王雅媛;梁凤霞;陈丽;卢威;周钰点;黄湘茜;杨姝瑞;

• 1:湖北中医药大学针灸骨伤学院/针灸治未病湖北省协同创新中心

摘要(Abstract)：

目的:观察不同部位腧穴配伍电针对肥胖大鼠胃肠运动及瘦素(LEP)、胆囊收缩素(CCK)的影响,探讨针刺减肥的相关机制。方法:从70只Wistar雄性大鼠中随机挑选10只为正常组,予以普通饲料饲养,其他大鼠采用高脂饮食饲养法造模,共8周。造模成功的40只大鼠随机分为模型组、腹部电针组、下肢部电针组及标本电针组,每组各10只。腹部电针组取"关元""中脘""天枢";下肢部电针组取"足三里""丰隆";标本电针组取腹部联合下肢部穴位,3组均电针20 min/次,3次/周,连续干预8周。观察并记录各组大鼠进食量、体质量、白色脂肪含量;检测大鼠胃排空率和小肠推进率;以全自动生化分析仪检测大鼠血清总胆固醇(TC)、甘油三酯(TG)、游离脂肪酸(NEFA);用ELISA法检测大鼠血清LEP、CCK的含量;用Wes-tern blot法检测小肠LEP、CCK的蛋白表达。结果:干预前与正常组比较,模型组及3个干预组进食量、体质量均升高(P<0.05)。干预后与正常组比较,模型组进食量、体质量、TC、TG、NEFA、白色脂肪含量、胃排空率、血清及小肠的LEP含量显著升高(P<0.01),小肠推进率、血清及小肠CCK含量显著降低(P<0.01)。干预后与模型组比较,3个干预组进食量、体质量、TC、TG、白色脂肪含量、胃排空率、血清及小肠的LEP含量均显著降低(P<0.05,P<0.01),小肠推进率、血清及小肠CCK含量显著升高(P<0.05,P<0.01),下肢部电针组、标本电针组血清NEFA含量显著下降(P<0.01)。与腹部电针组比较,下肢部电针组及标本电针组血清NEFA显著降低(P<0.05)。结论:针刺腹部、下肢部穴位对胃肠运动和LEP、CCK的调节作用一致,但在调节血清NEFA含量上存在一定差异。针刺腹部、下肢部穴位均可改善大鼠的肥胖状态,其机制可能与调控LEP、CCK的表达,从而延迟胃排空,加快小肠推进率,减少进食量有关。

关键词(KeyWords)： 腧穴配伍;电针;肥胖;胃肠运动;胆囊收缩素;瘦素

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金面上项目(No.81774420);国家自然科学基金青年基金项目(No.81804170);; 湖北中医药大学2019年度重大项目培育计划

作者(Author): 王雅媛;梁凤霞;陈丽;卢威;周钰点;黄湘茜;杨姝瑞;

Email:

