电针与西布曲明对肥胖大鼠脂肪细胞产物影响的差异

背景:针灸与药物均是治疗单纯性肥胖病的有效方法,电针与常用减肥药西布曲明影响肥胖机体脂肪细胞产物是否存在差异?目的:观察电针与常用减肥药西布曲明影响肥胖大鼠脂肪细胞产物的差异,以探讨针灸减肥的机制.设计:分层随机对照设计.单位:南京中医药大学针药结合实验室.材料:选用120只生后45 d雄性SD大鼠,由上海实验动物中心提供,实验过程中对动物的处置符合动物伦理学标准.盐酸西布曲明胶囊由太极集团涪陵制药厂生产,批号为国药准字X20010279;电针仪为韩氏LH402A穴位神经电刺激仪,由北京华卫产业开发公司生产.方法:实验于2004-1012006-11在南京中医药大学针药结合实验室和南京中医药大学实验动物中心完成.①高脂高能量饲料喂养100只SD雄性人鼠,选择食源性肥胖人鼠54只,分为电针组、药物组、肥胖组,每组18只,并以18只正常饲料大鼠为正常组.②电针组大鼠均以2/15 Hz,4 mA的电针治疗,针刺穴位为同侧的"后三里"、"内庭",每次针一侧2个穴位,隔日交替.以自制的束缚装置崮定,治疗时大鼠处于清醒而不剧烈挣扎状态,治疗时间15 min/d,每6天休息1 d,共观察49 d,治疗42次;药物组采用0.2g/L盐酸西布曲明溶液2.0mg/(kg·d)灌胃;正常组及肥胖组与针刺组同样束缚而不针刺.主要观察指标:①肥胖指标:检测各组大鼠体质量、体长、减重率及脂体比,生化比色法测定血清总胆固醇、高密度脂蛋白胆固醇及三酰甘油.②胰岛素敏感性指标:酶联免疫法测定空腹血清葡萄糖、胰岛素及胰岛素敏感指数.③脂肪细胞分泌调节物质水平:酶联免疫法测定血清抵抗素、瘦素、脂联素、肿瘤坏死因子α、白介素-6及其可溶性受体水平.结果:纳入大鼠120只,食源性肥胖大鼠模型成功54只及正常组18只均进入结果分析.①肥胖组大鼠体质量、体脂量、胆同醇、三酰甘油明显高于正常组,差异有统计学意义(P＜0.01).电针组大鼠体质量、体脂量、脂体比、胆固醇、三酰甘油低于肥胖组,差异有统计学意义(P＜0.01).药物组大鼠三酰甘油低于肥胖组,差异有统计学意义(P＜0.01).电针组减重率高于药物组,脂体比低于药物组,差异有显著性意义(P＜0.01).②肥胖组大鼠血糖、血清胰岛素明显高于正常组,胰岛素敏感指数低于正常组,差异均有统计学意义(P＜0.01).电针组及药物组血糖和胰岛素水平低于肥胖组,胰岛素敏感指数高于肥胖组,差异有统计学意义(P＜0.01).③电针组大鼠脂联素水半高于肥胖组,差异有统计学意义(P＜0.01).抵抗素、肿瘤坏死因子α水平均低于肥胖组,差异有统计学意义(P＜0.01).药物组大鼠抵抗素水平低于肥胖组,差异有统计学意义(P＜0.01).结论:电针在改变肥胖大鼠脂肪组织异常分泌的产物方面的作用较西布曲明更为明显,这可能是针灸减肥和防治肥胖相关疾病的重要机制之一.

