Hypoglycemic effect of electroacupuncture at "Tianshu" (ST 25) combined with metformin on rats with type 2 diabetes mellitus based on AMPK / 中国针灸

OBJECTIVE@#To observe the hypoglycemic effect of electroacupuncture (EA) at "Tianshu" (ST 25) combined with metformin on rats with type 2 diabetes mellitus (T2DM) as well as its effect on expression of adenosine monophosphate activated protein kinase (AMPK) in liver and pancreas.@*METHODS@#Thirty-six male SD rats were randomly divided into a blank group (6 rats) and a model establishing group (30 rats). The rats in the model establishing group were fed with high-fat diet and treated with intraperitoneal injection of low-dose streptozotocin (STZ) to establish T2DM model. The rats with successful model establishment were randomly divided into a model group, a control group, a metformin group, an EA group and a combination group, 6 rats in each group. The rats in the EA group were treated with EA at "Tianshu" (ST 25), dense-disperse wave, 2 Hz/15 Hz in frequency and 2 mA in current intensity, 20 min each time. The rats in the metformin group were treated with intragastric administration of metformin (190 mg/kg) dissolved in 0.9% sodium chloride solution (2 mL/kg). The rats in the combination group were treated with EA at "Tianshu" (ST 25) and intragastric administration of metformin. The rats in the control group were treated with intragastric administration of 0.9% sodium chloride solution with the same dose. All the treatments were given once a day for 5 weeks. After the intervention, the body mass and random blood glucose were detected; the serum insulin level was detected by ELISA; the expression of AMPK and phosphorylated adenosine monophosphate activated protein kinase (p-AMPK) in liver and pancreas was detected by Western blot method; the expression of protein gene product 9.5 (PGP9.5) was detected by immunofluorescence.@*RESULTS@#①Compared with the blank group, the body mass in the model group was decreased (P<0.05); compared with the model group, the body mass in the EA group and the combination group was decreased (P<0.05); the body mass in the EA group and the combination group was lower than the metformin group (P<0.05). Compared with the blank group, the random blood glucose in the model group was increased (P<0.01); compared with the model group, the random blood glucose in the metformin group, the EA group and the combination group was decreased (P<0.01). The random blood glucose in the combination group was lower than the metformin group and the EA group (P<0.05). ②Compared with the blank group, the insulin level in the model group was decreased (P<0.05); compared with the model group, the insulin level in the metformin group, the EA group and the combination group was all increased (P<0.05). The insulin level in the combination group was higher than the metformin group and the EA group (P<0.05). ③Compared with the blank group, the protein expression of AMPK and p-AMPK in liver tissue was decreased (P<0.05), and the protein expression of AMPK and p-AMPK in pancreatic tissue was increased (P<0.05) in the model group. Compared with the model group, the protein expression of AMPK and p-AMPK in liver tissue in the metformin group, the EA group and the combination group was increased (P<0.05, P<0.01); the protein expression of AMPK in pancreatic tissue in the metformin group was increased (P<0.05); the protein expression of AMPK in pancreatic tissue in the EA group and the combination group was decreased (P<0.05); the protein expression of p-AMPK in pancreatic tissue in the metformin group, the EA group and the combination group was decreased (P<0.05). The protein expression of AMPK and p-AMPK in liver tissue in the combination group was higher than that in the metformin group and the EA group (P<0.05); the protein expression of AMPK in pancreatic tissue in the EA group and the combination group was less than that in the metformin group (P<0.05), and the expression of p-AMPK protein in pancreatic tissue in the combination group was less than that in the metformin group and the EA group (P<0.05). ④Compared with the blank group, the expression of PGP9.5 in pancreatic tissue in the model group was increased (P<0.01); compared with the model group, the expression of PGP9.5 in pancreatic tissue in the metformin group, the EA group and the combination group was decreased (P<0.05, P<0.01). The expression of PGP9.5 in pancreatic tissue in the EA group was lower than the metformin group and the combination group (P<0.05).@*CONCLUSION@#Electroacupuncture at "Tianshu" (ST 25) could promote the effect of metformin on activating AMPK in liver tissue of T2DM rats, improve the negative effect of metformin on AMPK in pancreatic tissue, and enhance the hypoglycemic effect of metformin. The mechanism may be related to the inhibition of pancreatic intrinsic nervous system.

