Objective To observe the effect of electroacupuncture(EA) combined with Zhuang-medicine-thread moxibustion on silent information regulator-1(SIRT1)/nuclear factor kappa B(NF-κB) signal pathway and inflammatory factor expression in gastric antrum tissue of diabetic gastroparesis(DGP) rats

so as to explore its mechanism underlying improvement of DGP.Methods Male SD rats were randomly divided into normal

model

medication

EA

Zhuang-medicine-thread moxibustion(moxibustion) and EA+moxibustion groups(n=12 per group). The DGP model was established by intraperitoneal injection of streptozotocin(STZ). Rats of the medication group were treated by gavage of 0.15 mg/mL mosapride citrate suspension. EA(10 Hz/50 Hz

2 mA) or moxibustion(3 cones) or EA+moxibustion was applied to “Zhongwan”(CV12)

bilateral “Neiguan”(PC6) and bilateral “Sanyinjiao”(SP6) of the related group for 20 min

once a day for 3 weeks. Blood glucose

gastric emptying rate and intestinal propulsion rate were measured. The levels of serum interleukin(IL)-6

IL-8

IL-10 and tumor necrosis factor-α(TNF-α) were detected by ELISA; the phosphorylation level of the phosphorylated inhibitor of nuclear factor κBα inhibitor(pIκ-Bα)

the protein and mRNA expression of NF-κB p65 and SIRT1 in the gastric antrum tissue were detected by Western blot and real-time quantifitative PCR

respectively. Results(1) Compared with the normal group

the levels of blood glucose

serum IL-6

IL-8

TNF-α

and gastric pIκ-Bα and NF-κB p65 protein and mRNA expressions were significantly increased(P<0.01)

and the gastric emptying rate

intestinal propulsion rate

serum IL-10 level

and SIRT1 protein and mRNA expressions were considerably decreased in the model group(P<0.01).(2) In contrast to the model group

the blood glucose in the EA

moxibustion and EA+moxibustion groups

serum IL-6

IL-8 and TNF-α levels in the 4 treatment groups

as well as NF-κB p65 protein expression in the medication and EA+moxibustion groups

and NF-κB p65 mRNA expression and pIκ-Bα protein and mRNA expression in the 4 treatment groups were significantly decreased(P<0.01

P<0.05); while the gastric emptying rate and intestinal propulsive rate and IL-10 content in the 4 treatment groups

and SIRT1 protein and mRNA expression in the medication and EA+moxibustion groups were obviously increased(P<0.05

P<0.01).(3) The effects of EA+moxibustion were significantly superior to those of simple EA and moxibustion in increasing gastric emptying rate

IL-10

SIRT1 protein expression(P<0.05

P<0.01)

and in lowering IL-8 and TNF-α contents

pIκ-Bα protein and mRNA expression and NF-κB p65 mRNA expression(P<0.05

P<0.01). No significant differences were found among the 4 intervention groups in promoting the intestinal propulsive rate and among the EA

moxibustion and EA+moxibustion groups in lowering blood glucose(P>0.05). Conclusion EA combined with Zhuang-medicine-thread moxibustion can effectively reduce the level of serum inflammatory factors and regulate SIRT1/NF-κB signal pathway in DGP rats

which may contribute to its function in improving gastrointestinal movement.