2Hz電針不同俞穴降血糖之比較研究

COMPARISON OF HYPOGLYCEMIC EFFECT IN DIFFERENT ACUPOINTS RESPONSE TO 2 HZ ELECTROACUPUNTURE

根據傳統中醫理論，針刺不同俞穴能產生不同治療效果，透過經絡學說取穴的方法有局部取穴、遠部取穴及循經取穴等。本研究主要目的是：利用2Hz 電針分別刺激中脘關元及兩側足三里穴，以血糖變化為指標證實此一理論，同時比較兩者降血糖作用機轉的差異。方法是將雄性 Wistar 大白鼠，隨機分為實驗組及對照組。實驗組是去除兩側腎上腺後，以2Hz 電針中脘關元穴或足三里穴三十分鐘後觀察血糖之變化，並以 ELISA 測量血清腦內啡（β-endorphin ）及胰島素（Insulin ）的含量，而對照組則不將兩側腎上腺切除。另外，於電針正常大白鼠前三十分鐘施打納絡酮（Naloxone 1mg/kg , i.v. ），然後比較其對2 Hz 電針中脘關元穴及足三里穴血糖變化之影響。結果顯示：在對照組方面，2Hz 電針中脘關元穴或足三里穴兩者都有降血糖作用，同時增加血清腦內啡和胰島素的濃度。在實驗組方面：2 Hz 電針腹部中脘關元穴降血糖作用消失，而2Hz 電針兩側足三里穴有部分降血糖作用，但對於血清腦內啡及胰島素濃度的變化兩者電針前後皆無顯著差異。另一方面，納絡酮可完全阻斷正常大白鼠電針中脘關元穴降血糖作用，而無法完全阻斷足三里穴降血糖作用。結論是2Hz 電針大白鼠中脘關元穴有大量的腦內啡來自腎上腺刺激血清胰島素的分泌而導致血糖下降。2Hz 電針兩側足三里穴，其降血糖作用僅部份來自腎上腺，導致可能有非經由內生性的腦內啡降血糖機轉參與其中，但須進一步的研究。本研究證實了傳統中醫理論針刺不同俞穴確能產生不同的效果，也說明了針灸治療學的遠部取穴與循經取穴，確有實質意義。According to the theory of Traditional Chinese Medicine (TCM), Different acupoints have different effects. Through the meridian theory, Chinese physician can got the acupoint for disease treatment via following the meridian and/or far from the focus of disease. Aim of this study is to compare electrostimulating Zhongwan/ Gwanyuan with bilateral Zusanli acupoints and using the change of plasma glucose as indicator to prove this theory. In this study, male wistar rats were divided into experimental and control group randomly. Adrenalectomized rats (ADXR) were stimulated for 30 min to observe the change of plasma glucose at Zhongwan/ Gwanyuan or bilateral Zusanli acupoints by 2Hz electroacupuncture (EA) in experimental group. Plasma β -endorphin and insulin were detected by ELISA method for exploring the relationship with the changed plasma glucose. All of above result compared with the rats of control groups that were sham-operated. Furthermore, naloxone (1mg/kg, i.v.) was injected to block the opioid receptors sufficiently before EA for 30 min in normal wistar rats and to investigate the different influence of plasma glucose between these two sites. As our data showed, there was a significant hypoglycemic action in both sites, and plasma β -endorphin and insulin increased remarkably in control groups. In experimental groups, the hypoglycemic effect disappeared after electro stimulating Zhongwan/Gwanyuan with 2Hz EA and partial lowering plasma glucose was observed at bilateral Zusanli with the same frequency of stimulation, furthermore plasma β -endorphin and insulin no significant changed after stimulating both acupoints. In normal wistar rats, naloxone can block the hypoglycemic effect in Zhongwan/Gwanyuan totally, but only partially block in Zusanli stimulated by 2Hz EA. Basis of above result, we suggested that the hypoglycemic effect all came from adrenal gland and following the pathway of endogenous opioid peptide (EOP) effecting via insulin secretion after EA at Zhongwan/Gwanyuan with 2Hz frequency. Only partial lowering plasma effect came from adrenal gland and another hypoglycemic mechanism excluding EOP pathway participate in electro stimulating bilateral zusanli with the same frequency that must study further.