针刀对2型糖尿病大鼠降糖作用及其对胰腺交感神经影响

Sugar-reducing Effect and Pancreatic Sympathetic Disorder Correction of Acupotomy on Type 2 Diabetes Mellitus

目的观察针刀治疗对2型糖尿病(type 2 diabetes mellitus,T2DM)大鼠的降糖作用,以及针刀干预胸段交感神经对胰腺交感神经的影响。方法以高脂高糖配合腹腔注射链脲佐菌素(streptozocin,STZ)方法建立T2DM大鼠模型,随机分为模型组(乙组)、二甲双胍组(丙组)、针刀组(丁组),设置正常对照组(甲组)。4组均予以同样的捆绑束缚,同时乙组予双蒸水2 mL/kg灌胃,1次/d;丁组予乙组相同的双蒸水灌胃并行脊柱胸段针刀干预,1次/周;丙组予盐酸二甲双胍100 mg/kg灌胃,1次/d。干预疗程均为6周。每周固定时间测定体质量;治疗前后分别用强生血糖仪测定血清空腹血糖(fasting blood glucose,FBG);治疗结束ELISA检测血清空腹C肽水平、胰腺肾上腺素(adrenaline,AD)浓度;免疫组化法检测胰腺酪氨酸羟化酶(tyrosine hydroxylase,TH)分布;HE染色观察胰岛细胞状态。结果与甲组相比,造模结束当日乙组的体质量升高(P<0.01),FBG水平升高(P<0.05),治疗结束后乙组的C肽水平显著降低(P<0.01),TH密度和AD水平显著升高(均P<0.01);与乙组相比,治疗结束后丙组体质量明显上升(P<0.01),FBG水平降低(P<0.01),TH密度降低(P<0.05),但AD浓度差异无统计学意义(P>0.05);与乙组相比,治疗结束后丁组体质量上升(P<0.01),C肽水平上升(P<0.05),FBG水平、TH密度水平降低(均P<0.01),AD浓度明显降低(P<0.05)。HE染色:乙组胰岛萎缩,胰岛的结构不完整,细胞趋于坏死,炎性反应和增生明显;丁组结构较完整,胰岛数目较为丰富;丙组无明显炎性反应表现。结论针刀治疗可显著降低T2DM大鼠的血糖。其机制可能与调节胰岛内交感神经功能,促进胰岛功能恢复有关。

Objective To observe the sugar-reducing effect and mechanwasm of acupotomy on type 2 diabetes mellitus(T2 DM).Methods T2 DM models were establwashed in rats by high fat and high sugar diet combined with Streptozotocin(STZ).Randomly divided into 4 groups for observation including:model group(group II),melbine group(group III),acupotomy group(group IV)and normal group(group I)as reference.Tie them up same way,group II were given normal double-dwastilled water 2 mL/kg by gavage once a day,group IV were given double-dwastilled water same as group II by gavage and once a week and acupotomy onthoracic segment,group III were given metformin hydrochloride once a day,observation for 6 weeks.Weight measured at a fixed time each week.Fasting blood glucose(FBG)test by one touch Ultra.Serum fasting C-peptide measured by ELASA after treatment.Pancreatic tail tyrosine hydroxylase(TH)dwastribution test by immunohwastochemwastry.Pancreatic tail adrenaline(AD)concentration test by ELISA,HE staining waslet cells for status observation.Results Compared with group A,the body weight of group B was higher on the day of modeling(P<0.01),the level of FBG was higher(P<0.05),and the value of C peptide in group B was significantly lower after treatment(P<0.01),the levels of TH and AD were significantly higher(both P<0.01);compared with group B,the body weight of group C increased significantly after treatment(P<0.01),FBG level decreased(P<0.01),TH density decreased(P<0.05),but the difference in AD concentration was not statistically significant(P>0.05);compared with group B,the body weight of group D increased(P<0.01),the level of C peptide increased(P<0.05),and the levels of FBG and TH after the treatment decreased(all P<0.01),AD level was significantly reduced(P<0.05).HE staining:model group showed the reduction of waslets,pancreas waslet structural imperfection,waslet cells tend to necroswas,obvious inflammation and hyperplasia.Acupotomy group and model group showed pancreas waslet structural integrity,in addiction acupotomy group showed large quantity of pancreas waslet,western medicine showed no observed inflammation.Conclusion acupotomy treatment can reduce the blood sugar on T2 DM mellitus.The mechanwasm may related to pancreas waslet sympathetic nerve activity adjustment,pancreas waslet function improvement and insulin secretion promoting.