目的 分析“合募配穴”针刺干预对肥胖胰岛素抵抗（obesity and insulin resistance， OIR）大鼠骨骼肌组织中SIRT1（Sirtuin 1）及PGC-1α（peroxlsome proliferator-activated receptor-γ coactlvator-1α）基因及蛋白表达的影响，探讨“合募配穴”针刺是否能够改善OIR状态及效应机制。方法 雄性SD大鼠采用经典的“高脂高糖饮食结合低剂量链脲佐菌素（Streptozotocin， STZ）诱导”方法建立OIR大鼠模型，随机分为模型组（IR）、白藜芦醇激动剂组（RA）、手法针刺（MA+IR）组，各10只，10只正常大鼠作为空白组（Normal）。干预4周后检测各组大鼠Lee's指数、IRI、ISI及骨骼肌组织SIRT1与PGC-1α mRNA和蛋白表达水平，同时光镜下观察骨骼肌细胞生物形态结构差异。结果 与模型组比较，针刺组和激动剂组大鼠Lee's指数、IRI水平显著下降，ISI有所增强（P<0.05），光镜下骨骼肌细胞生物形态结构尚可，但较空白组生物完整性差，且两组之间未见明显差异；骨骼肌组织中SIRT1及PGC-1α蛋白及mRNA表达水平均显著上升（P<0.05）。结论 提示“合募配穴”针刺可调节OIR大鼠胰岛素抵抗状态，改善骨骼肌组织病理损伤，其机制可能与上调骨骼肌组织的SIRT1及PGC-1α基因及蛋白的表达水平，改善骨骼肌细胞能量代谢相关。

Objective o analyze the effect of "He-Mu combination" acupuncture intervention on SIRT1 (Sirtuin 1) and PGC-1α (Peroxlsome proliferator-activated receptor-γ coactlvator-1 α)in skeletal muscle of Obese insulin resistance (OIR) rats, And explore whether "He-Mu combination" acupuncture can improve OIR state and its mechanism.Methods Male Sprague Dawley (SD) rats were fed with the classic method of "high fat and high glucose diet combined with low-dose streptozotocin (STZ) induction" to establish OIR rats model, They were randomly divided into model group (IR), Resveratrol agonist group (RA) and Manual acupuncture (MA + IR ) group, with 10 rats in each group; Ten normal rats were used as the blank group (Normal). After 4 weeks of intervention, The levels of Lee's index, IRI and ISI were measured, And detect SIRT1 and PGC-1 α in skeletal muscle tissue mRNA and protein expression levels. At the same time, the differences of biomorphic structure of skeletal muscle cells were observed under light microscope. Results ompared with the IR group, the Lee's index and IRI level of rats in the acupuncture group and agonist group decreased significantly, and the ISI level increased (P<0.05); Under light microscope, the biomorphic structure of skeletal muscle cells was nearly complete, but the biological integrity was worse than that of the Normal group, and there was no significant difference between the two groups; SIRT1 and PGC-1 α in skeletal muscle The expression levels of protein and mRNA increased significantly (P<0.05).Conclusion "He-Mu combination" acupuncture can regulate insulin resistance state in obese rats with insulin resistance and improve the pathological damage of skeletal muscle tissue. The mechanism may be related to up regulating the expression of SIRT1 and PGC-1α in skeletal muscle tissue and improving energy metabolism of skeletal muscle cells.

国家自然科学基金委员会面上项目(86174092):“运腹通经”推拿法对中心型肥胖症患者胰岛素抵抗的干预作用及其相关机制研究，负责人：刘明军；国家自然科学基金委员会面上项目(82174525):指压法通过调控SIRT1/NF-κB信号通路对肥胖胰岛素抵抗大鼠抗炎作用的机制研究，负责人：刘明军；吉林省自然科学基金委员会面上项目(YDZJ202201ZYTS195):基于菌-肠-脑轴探讨“运腹通经”推拿法治疗肥胖胰岛素抵抗大鼠的抗炎效应机制，负责人：刘明军。