DOI: 10.13702/j.1000-0607.200023

参考文献(References)：

• [1] BLüHER M.Obesity:global epidemiology and pathogenesis[J].Nat Rev Endocrinol,2019,15(5):288.
• [2] HRUBY A,MANSON J E,QI L,et al.Determinants and consequences of obesity[J].Am J Public Health,2016,106(9):1656-1662.
• [3] NATIONAL INSTITUTES OF HEALTH.Clinical guidelines on the identification,evaluation,and treatment of overweight and obesity in adults-the evidence report[J].Obes Res,1998,6:51S-209S.
• [4] MUSHREF M A,SRINIVASAN S.Effect of high fat-diet and obesity on gastrointestinal motility[J].Ann Transl Med,2013,1(2):14.
• [5] MCNEELY W,BENFIELD P.Orlistat[J].Drugs,1998,56(2):241-249.
• [6] 王媛.中枢不同部位参与针刺调节大鼠胃功能的观察[D].南京:南京中医药大学,2014.
• [7] CHO S H,LEE J S,THABANE L,et al.Acupuncture for obesity:a systematic review and meta-analysis[J].Int J Obes (Lond),2009,33(2):183-196.
• [8] 余芝,鞠传慧,徐斌,等.针刺治疗单纯性肥胖的临床随机对照试验系统评价[J].时珍国医国药,2010,21(2):434-436.
• [9] KIM S Y,SHIN I S,PARK Y J.Effect of acupuncture and intervention types on weight loss:a systematic review and meta-analysis[J].Obes Rev,2018,19(11):1585-1596.
• [10] 王华,梁凤霞.腧穴配伍研究思路和展望[J].中国针灸,2012,32(4):359-362.
• [11] TAKAHASHI T.Acupuncture for functional gastrointestinal disorders[J].J Gastroenterol,2006,41(5):408-417.
• [12] LI Y Q,ZHU B,RONG P J,et al.Effective regularity in modulation on gastric motility induced by different acupoint stimulation[J].World J Gastroenterol,2006,12(47):7642-7648.
• [13] SATO A,SATO Y,SUZUKI A,et al.Neural mechanisms of the reflex inhibition and excitation of gastric motility elicited by acupuncture-like stimulation in anesthetized rats[J].Neurosci Res,1993,18(1):53-62.
• [14] ZECCHIN H G,PRIVIERO F B,SOUZA C T,et al.Defective insulin and acetylcholine induction of endothelial cell-nitric oxide synthase through insulin receptor substrate/Akt signaling pathway in aorta of obese rats[J].Diabetes,2007,56(4):1014-1024.
• [15] CHANDLER P C,VIANA J B,OSWALD K D,et al.Fee-ding response to melanocortin agonist predicts preference for and obesity from a high-fat diet[J].Physiol Behav,2005,85(2):221-230.
• [16] 李忠仁.实验针灸学[M].北京:中国中医药出版社,2003.
• [17] BELIVANI M,DIMITROULA C,KATSIKI N,et al.Acupuncture in the treatment of obesity:a narrative review of the literature[J].Acupunct Med,2013,31(1):88-97.
• [18] IBER F L,PARVEEN S,VANDRUNEN M,et al.Relation of symptoms to impaired stomach,small bowel,and colon motility in long-standing diabetes[J].Dig Dis Sci,1993,38(1):45-50.
• [19] 李永华,王晓川,韩裕璧,等.中医学对肥胖病因病机的认识[J].中医药学报,2012,40(4):4-5.
• [20] LIANG F,KOYA D.Acupuncture:is it effective for treatment of insulin resistance[J].Diabetes Obes Metab,2010,12(7):555-569.
• [21] MEYER-GERSPACH A C,W?LNERHANSSEN B,BEGLINGER B,et al.Gastric and intestinal satiation in obese and normal weight healthy people[J].Physiol Behav,2014,129:265-271.
• [22] NGUYEN N Q,DEBRECENI T L,BURGESS J E,et al.Impact of gastric emptying and small intestinal transit on blood glucose,intestinal hormones,glucose absorption in the morbidly obese[J].Int J Obes (Lond),2018,42(9):1556-1564.
• [23] WILDING J P H.Neuropeptides and appetite control[J].Diabet Med,2002,19(8):619-627.
• [24] REHFELD J F.Cholecystokinin-from local gut hormone to ubiquitous messenger[J].Front Endocrinol (Lausanne),2017,8:47.
• [25] CAMMISOTTO P G,BENDAYAN M,SANé A,et al.Receptor-mediated transcytosis of leptin through human intestinal cells in vitro[J].Int J Cell Biol,2010,2010:928169.
• [26] CAMMISOTTO P,BENDAYAN M.A review on gastric leptin:the exocrine secretion of a gastric hormone[J].Anat Cell Biol,2012,45(1):1-16.
• [27] 秦培洁,仝小林.肥胖的瘦素抵抗机制研究进展[J].医学综述,2010,16(5):662-665.
• [28] 严志康,杨智杰,陈锋.针刺对肥胖大鼠血清瘦素及肝细胞JAK 2-STAT 3信号通路的影响[J].针刺研究,2015,40(1):1-5.
• [29] COVASA M.Deficits in gastrointestinal responses controlling food intake and body weight[J].Am J Physiol Regul Integr Comp Physiol,2010,299(6):R1423-R1439.
• [30] GRABAUSKAS G,WU X Y,ZHOU S Y,et al.High-fat diet-induced vagal afferent dysfunction via upregulation of 2-pore domain potassium TRESK channel[J].JCI Insight,2020,5(6):137859.
• [31] 潘卫星.针刺双向调节效应及可能机制[J].针刺研究,2019,44(11):843-853.