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刺激耳甲腔降糖作用的动物实验及临床观察
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摘要
目的:随着我国经济的发展和生活方式的改变以及人口老龄化,糖尿病的患病率显著上升。口服降糖药和注射胰岛素是现代医学控制血糖最为快速和有效的,但对慢性并发症尤其是神经病变却往往疗效一般,且长期服用西药可能会带来各种严重的毒副作用和经济负担,因此寻求一种疗效确切、方便、价廉、副作用小的替代疗法是目前患者和临床医生迫切盼望的事情。本项研究通过对刺激耳甲腔降糖作用的观察,为糖尿病治疗另辟俏径,并为耳针降糖效应可能是通过耳—迷走神经反射机制完成的设想提供了佐证。方法:研究内容分两部分进行。
     1.动物实验:将30只大鼠分为正常组(A)10只,余20只造模后分为模型组(B)、耳针组(C),每组各10只。A、B两组每日进行抓取,不予其他治疗,C组采用耳甲腔埋针法治疗,每日两次,每次留针30分钟,治疗1个月。检测各组治疗前后空腹血糖、糖化血红蛋白,并观察治疗后胰岛形态学变化。
     2.临床研究:严格按入选标准收集50例2型糖尿病患者,用耳迷走神经刺激仪刺激耳甲腔治疗,每日一次,每次30分钟,治疗3个月。采用自身血前后对照的方法,观察治疗前后空腹血糖(FBG)、75克葡萄糖负荷2小时后血糖(P2BG)、糖化血红蛋白(HbAlc)的变化。
     结果:
     1.动物实验:A、B组治疗前后FBG及HbAlc无明显变化,C组FBG及HbAlc均较治疗前下降。C组胰岛β细胞较A组稍减少,较B组增多。
     2.临床实验:治疗3个月后,经统计学处理,HbAlc明显下降(P<0.01),FBG及P2BG治疗后较治疗前下降(P<0.05)。
     结论:针刺耳甲腔具有降糖作用,可以使血糖及糖化血红蛋白下降,具有预防慢性并发症的作用,可能具有修复受损胰岛β细胞的功能。
Objective: The prevalence of diabetes is significantly increased with China's economic development and changing of people's lifestyles and an aging population in China. Oral hypoglycemic agents and insulin injections are the most fast and effective way for the control of blood sugar in modern medical, However, they are often ineffective in controlling diabetic complications, especially neuropathy caused by diabetes ,and Long-term using western medicine may lead to a variety of side effects on the body and the family's economic burden. Therefore, at present, patients and clinicians are looking for an alternative therapy that is effective, convenient, cheap and low side effects for the treatment of diabetes. The purpose of this study is to find a new method for the treatment of diabetes by stimulating the cavity of auricular concha of Type-2 Diabetes Rats or Patients with diabetes, and the mechanism“ear - vagal reflex”may be a very important path for the treatment of diabetics by stimulating the cavity of auricular concha.
     Methods:
     1. The first part of the research: Separation of 10 rats form the 30 normal rats make up the control group(A) , and the remaining 20 rats were divided into the model group(10rats) (B) and the auricular acupuncture group(10rats) (C)after modeling with Chain of urine left streptozotocin. A, B without any treatment, and buried needle in the cavity of auricular concha of diabetes rats in the group C. Needle retention for 30 minutes, Bid. We detected the fasting blood glucose, glycosylated hemoglobin, and morphologic changes in pancreas islet before and after treatment after 1 month.
     2. The second part of the research: Collected 50 patients with type 2 diabetes in strictly accordance with the inclusion criteria. All of them were treated with auricular vagus nerve stimulation for 30 minutes each day. Detected the changes of the fasting plasma glucose (FBG), blood glucose load after 2-hour 75g oral glucose tolerance test (P2BG),and glycosylated hemoglobin (HbAlc) of before and after treatment after 3 months.
     Results:
     1. The first part: there is no significant difference on the FBG and HbAlc between Group A and group B before and after treatment. FBG and HbAlc of the group C significantly decreased after treatment by stimulating the cavity of auricular concha of the diabetes rats .Isletβcells in the Group C decreased slightly compared with Group A, but increased when compared with Group B under the electron microscope.
     2. The second part: By Statistical analysis ,the HbAlc of 50 patients with type 2 diabetics significantly decreased(P<0.01)and FBG and P2BG of them decreased(P<0.05) slightly than before treatment after 3 months.
     Conclusion: We have reached an initial conclusion that auricular acupuncture can regulate blood sugar level and decrease FBG and HbAlc in the diabetes rats or patients with diabetes, at the same time, this treatment may prevent the complications of diabetes and repair damaged pancreaticβcells.
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