电针“天枢”穴结合二甲双胍对2型糖尿病大鼠糖脂水平的影响

Effects of electroacupuncture Tianshu(ST 25)combined with metformin on glucose and lipid metabolism in type 2 diabetes mellitus rats

目的:观察不同干预方法调控2型糖尿病(T2DM)模型大鼠体质量、血糖及血脂的效应差异,探讨针药结合的效应特点。方法:30只SD大鼠随机分为空白组(6只)、造模组(24只),采用高脂饲料喂养配合小剂量链脲佐菌素腹腔注射的方法建立T2DM模型,模型大鼠根据干预措施不同分为模型组、二甲双胍组、电针组和针药结合组,每组6只;每周监测大鼠随机血糖及体质量;干预前后分别监测大鼠的葡萄糖耐量水平;二甲双胍组采用二甲双胍灌胃(190 mg/kg),电针组予双极电针刺激“天枢”穴(2 mA,2/15 Hz,20 min,每日1次,左右穴位交替);针药结合组先予药物灌胃,再予电针,干预方式同二甲双胍组及电针组;连续干预5周。干预结束后取大鼠空腹血清检测血清胰岛素、C肽、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、总胆固醇(TCH)、甘油三酯(TG)及胰高血糖素样肽-1(GLP-1)水平,检测肝脏组织中AMPK、p-AMPK蛋白表达水平。结果:与模型组比较,电针组及针药结合组体质量显著减轻(P<0.01),3个干预组血糖均下降(P<0.01),以针药结合降糖效果最显著(P<0.01),干预后以针药结合组葡萄糖耐量恢复最好(P<0.05);3个干预组血清胰岛素水平及C肽水平显著升高(P<0.05,P<0.01),以针药结合组C肽的水平升高最显著(P<0.01);电针组血清TG水平降低最显著(P<0.05),针药结合组血清LDL降低最显著(P<0.01);针药结合组的GLP-1水平增加最显著(P<0.01);针药结合组肝脏AMPK及p-AMPK的蛋白表达水平增加最为显著(P<0.05,P<0.01)。结论:电针“天枢”穴可以调节血糖水平,并且有明显的降血脂效果,而二甲双胍则以调节血糖水平为主,电针“天枢”穴结合二甲双胍协同治疗在明显增加降血糖效果的同时具有减脂效果,并且可以进一步激活肝脏内AMPK,提示针药结合对T2DM的治疗可能具有一定的优势。

Objective:To observe the effects of different intervention methods on type 2 diabetes mellitus(T2DM)model rats,observe the changes of weight,blood glucose and blood lipid,and explore the effect characteristics of acupuncture combined with medicine.Methods:A total of 30 SD rats were randomly divided into control group(Contorl,n=6)and model group(Model,n=24).Model animals were divided into metformin group(Met),electroacupuncture Tianshu(ST 25)group(EA)and electroacupuncture combined with medicine group(EA+Met)according to different intervention measures,with 6rats in each group.The T2DM model was established by feeding with high fat diet and intraperitoneal injection of small dose of streptozotocin(STZ),and the random blood glucose and weight of rats were monitored every week.The glucose tolerance level of rats was monitored before and after intervention.The Met group was given metformin(190 mg/kg),and the rats in the EA group were given acupuncture at Tianshu point(2 mA,2/15 Hz,20 min),once a day,alternating left and right acupoints).The EA+Met group was given medicine by gavage first,then acupuncture,and the intervention mode was the same as that of Met and EA groups continuous intervention for 5 weeks.After the intervention,fasting serum of rats was taken to detect the levels of insulin,C peptide,HDL,LDL,TCH,TG and GLP-1.The expression level of AMPK,p-AMPK protein in liver were detected.Results:Compared with the Model group,the weight of EA group and EA+Met group were reduced(P<0.01),the blood sugar of the three intervention groups were decreased(P<0.01),and the effect of EA+Met group was the most significant(P<0.01).After intervention,the glucose tolerance of EA+Met group recovered best(P<0.05).The levels of serum insulin and C peptide in three group were significantly increased(P<0.05,P<0.01),especially in EA+Met group(P<0.01).The levels of serum TG in the EA group decreased most significantly(P<0.05),and the level of serum LDL decreased most significantly(P<0.01).The GLP-1 level of EA+Met group increased most significantly(P<0.01).The expression level of AMPK,p-AMPK protein in liver of EA+Met group increased most significantly(P<0.05,P<0.01).Conclusion:Electroacupuncture Tianshu(ST 25)can regulate blood glucose level and has obvious effect of lowering blood lipid,while metformin mainly regulates blood glucose level.The synergistic effect of electroacupuncture combined with metformin can significantly increase the effect of lowering blood glucose and reducing blood lipid,and further activate AMPK in the liver,suggesting that the combination of electroacupuncture and medicine may have certain advantages in the treatment of T2DM.