Brief analysis on pivot effect of Tianshu (ST 25) / 中国针灸

The pivot effect of Tianshu (ST 25) was analyzed, which was explored from 5 aspects, named the ascending and descending of spleen and stomach

Effects of electroacupuncture at "Zhongliao" (BL 33) and "Tianshu" (ST 25) on ovarian function in rats with premature ovarian insufficiency / 中国针灸

<p><b>OBJECTIVE</b>To explore the effects of electroacupuncture (EA) at "Zhongliao" (BL 33) and "Tianshu" (ST 25) on ovarian function in rats with premature ovarian insufficiency (POI).</p><p><b>METHODS</b>A total of 48 SD female rats with regular estrus were divided into a blank group (=8), a model group (=10), an EA group (=10), a binding group (=10) and a tamoxifen (TAM) group (=10). The rats in the model group, EA group, binding group and TAM group were all treated with intraperitoneal injection of 4-vinylcyclohexene diepoxide (VCD, 160 mg/kg) for 15 consecutive days to establish the model of POI; the rats in the blank group were treated with normal diet. After the model was established successfully, the rats in the EA group were treated with EA at "Zhongliao" (BL 33) and "Tianshu" (ST 25) with continuous wave (1 to 3 Hz, 0.1 to 1 mA) for 20 minutes, once a day (five times a week) for the first two weeks and once every other day (three times a week) for the following two weeks. The rats in the TAM group were treated with subcutaneous injection of tamoxifen (1mg/kg), once a day (five times a week) for the first two weeks and once every other day (three times a week) for the following two weeks. The rats in the binding group were bound by a small sack as the EA group. The rats in the blank group and the model group were treated with normal diet. After four weeks, the sexual gland weight and index were tested in each group; the ELISA method was applied to test the level of anti-mllerian hormone (AMH) and inhibin B; the morphology of ovary was observed; the number of primordial follicles, primary follicle, antral follicle and atretic follicle was counted; the expression of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor-1 receptor (IGF-1R) were measured.</p><p><b>RESULTS</b>(1) Compared with the blank group, the ovary weight, ovary index, uterus weight and uterus index were significantly decreased after treatment in the model group, EA group, binding group and TAM group (all <0.01); but the differences between the model group and the EA group, binding group, TAM group were not significant (all >0.05). (2) Compared with the blank group, the levels of serum AMH, inhibin B and E were significantly reduced; the levels of FSH and LH were significantly increased in the model group; EA group, binding group and TAM group (all <0.01). Compared with the model group, the levels of serum AMH, inhibin B and E were significantly increased, the level of FSH and LH were significantly reduced in the EA group and TAM group (all <0.01). (3) Compared with the blank group, in the model group, EA group, binding group and TAM group the ovary was dark red and pale, surrounded by particle or not; the morphology was small and atrophic; the primordial follicles was reduced even vanished; the structure of primary follicle was damaged and loosely arranged; the mature follicle was few; the atretic follicle and interstitial gland were increased. (4) Compared with the blank group, the expressions of IGF-1 mRNA and IGF-1R mRNA were increased in the model group (all <0.01); compared with the blank group, the expression of IGF-1 mRNA was increased in the binding group (<0.05), but that of IGF-1R mRNA was not significantly different (>0.05); compared with the model group, the expression of IGF-1 mRNA was not significantly different in the EA group, binding group and TAM group (all >0.05), but that of IGF-1R mRNA was reduced (<0.05, <0.01).</p><p><b>CONCLUSION</b>EA at "Zhongliao" (BL 33) and "Tianshu" (ST 25) has improvement effect on ovarian function in rats with VCD-induced POI, which is likely to be related to regulating the IGF-1R mRNA expression to improve the IGF-1/ IGF-1R axis.</p>

Comparison of effects of electroacupuncture at "Dachangshu" (BL 25) or "Tianshu" (ST 25) on visceral sensitivity, c-kit and TRPV1 of irritable bowel syndrome rats / 中国针灸

