背景與目的：第2型糖尿病人有高的心血管病變罹病率與致死率，動物實驗顯示穴位電刺激可以調節心血管之反應及改善局部的循環。本研究目的為探討穴位電刺激對糖尿病患之下肢血管與血漿中一氧化氮代謝物、腦啡肽及腎上腺素的影響。方法：以42位第2型糖尿病患為受試者，隨機分配至電刺激與對照組各21位。電刺激組接受動作閾值強度的刺激15分鐘，二對刺激電極分別貼於左側內關、曲澤穴，另一對置於左側血海與陰凌泉穴。控制組則以相同方式貼電極但未予電刺激15分鐘。處置前、後立即以脈搏描記圖測量下肢血管的傳導性；血漿中一氧化氮代謝物以Griess reagent-based比色法分析血漿中硝酸鹽／亞硝酸鹽濃度；血漿腦啡肽及腎上腺素的濃度則以螢光免疫法檢測。所有描述性資料以平均值±標準差表示，以獨立樣本t檢測兩組受測者的臨床特質是否有顯著差異。以前測值為共變項，用單因子共變數分析檢測血管的反應、血漿中硝酸鹽/亞硝酸鹽濃度、腦啡肽及腎上腺素的變化組間是否達顯著差異。結果：經實驗處置後，電刺激組充血性動脈血流為25.51±8.18%/min，控制組為22.16±7.47%/min；電刺激組稍高於控制組，但未達顯著差異(p>0.05)。電刺激組靜脈張力為6.51±2.84%/mmHg，控制組為7.64±4.17%/mmHg；電刺激組的值顯著低於控制組(p<0.05)；電刺激組血漿中的腦啡肽及腎上腺素高於控制組(p<0.05)。但兩組血漿中硝酸鹽／亞硝酸鹽濃度未達顯著的差異，電刺激組為25.03±10.44μM，控制組為27.80±13.16μM。結論：第Ⅱ型糖尿病患施予肌肉收縮強度的穴位電刺激後，產生降低靜脈張力及升高血漿中的腦啡肽及腎上腺素濃度。臨床意義：單次動作閾值穴位電刺激可降低糖尿病患局部之靜脈張力，提供糖尿病患改善下肢循環的參考；但仍須進一步探討不同強度之穴位電刺激的療效及最適當的刺激參數。

Background and Purpose: Cardiovascular complications are mainly responsible for the high morbidity and mortality in people with diabetes. Electroacupuncture at the specific points modulate cardiovascular reflexes probably through the humoral or neural pathway in animals. However; the effect of acupoint electric stimulation (AES) on hemodynamics modulation in diabetic mellitus patients is still unclear. In this study, we assessed the vascular and neurohormone reactions to AES in patients with type 2 DM (T2DM). Methods: Forty-two T2DM patients (13 men and 29 women) were recruited from a metabolic clinic. They were randomly assigned into two groups: AES group (n=21) and control group (n=21). The motor-level 2-Hz transcutaneous electrical nerve stimulation with a pulse duration of 200 microseconds was applied on left Neiguan (P6), Quze (PC3), Xuehai (SP10), and Yinlingquan (SP9) acupuncture points in the AES group. Patients in the control group received sham treatment. Vascular and neurohormone responses were measured in all patients before and after intervention immediately. The vascular reaction was assessed by plethysmography. The serum concentrations of neurohormone were analyzed with commercial enzyme-linked immunosorbent assay (ELISA) kits. Results: Patients in the AES group had significantly (p<0.05) lower venous tone, and higher plasma adrenaline and endorphin levels than that in the control group. There were no significant differences in plasma nitrate/nitrite concentration and blood pressure between groups. Conclusions: AES stimulation on certain acupuncture points may decrease venous tone but not blood pressure in T2 DM patients. However, whether the reduction in venous tone of calf after AES was partially caused by flow-induced vasodilation via the humoral pathway need further study.