綜合以上的實驗結果顯示，以中頻率 15 Hz、固定強度 10 mA 電
針人體足三里穴三十分鐘能夠增強第二型糖尿病病人的血糖值的降
低、改善胰島素阻抗性，並且使得游離脂肪酸有下降的趨勢。這個結
果也印證了動物實驗中電針的療效，在人類治療上亦有其作用。至於
對第二型糖尿病的長期療效，則有賴長期的臨床實驗來印證。血糖值
的下降、胰島素阻抗性的改善及游離脂肪酸的下降趨勢三者間的關
聯，則有賴分子生物學實驗介入及採用 Glucose clamp 測試胰島素抗
性來達成。
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在基礎的動物實驗中發現電針可藉由內生性嗎啡 (endogenous opioid peptides) 與受
體結合，促進胰島素 (insulin) 分泌而調降血糖，且有改善胰島素敏感度作用與血中
在基礎的動物實驗方面，將正常實驗動物及 STZ 誘發糖尿病的動物以 prednisolone
40 mg/kg i.p. 30 min 誘導為胰島素阻抗的狀態，隨機分為對照組、電針組、藥物組
及針藥並用組，正常實驗動物進行各組前後 HOMA 值的比較及糖耐量試驗
(Glucose tolerance test，GTT) 的比較，而 STZ 的糖尿病動物在各組進行胰島素挑戰
試驗 (Insulin challenge test，ICT) 之比較，並檢測各組之 FFA、TG、Cholesterol 的
含量，在正常實驗動物各組前後 HOMA 值的比較中，以 naloxone 1 mg/kg i.v.阻斷
組處置前後 HOMA、β-endorphin 及 FFA、TG、Cholesterol 值的變化，以比較三
組對糖尿病人之影響。本研究主要結合電針與藥物的作用優點，期能較單獨使用藥
物有較佳的增敏作用，或提前增敏的作用，進而縮短療程、減少藥物的使用劑量及
副作用發生。完成此一研究除了針藥並用的動物實驗基礎探討外，能進一步落實先
前動物實驗之觀察於臨床。
附錄二 受試者同意書 中 國 醫 藥 大 學 附 設 醫 院
受試者同意書
試驗主題：
針藥並用改善胰島素敏感度之研究
執行單位：中西醫結合研所及相關之 醫療院所。
電話：04-22053366-1604/1647
試驗主持人：
張世良
職稱：助理教授協同主持人：
林榮宗、林振蔚
職稱：醫師緊急聯絡人：張世良 緊急聯絡電話：0936-321863 自願受試者姓名： 病歷號：
性別： 年齡：
通訊地址：
電話：
5.
評估及統計方法: HOMA、β-endorphin 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，同組前後均值的比較則採 self-paired t test。(三)參與試驗可能獲得之效益：
針藥併用或單獨使用，理論上有降血糖改善胰島素敏感度及改
善血脂代謝的作用，針藥併用應有較佳的效果。
(七)本人已詳閱上列各項資料，有關本臨床試驗計畫之疑問也經試驗主
持人詳
細予以解釋，瞭解整個實驗的狀況，並經過充份的考慮後，本人同 意接受
為此次臨床試驗之自願受試驗者。
自願受試驗者簽名(或法定代理人)： 日期：
身分證號碼: 電話:
見 證 人: 與受試者關係:
身分證號碼: 電話:
附錄三 中國醫藥大學附設醫院人體試驗委員會人體試驗計劃同意書
Abstract
A Randomized Controlled Clinical Trial in the Treatment of Type II Diabetes Mellitus with Electroacupuncture
Diabetes mellitus ranks among the top ten causes of mortality throughout the world. The managements of NIDDM patients are diet control, physical exercise and medicines. Among patients using oral antidiabetic drugs who initially achieve adequate blood glucose control, secondary failures may occur that warrant insulin therapy. Some studies reveal that physical exercise may increase glucagons and adrenaline secretion, which could raise the plasma glucose. Alternative therapies received attention for these reasons. Some animal model studies reveal that electroacupuncture applying on specific acupoints, such as Zhongwan and Zusanli, may reduce plasma glucose level and improve insulin resistance.
We undertook a randomized, single blind, sham group controlled study to evaluate the effect of electroacupuncture with middle frequency (15 Hz) and fixed intensity (10 mA) on human Zusanli acupoint for 30 minutes. A total of 26 NIDDM patients were enrolled in this study. They were randomly devided into 2 groups. There were 13 patients in the experimental group.
The main outcome was changes of laboratory parameter before and after electroacupuncture.
In the experimental group, the plasma glucose level was 166.8±26.6 mg/dL before electroacupuncture and 125.6±24.3 mg/dL after electroacupuncture (p<0.05). The HOMA index was 4.9±2.5 before electroacupuncture and 2.8±1.8 after electroacupuncture (p<0.05). In the control group, the plasma glucose level was 166±35 mg/dL before treatment and 162.6±32.9 mg/dL after treatment (NS). The HOMA index was 4.7±3.8 before treatment and 5.1±4.2 after treatment (NS). The percentage decrease of the plasma free fatty acid level was -10.5% in the experimental group and 46.2% in the control group.(p<0.05). In conclusion, applying electroacupuncture on human Zusanli acupoint can enhance the plasma glucose level decrease, lower insulin resistance and lower percentage decrease of plasma free fatty acid level.
Keyword: NIDDM, Electroacupuncture, Zusanli, Insulin resistance
謝 辭
僅 以 此 文 感 謝 行 政 院 國 家 科 學 委 員 會 提 供 研 究 計 劃 (NSC 94-2320-B-039-024) 經費，同時也感謝張世良博士及其研究助理團隊 提供的指導及協助，使本研究能順利完成。