Research On Acupuncture Points Related To Spleen In The Treatment Of Type 2 Diabetes Mellitus

Research objective:To observe the effects of spleen-related acupuncture points such as BL20, SP10, SP6, SP4, SP1, ST36 on the related indexes of Type Ⅱ diabetes mellitus in order to find the most effective acupoints for the treatment of Type Ⅱ diabetes mellitus.Research methods:1. Clinical Study:Forty patients with type 2 diabetes with Qi & Yin deficiency type body constitution are treated by acupuncture in addition to drug treatment. Here are the acupoints needled:BL20, LI11, REN12, SP10, ST36, SP6, ST44. For thirst and dry mouth, add LU10, REN24, Jinjin or Yuye; for large appetite, easy hunger and dry stool, add BL21, BL22, ST40; for profuse urination, night sweat, sore lower back and tinnitus, add KD7, BL23, REN4; for diarrhea and lassitude, add SP9, ST37. Retain needles in for 30 minutes, manipulate each needle for 10 seconds long in every 10 minutes with reinforcing-reducing, balancing technique. The treatment is given every other day,3 times per week for 1 month as a cycle; continue observation for 3 consecutive cycles (3 months). Before and after treatment, every patient’s clinical manifestation is documented; their blood glucose before meal, glycosylated hemoglobin, insulin, triglyceride levels are tested as well as recorded in their observation charts for before and after-treamtnet data comparison and analysis.2. Experimental Study:The successful models of type 2 diabetic SD rats are randomly divided into acupuncture treatment groups:BL20 group, SP10 group, SP6 group, SP4 group and SP1 group; acupuncture control group:ST36 group; model group; homologues non-diabetic SD rats as normal control group. Needle each acupuncture treatment group’s corresponding point (BL20 group, SP10 group, SP6 group, SP4 group, SP1 group) bilaterally, retain needles in for 20 minutes, manipulate each needle once every 5 minutes with twirling and reinforcing-reducing balancing technique. Treatment is given once daily, after every 6 treatments, take a one day break. For model group and normal control group, the mice are fixated onto mice holder with no other treatment assigned. The mice in all groups are treated for 4 consecutive weeks. Every other week, the mice’s weight and blood drawn on an empty stomach from mice’s tail are measured and recorded in a timely manner. After the experiment, blood and pancreatic tissue are taken, and fasting blood glucose, blood lipid, glycosylated hemoglobin, insulin, glucagon are tested. Microscopic observation of morphological changes of islet beta cell are observed.Research results:1.Clinical research:In addition to patient’s original drug treatment, acupuncture treatment can improve the clinical symptoms in patients with type 2 diabetes, and effectively reduce the fasting blood glucose,glycosylated hemoglobin, insulin secretion index, triglycerides and other indicators.This combined treatment method has statistically significant difference with the comparison of the data of before and after treatment;Second, Experimental study:(1) There is no significant weight difference between each group before the therapy. After treatment, acupuncture group and modeling group have shown obvious weight loss, but there is no significant statistical difference. The normal control group shows continuous weigh gain during the experiment.(2) FPG:Compare the level of blood glucose in acupuncture treatment group and acupuncture control group with model group, there is a statistically significant difference; ST36 group, SP10 group and BL20 group show significantly lower level of blood glucose than SP6 group, SP4 group and SP1 group. SP1 group shows significantly lower blood glucose than SP6 and SP4 groups.(3) TC, TG, HDL-C and LDL-C:TC:After the treatment, acupuncture group, acupuncture control group and normal control group are compared with the model group; the difference has statistical significance; Compare with normal control group, acupuncture treatment group and acupuncture control group contain higher level of TC. TC in BL20 group, SP1 group, ST36 group has no significant meaning in statistics, but it is significantly lower than SP 6 and SP 4 groups. SP10 group is lower in TC than BL20, SP1 and ST36 groups.TG:Compare with model group, all acupuncture treatment groups have obviously lower amounts of TG; BL20 group, SP6 group, SP4 group and SP1 group have higher TG than normal control group. Compare SP10 group and ST36 group with normal control group, there is no significant statistica difference. When compare BL20 group, SP10 group, SP1 group, ST36 group with each other, there is no difference between them, but statistically lower than SP6 group and SP4 group.HDL-C:Compare with model group and normal control group,all acupuncture treatment groups have higher amounts of HDL-C,the difference has statistical significance.BL20 group,ST36 group and SP1 group have higher HDL-C than SP6 group.Compare BL20 group and SP4 group, the difference has significant statistica meaning.When compare SP1 group, ST36 group, SP6 group with each other, there is no difference between them.Compare with all acupuncture group,SP10 group contain obviously higher level of HDL-C.LDL-C:Compare with model group, all acupuncture treatment groups have obviously lower amounts of LDL-C,the difference has statistical significance.Compare with normal control group,BL20 group, SP6 group, SP4 group, SP1 group and ST36 group have higher LDL-C than normal control group. SP10 group has the same amounts LDL-C as normal control group.BL20 group and SP10 group is lower in LDL-C than SP6, SP1 and ST36 groups.Compare SP10 group and BL20 group, SP1 group, the difference has significant statistica meaning.