穴位埋线对多囊卵巢综合征伴胰岛素抵抗模型大鼠子宫内膜GLUT-4、IRS-2表达的影响

Effects of Acupoint Catgut Embedding on GLUT-4 and IRS-2 Expression in Endometria of Polycystic Ovary Syndrome-Insulin Resistance Model Rats

【目的】探讨穴位埋线对多囊卵巢综合征(PCOS)伴胰岛素抵抗模型大鼠的治疗效果及其作用机制。【方法】将42只49日龄SD雌性大鼠随机分为空白对照组、模型组、治疗组,每组14只。采用胰岛素联合人绒毛膜促性腺激素(HCG)注射法复制PCOS伴胰岛素抵抗大鼠模型。治疗组选取关元、足三里(双)、上巨虚(双),太冲(双)、中极、三阴交(双)2组穴位,每隔7 d给予穴位埋线1次,共4次。治疗结束后,采用放射免疫法检测血清空腹胰岛素、性激素水平,采用苏木素—伊红(HE)染色法观察各组大鼠卵巢、子宫病理形态变化,采用免疫组织化学法检测各组大鼠子宫内膜葡萄糖转运体4(GLUT-4)和胰岛素受体底物2(IRS-2)的表达。【结果】与空白对照组比较,模型组大鼠空腹胰岛素、睾酮(T)、促黄体生成素(LH)水平升高(P<0.05),卵泡刺激素(FSH)水平降低(P<0.05);与模型组比较,治疗组大鼠空腹胰岛素、T、LH水平降低(P<0.05),FSH水平升高(P<0.05)。模型组大鼠卵巢呈多囊样改变,子宫内膜腺体数目明显减少,治疗组卵巢、子宫的病理变化较模型组明显减轻。模型组大鼠子宫内膜腺上皮细胞和间质GLUT-4、IRS-2表达水平显著低于模型组(P<0.05);治疗组大鼠子宫内膜腺上皮细胞和间质GLUT-4、IRS-2表达水平显著高于模型组(P<0.05)。【结论】穴位埋线可有效改善PCOS大鼠胰岛素抵抗,其机制可能与其促进子宫内膜GLUT-4、IRS-2的表达有关。

Objective To observe the therapeutic effects of acupoint catgut embedding on model rats of polycysticovary syndrome（PCOS）-insulin resistance（IR）and to explore its possible mechanism. Methods Forty-two femaleSD rats aged 49 days were randomly divided into blank control group,model group,and treatment group,14 ratsin each group. PCOS-IR rat model was established by injection of insulin（INS）combined with human chorionicgonadotrophin（HCG）. The rats in the treatment group were given acupoint catgut embedding at acupoint group oneincluding Guanyuan（CV4）,Zusanli（ST36,bilateral）,Shangjuxu（ST37,bilateral）,and acupoint group twoincluding Taichong（LR3,bilateral）,Zhongji（CV3）,Sanyinjiao（SP6,bilateral）,one time every seven days,for a total of four times. After treatment, serum levels of fasting insulin and sex hormones were tested byradioimmunoassay,the changes of ovarian morphopathological features in the ovary and uterus were observed byhematoxylin and eosin（HE）staining, and the expression levels of glucose transport 4（GLUT-4）protein andinsulin receptor substrate 2（IRS-2）in the endometrium were detected by immunohistochemistry. Results Compared with the blank control group,serum levels of fasting insulin,testosterone（T）,and luteinizing hormone（LH）were increased, follicle-stimulating hormone（FSH）level was decreased in the model group（P〈0.05）.Compared with the model group,serum levels of fasting insulin,T,and LH were decreased,and FSH level wasincreased in the treatment group（P〈0.05）. Polycystic ovaries were seen,and the count of endomethial glands wasobviously decreased in the uterus of the model group,and these pathological changes were much improved in thetreatment group（P〈0.05）. The expression levels of GLUT-4 and IRS-2 in endometrial glandular epithelial cellsand mesenchyme of the model group were lower than those of the blank control group（P〈0.05）, while theexpression levels of GLUT-4 and IRS-2 of the treatment group were higher than those of the model group（P〈0.05）. Conclusion Acupoint catgut embedding has certain effect on improving insulin resistance in PCOS rats,and its mechanism may be related with the increase of GLUT-4 and IRS-2 expression.