Objective To observe the effect of manual acupuncture stimulation of"Quchi"(LI 11)

"Hegu"(LI 4)

"Zusanli"(ST 36)

etc.with"spleen-stomach harmonizing"technique on insulin resistance index(ISI)and the expression of insulin receptor substrate-1(IRS-1)

IRS-2(two upstream key proteins)and glucose transporter-4(GluT-4

downstream key protein)of the phosphatidylinositol 3-kinase(PI 3K)/Akt signaling pathway in insulin resistance type 2diabetes(IRT 2D)rats

so as to explore its mechanism underling improvement of type 2diabetes.Methods A total of 35 male Wistar rats were used in the present study.The IRT 2Dmodel was established by feeding the animal with high-fat and high-sugar diet for 8weeks

and subsequent intraperitoneal injection(i.p.i.)of a low dose of streptozotocin(25mg/kg).Using the stratified random sampling method

20 successful IRT 2Drats were equally divided into model and acupuncture groups.Ten normal rats were used as the control group.The bilateral acupoints of LI 11

LI 4

ST 36

"Xuehai"(SP 10)

"Fenglong"(ST 40)

"Yinlingquan"(SP 9)

"Diji"(SP 8)

"Sanyinjiao"(SP 6)and"Taichong"(LR 3)were punctured with filiform needles

followed by manipulating the needles with"spleenstomach harmonizing"technique.The treatment was given once daily for 4weeks except the weekends.Fasting blood glucose and serum insulin levels were measured using ELISA.The quadriceps muscle of thigh of each rat was sampled to test the expression levels of IRS-1

IRS-2

and GluT-4proteins and genes with Western blot and quantitative Real-time PCR

respectively.Results Following 4weeks' acupuncture intervention

the modeling-induced remarkable increase of ISI

and considerable down-regulation of expression levels of IRS-1

IRS-2and GluT-4proteins and genes in the quadriceps femoris were significantly reversed relevant to the model group(P <0.01)

suggesting apossible activation of PI 3 K/Akt signaling after acupuncture administration.Conclusion Spleen-stomach regulation needling can improve insulin resistance and up-regulate the expression of IRS-1

IRS-2and GluT-4in the quadriceps femoris in type 2 diabetes rats.