(4)GHbA1c, INS, HOMA-β and Resistin:GHbA1c:Acupuncture treatment group and acupuncture control group have lower amounts of GHbAlc than the model group,but they are obviously higher than normal control group. GHbA1c in BL20 group, SP1 group has no significant meaning in statistics, but it is significantly lower than SP 6 and SP 4 groups.SP10 group, ST36 group is lower than BL20 and SP1 groups.INS:Compare with model group, all acupuncture treatment groups have obviously lower amounts of INS, there is significant statistica difference. SP6 group and SP4 group have higher INS than normal control group. When compare BL20 group, SP10 group, SP1 group with each other, there is no difference between them, but compare with SP6 group and SP4 group, the difference has significant statistica meaning.ST36 group is lower than BL20,SP10 and SP1 groups.HOMA-β:Compare with model group, BL20 group, SP10 group and ST36 group have obviously lower amounts of HOMA-β. SP6 group, SP4 group and SP1 group have lower HOMA-β than normal control group. HOMA-β in BL20 group, SP10 group has no significant meaning in statistics, but it is significantly higher than SP 6 and SP 4 groups. ST36 group contain obviously higher level of HOMA-β than SP6 group.SP10 group is higher than SP1 group.Resistin:Compared with model group,all acupuncture treatment groups have obviously lower amounts of Resistin. there is a statistically significant difference,but they are obviously higher than normal control group. BL20 group,SP10 group and SP1 group have lower Resistin than SP6 and SP 4 groups.Compared SP10 group with BL20 group,SP10 group has lower Resistin,the difference has statistically significant meaning. Resistin in BL20 group,SPl group is lower than ST36 group.Compare BL20 group with ST36 group, there is no significant statistica difference.(5)Impact on the structure of islet cells:A. Normal control group shows completely normal pancreatic islet structure, no damage in pancreatic alveoli and cells in pancreatic islet are well arranged, in high quantity and with standard shape. The swelling and necrosis of the islet cells are not obvious and infiltration of inflammatory cells is not seen. B:Model group’s islet structure is incomplete, pancreatic alveoli cells are broken with bubble-like changes; the cells within the pancreas are disorganized and in small quantity. The cytoplasm is swollen with obvious fibrous tissue hyerplasia. C:In ST36 group, the pancreatic islet structure is incomplete, a portion of islet cells are not arranged orderly, and the islet cells became smaller, in various shapes and with reduced quantity. Local pancreatic alveoli appear to have bubble-like changes,,Jhe cytoplasm of islet cells are not obviously swollen. D:All other acupuncture treatment groups show complete structure of islet cells, pancreatic alveoli are not damaged, the cells within pancreas are well arranged, with shape like those cells in normal control group, in large quantity and no cytoplasmic swelling and fibrous tissue hyperplasia.Research conclusions:One of the modern pathogenesis of type Ⅱ diabetes mellitus is an increasingly important aspect of the mechanism of spleen fails. Clinical studies of acupuncture points related to the spleen can effectively reduce blood sugar and blood lipids, stimulate insulin secretion and can improve clinical symptoms, efficiency up to eighty percent.Experimental study to better illustrate these points can effectively adjust the spleen-related type Ⅱ diabetic rats, blood lipids, insulin resistance index levels and other factors, and can improve the function of pancreatic islet (3 cells.In this study, the combined effect of all observed indicators point of view, in which the efficacy of the best is SP10, followed by BL20, SP1 and ST36; SP6and SP4 have the poorest outcome.Above all points can increase functions of spleen, but there are differences between different points in adjusting the internal organs function, but also confirmed the presence of differences affect different parts of the meridian points on the function of organs on the same meridian.After read the literature,there is basically no founding related to SP10, SP4 and SP1 in diabetes, but in this study, these points also showed better efficacy.