<p><b>OBJECTIVE</b>To compare the effects of electroacupuncture (EA) at "Dachangshu" (BL 25) or "Tianshu" (ST 25) for visceral sensitivity, gene expression product c-kit of colonic Cajal interstitial cells (ICC) and capsaicin receptor 1 (TRPV1) of irritable bowel syndrome (IBS) rats, so as to investigate the effect and mechanism differences of EA at the back point and the front point of large intestine for IBS rats.</p><p><b>METHODS</b>Forty-two Wistar neonatal rats were randomly divided into a blank group (9 rats) and a model group (33 rats). IBS model was established with mother and child separation, acetic acid enema in young rats and colorectal dilatation method. Twenty-seven IBS rats in life were randomly divided into a model control group, a Dachangshu group and a Tianshu group, 9 rats in each group. EA (disperse-dense wave, 2 Hz/100 Hz, 0.1-0.3 mA) for 20 min was used at "Dachangshu" (BL 25) and "Tianshu" (ST 25) respectively in the Dachangshu and Tianshu groups, once every other day, totally 5 times. The rats in the model control group were fixed with soft cloth sleeve for 20 min, without acupuncture. No intervention was used in the blank group. The stool property Bristol grading score was recorded before and after intervention in each group. The visceral sensitivity was evaluated by abdominal withdrawal reflex. The latency until the first systolic wave occurred and the number of systolic wave within 90 s were observed. Immunohistochemical was used to detect the positive expressions of c-kit and TRPV1, the ICC colon specific marker.</p><p><b>RESULTS</b>Compared with the blank group, the Bristol score increased，latency period shortened, systolic wave number increased, c-kit and TRPV1 positive expressions increased in the model control group (all <0.01). Compared with the model control group, the Bristol score decreased, latency period increased, systolic wave number decreased, c-kit and TRPV1 positive expressions decreased after intervention in the Dachangshu and Tianshu groups (<0.05, <0.01). Compared with the Dachangshu group, the TRPV1 positive expression decreased after intervention in the Tianshu group (<0.05).</p><p><b>CONCLUSION</b>EA at "Dachangshu" (BL 25) or "Tianshu"(ST 25) can improve the diarrhea in IBS model rats, reduce the visceral sensitivity, and its mechanism may be related to regulating the expressions of colon c-kit and TRPV1. EA at "Tianshu" (ST 25) is more apparent for TRPV1 than at "Dachangshu" (BL 25).</p>

Protective effects of electroacupuncture pretreatment on ovarian in rats with premature ovarian insufficiency / 中国针灸

<p><b>OBJECTIVE</b>To explore the protective effect and possible mechanism of electroacupuncture (EA) pretreatment at "Zhongliao" (BL 33) and "Tianshu" (ST 25) on ovarian in rats with premature ovarian insufficiency (POI).</p><p><b>METHODS</b>A total of 32 SD female rats with regular estrus were randomly divided into a blank group, a model group, an EA group and an immobilization group, 8 rats in each one. The rats in the model group, EA group and immobilization group were treated with intraperitoneal injection of 4-vinylcyclohexene diepoxide (160 mg/kg) for 15 days to establish the model. From the beginning of model establishment, the rats in the EA group were treated with EA pretreatment at "Zhongliao" (BL 33) and "Tianshu" (ST 25), once a day for the first two weeks (5 treatments per week) and once every two days for the last two weeks (3 treatments per week). EA was given 20 min per treatment for four weeks. The rats in the immobilization group were treated with immobilization with identical duration, frequency and total amount as the EA group. No treatment was given in the blank group and model group. When model was successfully established in the model group, rats were sacrificed to test the weight of sexual gland and the sexual gland index; the ELISA method was applied to test the level of anti-müllerian hormone (AMH) and inhibin B; the radioimmunoassay method was applied to test the level of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E), progesterone (P) and testosterone (T). In addition, the morphology and the number of ovarian follicles were observed; and western blot method was applied to test the expression of B-cell lymphoma-2 (Bcl-2) and Bcl-2-associated X protein (Bax) in ovarian tissue.</p><p><b>RESULTS</b>Compared with the blank group, the bilateral ovary weight, ovary index, uterus weight and uterus index decreased (<0.05, <0.01); serum AMH, inhibin B, E and P reduced, while serum FSH, LH and T increased in the model group (all <0.01); primordial follicles and primary follicles decreased, while atretic follicles increased in the model group (all <0.01); the expression of Bax protein increased, while the expression of Bcl-2 protein decreased in the model group (both <0.01). Compared with the model group, the bilateral ovary weight, ovary index and uterus weight increased (<0.05, <0.01); serum AMH, inhibin B, E and P increased, while serum FSH and LH reduced (<0.05, <0.01); primordial follicles and primary follicles increased, while atretic follicles reduced (<0.05, <0.01); the expression of Bax protein reduced, while the expression of Bcl-2 protein increased in the EA group (<0.05, <0.01). The differences of each outcome indexes were not significant between the model group and immobilization group (all >0.05).</p><p><b>CONCLUSION</b>EA pretreatment at "Zhongliao" (BL 33) and Tianshu (ST 25) for 4 weeks has certain protective effect on ovarian in POI rats, which is likely to be related with up-regulating ovarian granular cells, inhabiting the expression of Bcl-2 protein and down-regulating the expression of Bax protein.</p>

