臨床應用上目前認為防止胰島素阻抗性已是治療最重要目標，應該 早期介入胰島素增敏劑的使用，以防止β 細胞功能喪失。經由動物研究 初步證實兩者合併使用，較單獨電針或口服Rosiglitazone 都有較好的降 糖效果；但臨床試驗中，可能因干擾因子太多，而未能達明顯降糖，但 卻可見到，Rosiglitazone 或合併電針都有明顯改善胰島素敏感度的作 用，而且，此胰島素阻抗的改善可能是透過調降游離脂肪酸。因此，電 針用於糖尿病病人可以透過調降游離脂肪酸，改善胰島素阻抗程度，進 而調整血糖。合併用藥是否能有更好的作用，目前僅是短期介入前後的 比較，仍須長期試驗結果才能證實針藥並用可以較快達到理想控制血糖 的目標。針藥並用，調節的多種 Cytokines，這些 Cytokines 是否參與了 胰島素阻抗的改善，仍需進一步的研究。
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附錄一
附錄二
附錄三
附錄四
附錄五 減少Rosiglitazone 產生副作用的機會。
(二)試驗方法：
1. 受試者標準及數目：年齡為 20~65 歲，本國籍病人；五年內新 診斷為Type 2 DM，且於實驗前使用相同類型降血糖藥控制血 糖者，且無心衰竭或裝有心臟節律器。排除合併有肝功能異常
（GOT、GPT 大於正常上限值 2 倍）、肝硬化；腎病徵候群（尿 蛋白＞3.5 g/d，水腫）、腎衰竭（Cr＞1.3 mg/dl）；懷孕婦女者為 對象共四十人。
中 國 醫 藥 大 學 附 設 醫 院 受 試 者 同 意 書
(二)試驗方法：
2. 試驗設計及進行步驟：病人平常皆在門診處方控制血糖，隨機分 為針藥並用組、藥物控制組，每組二十人，在試驗前空腹 8 小 時，針藥併用組和藥物組將於試驗前 30 min 服用 Rosiglitazone 8 mg，30 min 後電針，將於電針試驗前後抽血各 5 ㏄，觀察其短 時間 30 min 電針處置前後 HOMA 值及 FFA、TG、Cholesterol 值的變化，並比較cytokine（細胞激素）血中濃度的變化。試驗 針 機 （ Han’s Healthronic Likon, Taipei, Taiwan），正極接在陰陵泉
5. 評估及統計方法：HOMA 值及 FFA、TG、Cholesterol 值的變化皆於 中西所實驗室進行檢驗分析。組間以One Way ANOVA 檢定，同組 前後均值則採 self-paired t test。相關的 cytokine 由 RayBiotech 公司 antibody array 進行分析。
(三)參與試驗費用說明：除正常門診外，無須再掛號看診。
陰陵泉 足三里
中 國 醫 藥 大 學 附 設 醫 院 受 試 者 同 意 書
(四)參與試驗可能獲得之效益：
針藥併用理論上應有比單獨藥物使用有較佳的降血糖效果，並改善胰島 素敏感度。
(五)可能產生之副作用及危險：
所採用的電針皆為目前臨床常用者，應無顯著傷害。為抽血或電針 過程可能造成的疼痛、瘀青、血管炎或其他可能產生的併發症。雖 Rosiglitazone 長期大量使用易有肝腎的毒副作用，本實驗僅短期介入，
副作用極少；使用的藥物是Rosiglitazone，也是目前臨床糖尿病常用處 方，使用劑量也是臨床常用者，而且研究顯示服用Rosiglitazone 不會增 加低血糖的機會。
(若有抽血請務必填入：抽血過程可能造成的疼痛、淤青、血管炎或其他 可能產生的併發症。若試驗中無抽血項目請將此註記說明刪除)
(六)目前其他可能之療法及其說明：
目前降血糖的方法一方面為補充胰島素或增加胰島素分泌的藥物；
另外一方面為改善胰島素敏感度的藥物，主要為Thiazodinediones 類藥 物，但長期的使用，可能有水腫、肝衰竭的毒副作用；本研究僅試驗時 短期介入，使用針藥併用，目的是為了減少藥物副作用，減少用藥劑量，
另外一方面為改善胰島素敏感度的藥物，主要為Thiazodinediones 類藥 物，但長期的使用，可能有水腫、肝衰竭的毒副作用；本研究僅試驗時 短期介入，使用針藥併用，目的是為了減少藥物副作用，減少用藥劑量，