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[针灸治疗糖尿病的作用机制研究进展]

[Progress of Research on Mechanism of Acupuncture for Diabetes Mellitus].

作者信息

Chen Chao, Wang Hong-Cai, Zhai Xu, Huang Feng, Wu Dong, Rong Pei-Jing

机构信息

Institute of Acupuncture-moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China.

Graduate School, China Academy of Chinese Medical Sciences, Beijing 100700, China.

出版信息

Zhen Ci Yan Jiu. 2018 Sep 25;43(9):601-5. doi: 10.13702/j.1000-0607.180009.

Abstract

Acupuncture has been used to treat diabetes mellitus (DM) for more than one thousand years. In the present paper, we review new progress of researches on the underlying mechanism of acupuncture intervention for DM. Results showed that acupuncture intervention can relieve DM by 1) reducing body weight through up-regulating leptin level, suppressing insulin resistance and appetite to reduce food intake possibly by way of down-regulating expression of neuropeptide Y in the hypothalamus, retarding gastric emptying velocity, increasing small intestinal peristalsis, raising plasma levels of glucagon-like peptide-1 (GLP-1) and peptide YY, etc.; 2) improving pancreas function, raising insulin sensitivity to improve insulin resistance possibly by activating AMP-activated protein kinase and sirtuin 1/ peroxisome proliferator-activated receptor γ coactivator 1 α signaling, up-regulating activities of cholinergic nerve activity and nitric oxide synthase, and inhibiting apoptosis of pancreatic beta-cells; 3) lowering blood glucose possibly by increasing anaerobic glucose metabolism, regulating activities of vagal and sympathetic nerves; 4) adjusting the levels of related hormones such as melatonin, insulin, glucocorticold, epinephrine, etc. Moreover, acupuncture treatment combined with hypoglycemic drugs has a synergic effect in lowering blood glucose, suggesting a potentially effective approach for improving DM and being worthy of further studying in clinical practice.

摘要

针灸治疗糖尿病已有一千多年的历史。在本文中,我们综述了针灸干预糖尿病潜在机制的研究新进展。结果表明,针灸干预可通过以下方式缓解糖尿病:1)上调瘦素水平、抑制胰岛素抵抗和食欲以减少食物摄入(可能是通过下调下丘脑神经肽Y的表达)、延缓胃排空速度、增加小肠蠕动、提高血浆胰高血糖素样肽-1(GLP-1)和肽YY水平等,从而减轻体重;2)改善胰腺功能,通过激活AMP激活的蛋白激酶和沉默信息调节因子1/过氧化物酶体增殖物激活受体γ共激活因子1α信号通路、上调胆碱能神经活性和一氧化氮合酶的活性以及抑制胰腺β细胞凋亡,提高胰岛素敏感性以改善胰岛素抵抗;3)可能通过增加无氧糖代谢、调节迷走神经和交感神经活动来降低血糖;4)调节褪黑素、胰岛素、糖皮质激素、肾上腺素等相关激素水平。此外,针灸治疗与降糖药物联合使用在降低血糖方面具有协同作用,提示这是一种改善糖尿病的潜在有效方法,值得在临床实践中进一步研究。

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