospital, Xinjiang Medical University from February 2003 to May 2004. ①Models of 30 type 2 diabetic rats were made and divided into three groups, and normal control group(control group) was established with 10 in each group. Diabetic acupuncture group(acupuncture group): Electroacupuncture was used to puncture at its half Pishu (UB 20), Geshu (Ub 17), Zusanli (St 36) and Neiting (St 44). Diabetic drug group(drug group): 100 mg/kg per day metiguanide were given by gastric perfusion. Diabetic control group (model group) and control group: Saline of the same volume was given by gastric perfusion. ②After 40-day treatment, the levels of fasting blood glucose, fasting serum insulin, triacylglycerol, cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol were measured. The levels of interleukin 6, tumor necrosis factor alpha, C reactive protein, plasma activator of plasminogen inhibitive factor were determined with enzyme-linked immunosorbent assay (ELISA). RESULTS: One rat in the control group died, and 39 were involved in the result analysis. ①Comparison of glycometabolism related indexes in rats of each group: Compared with the model group, the levels of fasting blood glucose, fasting serum insulin and homa-insulin resistance reduced significantly in the acupuncture group and drug group (P < 0.01,P < 0.05), while the insulin sensitive index increased obviously (P < 0.05). The fasting blood glucose in the acupuncture group were higher than those in the control group, and the other indexes had no statistical significance in the pairwise comparison with the control group and drug group (P > 0.05). The functional indexes of homa-beta cells in the three groups were markedly lower than that in the control group (P < 0.01). ②Comparison of blood lipid of rats in each group: The levels of triacylglycerol, cholesterol and low density lipoprotein cholesterol in the acupuncture group and drug group were remarkably lower than those in the model group (P < 0.01,P < 0.05). There was no significant difference as compared with the control group in pairwise comparison(P > 0.05). The level of high density lipoprotein cholesterol in the acupuncture group was distinctly higher than that in the model group and drug group (P < 0.01,P < 0.05). There was no statistical difference as compared with the control group(P > 0.05). ③Comparison of mediators of pre-inflammation and blood coagulation factor of rats in each group: The levels of tumor necrosis factor alpha, interleukin 6, C reactive protein and plasma activator of plasminogen inhibitive factor in the acupuncture group and drug group were significantly lower than those in the model group (P < 0.01,P < 0.05). There was no statistical difference as compared with the control group (P > 0.05). ④Related analytic outcome of homa-insulin resistance index: Single factor analysis indicated that homa-insulin resistance index was positively associated with tumor necrosis factor alpha, interleukin 6, C reactive protein, plasma activator of plasminogen inhibitive factor, cholesterol, triacylglycerol and low density lipoprotein cholesterol (P < 0.01,P < 0.05), so did inflammatory factor (P < 0.01,P < 0.05=. CONCLUSION: ①Acupuncture may significantly decrease blood glucose and serum insulin, improve insulin resistance. The effect is similar to the metiguanide. ②The mechanism of insulin resistance improvement with acupuncture may have correlation with the decrease of inflammatory factors. ③Acupuncture may obviously improve lipid metabolic disorder and superior to the metiguanide in increasing high density lipoprotein cholesterol.更多还原