中国组织工程研究

中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (35): 5628-5633.doi: 10.12307/2023.891

• 组织构建实验造模 experimental modeling in tissue construction • 上一篇    下一篇

推拿干预2型糖尿病大鼠骨骼肌功能及肌纤维类型的转换

蒙  蒙1，2，胡冠宇3，吴兴全1，丛德毓1   

  1. 1长春中医药大学附属医院，吉林省长春市  130021；2长春中医药大学，吉林省长春市  130117；3南方医科大学第三附属医院，广东省广州市  510630
  • 收稿日期:2022-10-25 接受日期:2022-12-09 出版日期:2023-12-18 发布日期:2023-06-02
  • 通讯作者: 丛德毓，主任医师，长春中医药大学附属医院推拿科，吉林省长春市 130021
  • 作者简介:蒙蒙，女，1992年生，吉林省长春市人，汉族，博士，主治医师，主要从事经穴推拿治疗脏腑病的研究。
  • 基金资助:
    国家自然科学基金项目(82274673)，项目负责人：丛德毓

Effects of skeletal muscle massage on skeletal muscle function and conversion of skeletal muscle fiber types in type 2 diabetic rats

Meng Meng1, 2, Hu Guanyu3, Wu Xingquan1, Cong Deyu1   

  1. 1Affiliated Hospital of Changchun University of Chinese Medicine, Changchun 130021, Jilin Province, China; 2Changchun University of Chinese Medicine, Changchun 130117, Jilin Province, China; 3The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, Guangdong Province, China
  • Received:2022-10-25 Accepted:2022-12-09 Online:2023-12-18 Published:2023-06-02
  • Contact: Cong Deyu, Chief physician, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun 130021, Jilin Province, China
  • About author:Meng Meng, MD, Attending physician, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun 130021, Jilin Province, China; Changchun University of Chinese Medicine, Changchun 130117, Jilin Province, China
  • Supported by:
    National Natural Science Foundation of China, No. 82274673 (to CDY)

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摘要：


文题释义：

肌纤维类型：肌纤维依据不同的收缩速度和力量可大体分为两型：Ⅰ型为慢缩型，Ⅱ型为快缩型。Ⅰ型肌纤维只有一种，Ⅱ型肌纤维还可以分出许多亚型，主要有Ⅱa、Ⅱb和Ⅱx 3种，其中人类Ⅱx肌纤维的数量与动物Ⅱb肌纤维大致相等，不同类型的肌纤维在代谢功能上也存在较大的差异。
糖尿病肌少症：糖尿病在发展过程中会造成机体胰岛素敏感性的受损、糖酵解型肌纤维的增加，并进而导致蛋白质合成的减少和肌纤维流失的加剧，最终导致肌肉质量和力量的减少，甚至导致肌肉减少症的发生。肌少症与糖尿病患者的胰岛素抵抗和氧化应激有关，导致肌肉力量和肌肉质量下降，以及肌肉萎缩。

背景：既往研究表明，推拿可调控血糖的平衡，并能减缓骨骼肌的流失，促进肌纤维类型的转化，骨骼肌也是维持血糖平衡稳定的重要器官，但其具体关联和机制尚不明确。
目的：探讨推拿对2型糖尿病大鼠骨骼肌结构和功能及骨骼肌纤维类型转换的影响。
方法：取Wistar大鼠24只，通过高脂喂养联合小剂量链脲佐菌素腹腔注射建立2型糖尿病大鼠模型，将造模成功的18只大鼠采用随机数字表法分3组，每组6只：模型组不进行任何治疗，药物组灌胃给予盐酸二甲双胍，1次/d，6次/疗程，疗程间休息1 d，共灌胃治疗8个疗程；推拿组于丰隆、足三里、三阴交、血海等穴位用小动物按摩器进行推拿治疗，1次/d，6次/疗程，疗程间休息1 d，共治疗8个疗程。选择6只健康大鼠作为空白组，不进行任何干预。治疗结束后，检测大鼠血糖与血清胰岛素水平、肢体抓握力、游泳力竭时间、骨骼肌湿质量及腓肠肌中生肌决定因子、肌肉生长抑制素的蛋白及mRNA表达，采用ATPase染色观察骨骼肌纤维类型变化。

