耳甲电针调节糖耐量减低机制研究

糖耐量减低（Impaired Glucose Tolerance, IGT）是一种处于正常葡萄糖稳态和糖尿病之间的异常代谢状态，是糖尿病病程中的一个重要阶段，发生机制主要是胰岛素抵抗和胰岛β细胞功能减低。IGT是针灸治疗的适宜病种。我们前期的工作证明耳甲区有迷走神经末梢分布，经皮耳甲迷走神经刺激（transcutaneous auricular vagus nerve stimulation，taVNS）能够提高迷走神经系统的兴奋状态，增强胰岛β-细胞活性，促进胰岛素的分泌，上调中枢和外周组织胰岛素受体的表达，改善糖代谢。本研究目的：1）通过动物实验进一步阐明耳甲（“胰胆-脾”穴）电针调节IGT模型大鼠糖代谢、改善IGT状态，及其对胰岛素受体表达和胰岛素抵抗的作用机制；2）系统观察该疗法对IGT和空腹血糖受损患者的血糖水平和糖化血红蛋白浓度的影响，为临床提供有效的治疗方案。

Impaired Glucose Tolerance (IGT) is an abnormal metabolic state following glucose metabolic steady state but prior to diabetes. IGT is an important stage during the progression of diabetes, with an underlying mechanism of insulin resistance and pancreatic β cell dysfunction. IGT is one of the diseases that shows significant beneficial response to acupuncture treatment. Original findings from our laboratory show that transcutaneous auricular vagus nerve stimulation (taVNS) which is innervated by vagus nerve, would enhance the activity of pancreatic β cells, promote the secretion of insulin, upregulate the expression of insulin receptors in central as well as peripheral tissues, thus to improve glycometabolism. In this study, we would further illuminate the mechanism of taVNS at “yidan-pi” auricular acupoints on the regulation of glucose metabolism, its improvement of the IGT state in rat model, as well as its regulation effect on insulin receptor expression and insulin resistance, and systematically illustrate the clinical effective of this treatment on IGT, with emphasize on its influence on the concentrations of glucose and HbA1c, and thus provide an effective proposal for clinical acupuncture.