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EFFECT_2

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EFFECT_2

    EFFECT

WormJ.Acup-Mox.Vo1.11,No.3,September,2001

    ;EFFECToFACUPUNCTUREoNSERUMGLUCAGoNAND

    ;IMMUNoCYToKINELEVELSINTYPEIIDIABETESPATIENTS

    ;ChenJianfei(谌剑飞)

    ;TheA{liatedZhuhaiTCMHospitalofGuangzhouUniversity

    ;ofTCMandPharmacyZhuhai519015,China

    ;ABSTRACTObjective:Tostudytheeffectofacupunctureonserumglucagon(GL)andimmuno-cytokinesindia-

    ;betestype-IIpatients.Methods:AtotaIof120diabetestyDe-llpatientsincluding70inpatientsand50outpatientswere

    ;randomlydividedintosimpleacupuncturegroup(n=18),acupunctureplusmedicationgroup(n=52)andsimplemedi-

    ;cationgroup(n=50).AcupointsusedwerePishu(BL20),Yishu,Shenshu(BL23),Qihai(CV6),aIuchi(LI11),

    ;Neiguan(PC6),ZusanIi(ST36),Sanyinjiao(SP6),etc.andmedicinesusedwereGlipizide(2.55mg,t.i.d.),

    ;Dimethyldiguanidehydrochloride(0.250.5g.t.i.d),etc.SerumGL,tumor

    necrosisfactor(TNF)-oandinte

    ;Iukin(IL)-6contentsweredeterminedwithradioimmunoassay,andbloodsu

garwasalsodetectedwithroutinemethod.

    ;

    ;Resu

    ;lts:Aftertreatment,serumGL,TNF-o

    andIL-6contentsdeclinedsignificantlyincomparisonwithpre-treatment ;(P<0.05,0.01),andtheeffectofacupunctureplusmedicationgroupissuperiortothoseofsimpleacpunctureor

    ;medicationgroups,particularlyinloweringserumGL(P<0.01)lC

    ;onclu

    ;sion~Theregulativeactionofacupunctureon

    ;bloodGLandimmuno-cytokinelevelsmaybecontributetoitsfunctionsinstabilizingbloodsugarandpreventingcompli-

    ;cations.

    ;KEYWORDSAcupuncturetherapyDiabetestype-IIGlucagonImmuno-cytokine

    ;From1980on,undertheguidanceofPro

    ;fessorWeiJia,awellknownacupuncturology

    ;specialist,wehavebeenconductingclinicaland

    ;experimentalresearchesonacupuncturetreat

    ;mentofdiabetesmellitus(DM)andexploredits

    ;actionmechanisms[,.includingobsen,ationon

    ;theclinicaltherapeuticeffectofacupuncturein

    ;thetreatmentofcomplicationsoftheheart, ;brainandperipheralnerve,etc.ofdiabetestype

    ;II[35]andaseriesofstudiesonacupointtissue ;transplantationderivedfromtypeIandIIand ;severediabetespatientsusingculturedembryonic ;islettissuetechnique[?.

    ;Butthetherapeutic

    ;effectofacupunctureinreducingbloodsugaris

     ;notsatisfied.Inrecentyears,combinedtreat

    ;mentofdiabeteswithacupunctureandmedicines ;f0rraisingtheeffectfurtherhasbecomeacur

    ;renttendency[.Inthepresentpaper.wetryto ;elucidatethebiologicalmechanismofendocrine ;andimmunesysteminthecombinedtreatment ;ofdiabeteswithacupunctureandmedicines. ;1GENERALDATA

    ;Atotalof120casesofdiabetestype.IIpa..