结果与结论：①治疗结束后，与模型组比较，药物组、推拿组大鼠空腹血糖与血清胰岛素水平明显降低(P < 0.01)；②与模型组比较，推拿组大鼠肢体抓握力增强(P < 0.01)、游泳力竭时间增加(P < 0.01)、骨骼肌湿质量增加(P < 0.01)，药物组大鼠肢体抓握力、游泳力竭时间、骨骼肌湿质量均无明显变化(P > 0.05)；③ATPase染色显示，与空白组比较，模型组大鼠Ⅱ型肌纤维明显增多；与模型组比较，推拿组大鼠Ⅰ型肌纤维数量增加；④Western Blot与qPCR检测显示，与空白组比较，模型组大鼠腓肠肌中生肌决定因子的蛋白与mRNA表达降低(P < 0.01)，肌肉生长抑制素的蛋白与mRNA表达升高(P < 0.01)；与模型组比较，推拿组大鼠腓肠肌中生肌决定因子的蛋白与mRNA表达升高(P < 0.01)，肌肉生长抑制素的蛋白与mRNA表达降低(P < 0.01)；⑤结果表明，推拿可降低血糖并改善2型糖尿病大鼠骨骼肌功能障碍，其机制可能是通过促进骨骼肌Ⅱ型纤维向Ⅰ型纤维转换、促进骨骼肌生肌决定因子表达、抑制肌肉生长抑制素表达，进而促进肌卫星细胞的成肌分化。

http://orcid.org/0000-0002-4355-7154(蒙蒙)

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

关键词: 推拿, 糖尿病肌少症, 骨骼肌功能, 肌纤维类型, 肌肉减少症

Abstract: BACKGROUND: Previous studies have revealed that massage can regulate the balance of blood glucose, delay the loss of skeletal muscle mass, and promote the conversion of muscle fiber types. Skeletal muscle is also an important organ to maintain blood glucose balance and stability, but its specific association and mechanism are still unclear.
OBJECTIVE: To investigate the effects of massage on the changes of skeletal muscle structure and function and the conversion of skeletal muscle fiber types in type 2 diabetic rats.
METHODS: Animal models of type II diabetics mellitus were established in 24 Wistar rats by high-fat feeding combined with low-dose streptozotocin intraperitoneal injection. Eighteen rat models were randomly divided into three groups (n=6 per group): model group, metformin group and massage group. In the model group, no treatment was given; in the metformin group, metformin hydrochloride was given by gavage, once a day, 6 times per session, with an 1-day interval between sessions, for 8 sessions in total; in the massage group, massage treatment was given by small animal massager at Fenglong, Zusanli, Sanyinjiao and Blood Sea points, once a day, 6 times per session, with an 1-day interval between sessions, for 8 sessions in total. Another six healthy rats were set as blank group and received no treatment. Blood glucose and serum insulin levels, grip strength, swimming exhaustion time and skeletal muscle wet mass were measured after treatment. Western blot and qPCR were used to detect the protein and mRNA expression of myogenic determinant and myostatin in gastrocnemius muscle. ATPase staining was used to observe the changes of skeletal muscle fiber types.
RESULTS AND CONCLUSION: Compared with the model group, fasting blood glucose and serum insulin levels after treatment were significantly reduced in the metformin group and massage group (P < 0.01). Compared with the model group, grip strength, swimming exhaustion time and skeletal muscle wet mass were increased in the massage group (P < 0.01), but there were no significant changes in the metformin group (P > 0.05). Compared with the blank group, there was a significant increase in type II muscle fibers in the model group. Compared with the model group, the number of type I muscle fibers was increased in the massage group. Compared with the blank group, the protein and mRNA expression of myogenic determinant in the gastrocnemius muscle was decreased 
(P < 0.01), while that of myostatin in the gastrocnemius muscle was increased in the model group (P < 0.01). Compared with the model group, the protein and mRNA expression of myogenic determinant in the gastrocnemius muscle was increased (P < 0.01), while that of myostatin in the gastrocnemius muscle was decreased in the model group (P < 0.01). To conclude, massage can reduce blood glucose and improve skeletal muscle dysfunction in type 2 diabetic rats. The mechanism may be through promoting the conversion of skeletal muscle type II fibers to type I fibers, promoting the expression of myogenic determinant and inhibiting the expression of myostatin in skeletal muscle, thereby promoting the myoblastic differentiation of muscle satellite cells.

Key words: massage, diabetic sarcopenia, skeletal muscle function, muscle fiber type, sarcopenia

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