Effects of electroacupuncture versus sibutramine on adipocyte products in obesity rats

BACKGROUND:Both acupuncture and moxibustion and drug ale effective methods to treat simple obesity.Whether electroacupuncture is different from sibutramine to affect adipocyte products in obese organisms?OBJECTIVE:To observe the different effects of electroacupuncture and sibutramine on adipocyte produces in obesity rats and to investigate the mechanism of weight reduction by acupuncture and moxibustion.DESIGN:Layering-randomized controlled study.SETTING:Laboratory of Acupuncture and Pharmacology.Nanjing University of Chinese Medicine.MATERIALS:12045-day-old male SD rats were provided by Shanghai Experimental Animal Center.The experiment was in accordance with animal ethics standards.Sibutramine hyrdrochloride capsule was made in Fuling Pharmaceutical Factory of Taiji Group(batch number:X20010279).Electro-acupuncture apparatus(LH402A acupoint neutoelectrical stimulation equipment)was made in Beijing Huawei Chanye Developing Company.METHODS:This study was performed at the Laboratory of Acupuncture and Pharmacology,and Expefimental Animal Center,Nanjing University of Chinese Medicine from October 2004 to November 2006.①100 male SD rats underwent high-fat diet.Fifty-four alimentary obesity rats were randomly divided into electroacupuncture group,sibutramine group and obesity group.wim 18 rats in each group.Another 18 rats were regarded as a normal group.②Rats in the electroacupuncture group were given electrical stimulation(2/15 Hz,4 mA)at lateral Housanli and Neiting acupoints,contralateral alternation every other day.Rats were fixed with self-made binding instrument,and rats maintained a consciousness but not an intense struggle.The electricai stimulation lasted for 15 minutes every day,one day was an interval every 6 days.and the electroacupuncture was given for 49 days and 42 times in total.Rats in the sibutramine group were ingragastrically administrated with 0.2 g/L sibutramine hydrochloride(2.0 mg/kg/d).Rats in the control group and obesity groups were fixed the same as electroacupuncture group but not given electrical stimulation.MAIN OUTCoME MEASURES:①Obese marker:To detect body mass,body length,weight reduction rate and body mass/body fat mass,and to measure total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)and triacylglycerol (TG)with biochemical chromatometry;②insulin sensitivity index:To measure fasting blood glucose,insulin and insulin sensitivity index with enzyme-linked immunosorbent assay;③adipocyte secreting regulatory substance level:To measure serum resistin,leptin,adiponectin,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and its soluble receptor level with enzyme-linked immunosorbent assay.RESULTS:Among 120 rats,54 alimentary obesity rat models and 18 normal rats were included in the final analysis.①Obesemarker:Bodymass,bodyfatmass,cholesterol and TG levels in the obesity group were significantly higher than in the normal group(P＜0.01).Body mass,body fat mass,body mass/body fat mass,cholesterol and TG levels in the electroacupuncture group were significantly lower than in the obesity group(P＜0.01).TG level in the sibutramine group was significantly lower than in the obesity group(P＜0.01).Weight reduction rate in the electroacupuncture group was significantly higher than in the sibutramine group(P＜0.01).Body mass/body fat mass in the electroacupuncture group was significantly lower than in the sibutramine group(P＜0.01).②Insulin sensitivity:Blood glucose and serum insulin levels in the obesity group were significantly higher than in the normal group,and insulin sensitivity index was significantly lower than in the normal group(P＜0.01).Blood glucose and insulin levels in the electroacupuncture and sibutramine groups were significantly lower than in the obesity group,but insulin sensitivity index was significantly higher than in the obesity group(P＜0.01).③Adipocyte secreting regulatory substance level:Adiponectin in the electroacupuncture group was significantly higher than in the obesity group (P＜0.01).Resistin and TNF-αin the electroacupuncture group was significantly lower than in the obesity grollp(P＜0.01).Resistin level in the sibutramine group was significantly lower than in the obesity group(P＜0.01).CONCLUSION:The effect of electroacupuncture on abnormally secretary products of adipose tissues in obesity rats is superior to the effect of sibutramine.This may be one of important mechanisms of weight reduction by acupuncture and moxibustion,and prevention and cure of obesity and its related diseases.