    ;tientsincluding70inpatientsand50outpatients ;fromourhospitalandthespecialistdepartment ;accordedtothediagnosticstandardsofWHO ;formulatedin1985andhadnoseverecomplica

    ;tionsofcerebra1.1iverandrenaldiseases.They

    ;wererandomlydividedintosimpleacupuncture ;group(n=18),acupuncturecombinedwith ;medicationgroup(n=52)andsimplemedication ;group(n=50).Ofthe18casesofacupuncture ;group,10weremaleand8femaleranginginage ;from35to68years(mean45.53?11.83

    ;years).Thedurationofdiseasewasfrom6 ;monthsto5years,averaging2.04?2.23 ;years.Ofthe52casesofacupuncturecombined ;withmedicationgroup,32weremaleand20fe

    ;maleranginginagefrom27to66yearsandwith ;anaverageof50.3?4.96years.Theshortest ;durationofdiseasewasonemonthandthe ;longest15yearsaveraging4.65?4.78years.In ;

    ;World.Acup-Mox.Vo1.11,No.3,September,2001 ;simplemedicationgroup,ofthe50cases,26 ;weremaleand24femaleranginginagefrom28 ;to73yearsandwithanaverageof53.3?3.57 ;years.Thedurationofdiseasewasfrom1month ;to13years,averaging4.38?4.55years. ;2METHoDS

    ;2.1Treatmentmethodsinacupuncturegroups ;Themethodswerethesametothoseusedin ;thepast[,9].Themainacupointsusedwere ;Pishu(BL20),Yishu,Shenshu(BL23),Qi

    ;hai(CV6),Quchi(LI11),Neiguan(PC6), ;Zusanli(ST36),Sanyinjiao(SP6),etc.com

    ;binedwithotheracupointsinaccordancewith ;theconcretesymptoms.Theseacupointswere ;puncturedwithfiliformneedlesandtheneedles ;weremanipulatedfor15minandthenconnected ;withaG6805ElectroacuDunctureTherapeutic ;Apparatusforstimulatingtheacupointswith ;densesparsewaves,frequency80100Hz,en

    ;durableelectriccurrentstrengthanddurationof ;15min.Thetreatmentwasgivenoncedaily ;with10sessionsbeingatherapeuticcourse.In ;simplemedicationgroup,patientswereaskedto ;takeGlipizide(2.55mg,t.i.d.),

    ;DimethyldiguanideHydrochloride(0.250.5

    ;g,t.i.d.).InAcupuncturewithmedication ;group,theacupointsandmedicinesusedwere ;thesametothosementionedabove.Allthepa

    ;tientswereobservedfor2therapeuticcourses. ;2.2Detectionofbloodsamples

    ;Intheearlymorning,thevenousblood

     ;samples(6mL)weretakenfromfastingdia

    ;betespatientstoputintotesttubesfilledwith ;trasylol,ethylenediaminetetraaceticacid(ED

    ;TA),mixedevenlyandthencentrifugatedfor ;30min.Theisolatedserumwasstoredina ;fridgeunder20?fordetection.Serum

    ;glucagon(GL),tumornecrosisfactor(TNF)a

    ;andinterlukin(IL)6contentsweredetermined

    ;withradioimmunoassaytechniqueusingSN

    ;697BCounter(madebyShanghaiFuguang ;Company)andaccordingtotheinstructionsof ;reagentkits(providedbyIsotopeInstituteof ;ChineseAcademyofAtomicEnergyandBeijing ;NorthernC:hinaBiolotechniqueInstitute).Fast

    ;ingbloodsugar(FBS)contentwasdetectedwith ;routine,

    ;method.

    ;2.3Statisticalanalysis

    ;Thequantitativevalueswereexpressedas

;mean?SandanalyzedusingStudent’st—test

    ;andMicrosoftExcel97software.AvalueofP ;<0.05wasconsideredtobesignificant. ;3RESULTS

    ;3.1ComparisonofGL,TNFa,IL6andFBS

    ;beforeandaftertreatment

    ;Table1.ComparisonofGL,TNF-

    ,IL-6andFBSbeforeandafterTreatmentinthe3Groups(M?S)

    ;Note:Pre-T=pretreatment,PostT=posttreatment.

    ;*P<0.05,**P<0.01,***P<0001vspretreatment

    ;

    ;WorldJ.Acup-Mox.Vo1.11,No.3,September,2001 ;ResultsofTable1showthatnosignificant ;differencesarefoundinGL,TNFa,IL6and

    ;FBSbeforetreatmentamongthe3groups(P> ;0.05),whileaftertreatment,GL,TNFa,IL

    ;6andFBScontentsalldecreaseconsiderably(P ;<0.05,0.01),particularlythoseofacupunc

    ;turecombinedwith

    ;0.001).

