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Elektroakupunktur pada titik Zusanli (ST-36) dengan frekuensi 2 Hz selama 30 menit dapat menurunkan kadar glukosa darah, meningkatkan

kadar insulin dan beta endorfin dalam plasma pada tikus yang diinduksi STZ (Chang et al., 2005). Penurunan kadar gula darah diduga karena adanya stimulasi nervus kolinergik yang kemudian menyebabkan pengeluaran opioid endogen (beta endorfin) yang dapat mengaktifkan reseptor-reseptor spesifik pada pankreas sehingga memacu sekresi insulin (Chang et al., 2005; Chen, 1992; Khawaja et al.,1990; Lin et al., 2002; Lin et al., 2009; Yu et al., 2011). Selain itu beta endorfin dapat meningkatkan sensitivitas insulin melalui modulasi jalur signal insulin (Liang et al., 2011; Su et al., 2004). Akupunktur pada titik Zusanli (ST-36) dapat menurunkan produksi radikal bebas dan meningkatkan antioksidan sehingga menurunkan terjadinya stres oksidatif (Yu et al., 2010). Stimulasi akupunktur dari nervus vagus IL-1, IL-6, IL-18 (Zijlsrta, 2003). Secara keseluruhan elektroakupunktur dapat mencegah kerusakan tubulus seminiferus dengan cara mengendalikan hiperglikemia melalui peningkatan produksi insulin dan meningkatkan sensitivitas insulin. Elektroakupunktur juga meningkatkan antioksidan dan menurunkan produksi radikal bebas sehingga menghambat pembentukan stress oksidatif, yang dapat mengurangi kerusakan jaringan tubulus seminiferus pada tikus yang diinduksi STZ (Riccie G et al, 2009). Chang S.L. , Tsai C.C,Lin J.G., Hsieh C.L.,Lin R.T. and Cheng J.T. 2005. Involvement of serotonin in the hypoglycemic response to 2 Hz electroacupuncture of zusanli acupoint (ST36) in rats. Neuroscience letter .vol.379: 69-73. Chen X.H., Han J.S.1992. Analgesia induced by electroacupuncture of different frequencies is mediated by different types of opioid receptors: another crosstolerance study. Behav Brain Res . 47(2):143-149. Khawaja X.Z., Green I.C., Thorpe J.R., Titheradge M.A. 1990. The occurrence and receptor specificity of endogenous opioid peptides within the pancreas and liver of the rat. Comparison with brain. Biochem J. 267(1):233-240. Kianifard, Davoud, Hasanzadeh, Shapour. 2011. The Histological, Histomorphometrical and Histochemical Changes of Testicular Tissue in the Metformin Treated and Untreated Streptozotocin-Induced Adult Diabetic Rats. Veterinary Reserseach Forum (2)1, 13-24. dapat menghambat aktivasi makrofag dan produksi sitokin pro-inflamasi seperti TNF,

Liang F, Chen R, Nakagawa A, Nishizawa A, Tsuda S, Wang H, Koya D. 2011. Low frequency electroacupuncture improves insulin sensitivity in obese diabetic mice through activation of SIRT 1/PGC-1 in skeletal muscle. Evidence-Based Complementary and Alternative Medicine. Vol 2011. Lin J.G., Chang S.L., and Cheng J.T. 2002. Release of beta-endorphin from adrenal gland to lower plasma glucose by the electroacupuncture at Zhongwan acupoint in rats. Neuroscience Letters. Vol. 326, pp: 17-20. Lin R.T., Tzeng C.Y., Lee Y.C., Ho W.J., Cheng J.T., Lin J.G., Chang S.L. 2009. Acute effect of electroacupuncture at the zusanli acupoints on decreasing insulin resistance as shown by lowering plasma free fatty acid levels in steroidbackground male rats. BNC Complementary and Alternative Medicine. 9:26. Ricci G, Catizone A, Esposito R, Pisanti FA, Vietri MT, Galdieri M. 2009. Diabetic rat testes: morphological and functional alterations. Andrologia. 361-8. Su C.F., Chang Y.Y., Pai H.H., Liu I.M., Lo C.Y., Cheng J.T. 2004. Infusion of betaendorphin improves insulin resistance in fructose- fed rats. Horm Metab Res. 36(8): 571-577. Yu C.L., Te M.L., Chung T.T, Ying I.C., Wai J.H.,Jaong G.L., Shih L.C. 2011. Electroacupuncture at Zusanli (ST-36) acupoint induces a hypoglycemic effect by stimulating the cholinergic nerve in a rat model of streptozotocin- induced insulin dependent diabetes mellitus. Evidence-Based Complementary and Alternative Medicine. Yu YP, Ju WP, Li ZG, Wang DZ, Wang YC, Xie AM. 2010. Acupuncture inhibits oxidative stres and rotational behavior in 6-hydroxydopamine lesioned rat. Brain Res. 1336:58-65. Zijlstra F.J., I. Van Den Berg-De Lange, Huygen F. J. P. M., and J. Klein. 2003. Antiinflammatory actions of acupuncture. Mediators of Inflammation. Vol. 12(2): 59 69.