Department of Surgery, Cheng Ching Hospital, Taichung City.
Department of Medicinal Botanicals and Health Applications, Da-Yeh University, Dacun.
Acupunct Med. 2020 Oct;38(5):335-342. doi: 10.1177/0964528419901135. Epub 2020 Apr 16.
Previous studies have reported that electroacupuncture (EA) induces a glucose-lowering effect by improving insulin resistance (IR) and reduces plasma free fatty acid (FFA) levels in rats with steroid-induced insulin resistance (SIIR). In addition, EA can activate cholinergic nerves and stimulate endogenous opioid peptides to lower plasma glucose in streptozotocin-induced hyperglycemic rats. The aim of this study was to investigate the glucose-lowering effects of 15 Hz EA at bilateral ST36 in combination with acarbose (ACA). We hypothesized that EA combined with ACA would produce a stronger glucose-lowering effect than ACA alone.
In this study, normal Wistar rats and SIIR rats were randomly divided into two groups: ACA and ACA + EA. To explore the potential mechanisms underlying the glucose-lowering effect, plasma FFA/insulin and insulin transduction signal pathway proteins were assayed.
Combined ACA + EA treatment had a greater glucose-lowering effect than ACA alone in normal Wistar rats (-45% ± 3% vs -19% ± 3%, < 0.001) and SIIR model rats (-43% ± 2% vs -16% ± 6%, < 0.001). A significant reduction in plasma FFA levels, improvement in homeostatic model assessment of IR (HOMA-IR) index (-48.9% ± 4.0%, < 0.001) and insulin sensitivity index (102% ± 16.9%, < 0.001), and significant increases in insulin receptor substrate 1, glucose transporter 4, and peroxisome proliferator-activated receptor γ protein expressions in skeletal muscle, were also observed in the ACA + EA group of SIIR rats.
Combined EA and ACA therapy had a greater glucose-lowering effect than ACA monotherapy; this combined therapy could be more effective at improving IR in SIIR rats, which may be related to a reduction in plasma FFA levels and an elevation of insulin signaling proteins. Whether this combined therapy has an effect in type 2 diabetes mellitus (T2DM) patients still needs to be explored.
既往研究报道电针（EA）通过改善胰岛素抵抗（IR）降低固醇诱导的胰岛素抵抗（SIIR）大鼠的血浆游离脂肪酸（FFA）水平，从而产生降糖作用。此外，电针可激活胆碱能神经并刺激内源性阿片肽，降低链脲佐菌素诱导的高血糖大鼠的血糖。本研究旨在探讨双侧足三里穴 15Hz 电针对阿卡波糖（ACA）的降糖作用。我们假设电针与 ACA 联合应用比单独应用 ACA 降糖作用更强。
本研究将正常 Wistar 大鼠和 SIIR 大鼠随机分为 ACA 和 ACA+EA 两组。为探讨降糖作用的潜在机制，检测了血浆 FFA/胰岛素和胰岛素转导信号通路蛋白。
与 ACA 单药组相比，ACA+EA 联合治疗在正常 Wistar 大鼠（-45%±3%比-19%±3%， <0.001）和 SIIR 模型大鼠（-43%±2%比-16%±6%， <0.001）中均具有更强的降糖作用。ACA+EA 组 SIIR 大鼠的血浆 FFA 水平显著降低（-48.9%±4.0%， <0.001），IR 稳态模型评估（HOMA-IR）指数（-48.9%±4.0%， <0.001）和胰岛素敏感性指数（102%±16.9%， <0.001）显著改善，骨骼肌中胰岛素受体底物 1、葡萄糖转运蛋白 4 和过氧化物酶体增殖物激活受体 γ 蛋白表达显著增加。
电针与 ACA 联合治疗比 ACA 单药治疗具有更强的降糖作用；这种联合治疗可能更有效地改善 SIIR 大鼠的 IR，这可能与降低血浆 FFA 水平和提高胰岛素信号蛋白有关。这种联合治疗在 2 型糖尿病（T2DM）患者中是否有效仍需进一步探讨。