    ;medicationgroup(P<

    ;3.2ComparisonofdifferencevaluesofGL,

;TNFa.IL6andFBSbeforeandaftertreat

    ;mentinthe3groups

    ;Table2.ComparisonoftheDifferenceValuesofGL,TNF?a,IL?6

    ;andFBSbeforeandafterTreatmentinthe3Groups(M?S) ;**P<0.01,***P<0.001vsacupuncture

    medicationgmup;#P<0.05,vsacupuncturegroup ;FromTable2,itcanbeseenthattheregu

    ;lativeactionofacupunctureplusmedication ;grouponGL,TNFa,IL6andFBSissignifi

    ;cantlysuperiortothatoftheothertwogroups ;(P<0.01).Whiletheeffectofacupunctureis ;mushbetterthanthatofmedicationgroupin ;loweringTNFaandFBSlevels(P<0.05).

    ;Thusacupuncturetherapyandmedicationhavea ;strongersynergisticactioninmodulatingthe ;abovementionedsIbstances.

    ;4DISCUSSION

    ;Pancreaticglucagonhasacloserelationwith ;theabnormalmetabolismofdiabetesmel~tus. ;It’sabnormalsecretionisresponsibleforincrease

    ;ofbloodsugarlevelexceptforinsufficiencyofin

    ;sulin.Additionally.GLlevelandthetypeof

    ;DMandcontrolledbloodsugarstatealsopresent ;a1inearrelation.ItwasreportedthatwhenFBG

     ;wasbelow6.1mmol/L,plasmaGLofthenor

    ;malgroupwas68.8?36.0ng/L:whilewhen ;FBGraisedtomorethan11.2mmol/L.plasma ;GLwassignificantlyhigherthanthatofnormal ;controlgroup[.]Findingsofthepresentpaper ;showthatacupuncturecanobviouslylowerGL ;content,whichhasapositiverelationMthde

    ;creaseofFBGcontent,whileacupuncturecom

    ;binedwithmedicineshasafarbettereffect.Re

    ;gamingthemechanismofacupunctureinlower

    ;ingplasmaGLleve1.itremainsnotveryclearat ;themoment,exceptforreducingbloodsugarand ;regulatinginsulinsecretion,itcanalsostabilize ;ACTHandcortisollevelstoacertaindegree. ;Recently,itisreportedthatimmunocy

    ;tokinesarecapableofactivatingthesecretionof ;GL,particularlytheincreaseofTNFa(4.12

    ;timeshigherthanthatofcontrolgroup)[. ;Currently,IL1/3,interferon(IFN)7andTNF

    ;aareconsideredtobeassociatedwiththepatho

    ;genesisofDM.Ithasbeendemonstratedthat ;TNFQmaypromotetheabnormalgenerationof ;glycogen.48hrsafterintraperitonealinjectionof ;TNFainmice.theglycongenesislevelwithin ;thehepatocytesincreasedby50%,andthatof ;GLincytoplasmraised3times.Henee.research ;ontheeffectofacupunctureonimmunocytokines ;isanimportantpathwayforanalyzingthemech

    ;anismsofacupunctureinthetreatmentofDM. ;Inthisstudy,resultsindicatedthatafter ;acupuncturetreatment.TNFaandIL6levels

    ;decreasedsignificantlyexceptforGL,suggesting ;thatacupuncturetreatmentcanenhancetheim

    ;

    ;WorldJ.Acup-Mox.Vo1.11,No.3,September,2001 ;munityofthebodyandmaybemaintainthemu

    ;tualrestrictionandbalanceofINS,GLandso

    ;matostatinviareducingthedirecttoxiceffecton ;isletcells.Thisisinlinewiththetherapeutic ;principlesofclearingandmoisteningthelung, ;strengtheningthespleen,replenishingqi,toni

    ;fyingthekidneytoconsolidatetheconstitution

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