Elongated needle for post-stroke indigestion / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical efficacy difference among elongated needle, filiform needle and medication for post-stroke indigestion.</p><p><b>METHODS</b>Sixty cases of post-stroke indigestion were randomly assigned into an elongated needle group, a filiform needle group and a medication group, 20 cases in each one. Acupuncture of restoring consciousness and inducing resuscitation and conventional medical treatment were applied in the three groups. 125 mm elongated needles were perpendicularly inserted at Zhongwan (CV 12), Liangmen (ST 21) and Tianshu (ST 25) in the elongated needle group; 20 to 30 mm perpendicular filiform at the same points in the filiform needle group. All the treatment was given for 4 weeks, 6 times a week, 1 time a day. Domperidone was prescribed orally in the medication group for 4 weeks, 3 times a day and once 10 mg. The indexes were dyspepsia TCM symptom score, Liz dyspepsia questionnaire (LDQ), Nepean Dyspepsia Index of quality of life (NDLQI), Safety Data Sheet (SDS) self rating scale and side effect scale (TESS). The effects were evaluated.</p><p><b>RESULTS</b>The scores of TCM symptom, LDQ, SDS scores in the three groups decreased and NDLQI increased after 7-day, 14-day, and 28-day treatment as compared with those before treatment (<0.05,<0.01). The TCM symptom score and LDQ score in the elongated needle group after 28-day treatment were lower than those in the filiform needle and medication groups (<0.05,<0.01). The SDS score in the medication group was lower than that in the elongated needle and filiform needle group (both<0.05). There were no significant statistical difference for NDLQI score in the three groups (>0.05). The total effective rate was 90% (18/20) in the elongated needle group; those in the filiform needle group and medication group were 70% (14/20) and 75% (15/20) respectively, indicating statistical significance (<0.01).</p><p><b>CONCLUSION</b>Acupuncture with elongated needle can obviously improve symptoms in the patients with post-stroke indigestion, which is better than filiform needle and medication.</p>

Observation of Therapeutic Effects of Needle Warming Moxibustion for Chronic Diarrhea / 针灸推拿医学（英文版）

Objective: To observe the therapeutic effects of needle warming moxibustion for chronic diarrhea. Methods: Two-hundred cases with chronic diarrhea were divided randomly into a treatment group and a control group. 100 cases in the treatment group were treated with needle warming moxibustion on specific acupoints. 100 cases in the control group were treated by oral administration of Smecta. Results: The therapeutic results showed cure in 52 cases, remarkable effect in 34 cases, improvement in 14 cases and the total effective rate in 100.0% in the treatment group, and cure in 5 cases, remarkable effect in 23 cases, improvement in 33 cases, failure in 39 cases and the total effective rate in 61.0% in the control group. The comparison of the total effective rate between the two groups was statistically significant (P<0.05). Conclusion: The needle warming moxibustion on specific acupoints is better than oral administration of Smecta in the therapeutic effects.

Clinical Study on Deep Insertion at Tianshu(ST 25)for Colonic Slow Transit Constipation / 针灸推拿医学（英文版）

Objective:To observe the clinical effect of deep insertion at Tianshu(ST 25)for colonic slow transit constipation(STC).Methods:120 cases of STC patients were randomly divided,60 cases in a deep insertion group,30 cases in an electroacupuncture group and 30 cases in a medication group by 2:1:1 ratio.The deep insertion group was treated with deep insertion at Tianshu(ST 25).The electroacupuncture group was treated with routine insertion at Tianshu(ST 25).The medication group was treated with oral administration of Lactulose oral liquid.The first voluntary defecation time,and constipation scores before the treatment,four weeks after the treatment and relevant scores of clinical symptoms were assessed in the three groups of the patients.Results:The scores of the clinical symptoms in improvement of constipation were better in the deep insertion group than in the electroacupuncture group and medication group,with differences in statistical significance(P<0.01).The unsuccessful numbers in the improvement of defecation and abdominal pain were also better in the deep insertion group than in the other two groups,and better in instant effect in the deep insertion.Conclusion:The improvement of STC clinical symptoms was better by deep insertion at Tianshu(ST 25)than by medication and routine acupuncture method at Tianshu(ST 25).