Objective To observe the clinical efficacy of shuanggu yitong acupuncture therapy(the therapy for both replenishment and unblocking) combined with domperidone on diabetic gastroparesis(DGP) of liver stagnation and spleen deficiency pattern and explore its effect mechanism. Methods DGP patients differentiated as liver stagnation and spleen deficiency pattern were divided into a control group(n=42) and an observation group(n=42) according to the random number table. The patients in the control group took domperidone tablets orally

10 mg each time

3 times a day for 28 days. In the observation group

on the base of the treatment as the control group

shuanggu yitong acupuncture therapy was applied to Baihui(GV20)

Shenting(GV24)

Zhongwan(CV12)

bilateral Zusanli(ST36)

Hegu(LI4)and Taichong(LR3)

stimulated for 30 min in each treatment. Acupuncture was given once daily

3 times a weeks for 28 days consecutively. Fasting blood glucose(FBG)

2-hour postprandial blood glucose(2 h PBG) and glycosylated hemoglobin(HbA1c) were detected before and after treatment in the patients of two groups separately. The score of symptom severity index of gastroparesis(GCSI)

traditional Chinese medicine(TCM) syndrome score and gastric emptying rate were assessed in the patients of two groups. Using ELISA

radioimmunoassay and colorimentry methods

the contents of motilin in plasma

gastrin

tumor necrosis factor-α(TNF-α)

interleukin-6(IL-6)

interleukin-1β(IL-1β) and interferon-gamma(INF-γ) in serum

as well as the activity of superoxide dismutase(SOD)

reactive oxygen species(ROS) and malondialdehyde(MDA) in the serum were determined in the two groups. The clinical curative effect was evaluated. Results After treatment

the levels of FBG

2 h PBG and HbA1c

the scores of GCSI and TCM syndrome

the contents of motilin in plasma

gastrin

TNF-α and MDA

as well as the activity of ROS in serum were all reduced when compared with those before treatment in each group(P<0.05

P<0.01)

while gastric emptying rate and SOD activity in the serum were higher than those before treatment(P<0.05

P<0.01). After treatment

the serological content of INF-γ was lower than that before treatment in the control group(P<0.05)

and the contents of IL-6 and IL-1β were reduced than those before treatment in the observation group(P<0.05). Compared with the control group

the levels of FBG

2 h PBG and HbA1c

the scores of GCSI and TCM symptoms

the contents of motilin in plasma

gastrin

TNF-α

MDA

IL-6 and IL-1β

and the activity of ROS in serum in the observation group were all lower significantly(P<0.05

P<0.01)

while the SOD activity and gastric emptying rate in the observation group were higher than those in the control group(P<0.05

P<0.01). The total effective rate was 90.5%(38/42) in the observation group

better than the control group(73.8%

31/42

P<0.05). Conclusion Shuanggu yitong acupuncture therapy combined with domperidone remarkably relieves the clinical symptoms and improves the gastric emptying rate

effectively reduces motilin and gastrin and regulates oxidative stress and inflammatory responses in the patients with DGP of liver stagnation and spleen deficiency.