目的 观察振腹推拿对2型糖尿病(type 2 diabetes mellitus,T2DM)大鼠腓肠肌及腹直肌组织AMPK及Glut4基因转录及蛋白表达的影响,探讨其改善T2DM糖代谢的作用机制.方法 24只Wistar大鼠随机取出6只为空白组,其余高脂高糖饮食联合低剂量(35 mg/kg)链脲佐菌素腹腔注射建立T2DM模型,成模大鼠随机分为模型组、西药对照组及西药推拿组.空白对照组及模型组每日灌胃蒸馏水,西药对照组每日以250 mg/kg标准进行二甲双胍灌胃一次,西药推拿组在相同给药标准基础上每日加用振腹推拿治疗一次.分别在干预第0、2、4、8周测定大鼠FBG水平,干预8周后,测定腓肠肌与腹直肌AMPK以、Glut4基因转录与蛋白表达.结果 与空白组比较,模型组FBG值在第0、2、6、8周时均显著上升,干预8周后,腹直肌AMPKα及Glut4基因转录及蛋白表达均显著下降,腓肠肌AMPKα2基因转录及蛋白表达均显著下降,腓肠肌Glut4蛋白表达显著下降.与模型组比较,西药组及西药推拿组FBG值在第2、6、8周时均显著下降,西药组腹直肌AMPKα2基因转录显著上升,Glut4基因转录及蛋白表达显著上升,西药推拿组腹直肌AMPKα2及Glut4基因转录及蛋白表达均显著上升,腓肠肌AMPKα2基因转录及蛋白表达均显著上升.结论 在二甲双胍常规治疗基础上,联合振腹推拿可进一步改善T2DM大鼠的FBG水平,其对糖代谢的改善机制与调控骨骼肌AMPK/Glut4信号链有关.%Objective To observe the influence of Zhenfu Tuina treatment on AMPK and Glut4 gene transcription and protein expression in gastrocnemius and rectus abdominis tissues in rats with type 2 diabetes mellitus (T2DM),so as to investigate the mechanism of improving glycometabolism in T2DM.Methods 6 Wistar rats were used as control group(C),6 Wistar rats were given high-fat and high-sugar diets combined with intra-peritoneal injection with low dose (35 mg/kg) of streptozotocin to establish T2DM rat models.After successful established rat models,the rats were randomly divided into model group (M),western medication group(WM) and western medication combined with Tuina group(WT).Rats in C and M were given daily intragastric administration of distilled water while rats in WT were given metformin (250 mg/kg),once per day.On the basis of WM group,Zhenfu Tuina was added in the WT group.All rats were sacrificed after 8 weeks of intervention,and the level of FBG and gene transcription and protein expression of AMPK and Glut4 in gastrocnemius and rectus abdominis muscles was detected.Results Compared with C group,level of FBG in M group was significant increase at 2,6 and 8 week,gene transcription and protein expression of AMPKα2 and Glut4 in rectus abdominis were significant decrease,gene transcription and protein expression of AMPKα2 in gastrocnemius was significant decrease and the protein expression of Glut4 in gastrocnemius was decrease.Compared with M group,level of FBG was significant decrease of WM group and WT group at 2,6 and 8 week.Compard wiht M group,AMPKα2 gene transcription and protein expression of Glut4 in the rectus abdominis of WM was significant increase.Compared with M group,gene transcription and protein expression of AMPKα2 and Glut4 in rectus abdominus of WT was significant increase.Conclusion On the basis of conventional treatment of mefformin,combined with Zhenfu Tuina can further improve the FBG level in T2DM rats,and the mechanism is related to the improvement of glucose metabolism and the regulation of AMPK/Glut4 signaling chain in skeletal muscle.
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