八段锦运动处方改善气阴两虚证2型糖尿病患者胰岛β细胞功能的临床研究
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摘要
目的:评价八段锦运动处方对气阴两虚证2型糖尿病的临床疗效并探讨其作用机制。方法:采用随机对照的临床试验研究方法,将符合2型糖尿病诊断标准,辨证为气阴两虚证的患者按就诊顺序随机分为治疗组(八段锦运动处方)和对照组(步行),每组15例,各组予相应治疗,以HOMA-β和HOMA-IR指数,空腹、餐后血糖和糖化血红蛋白(HbA1C)作为主要观察指标,中医证候积分、血脂水平作为次要观察指标,共观察12周。结果:治疗组治疗后HOMA-β升高,HOMA-IR下降,且优于对照组(P<0.01),治疗组治疗后空腹血糖和HbA1C较治疗前显著下降,且优于对照组(P<0.01)。治疗组总有效率92.31%,优于对照组76.92%(P<0.05),治疗后治疗组中医证候积分和甘油三酯,显著低对照组(P<0.01)。结论:八段锦运动处方能够改善2型糖尿病患者胰岛β细胞功能,能明显降低2型糖尿病患者空腹血糖、糖化血红蛋白、甘油三酯水平,改善患者临床症状,临床疗效要优于步行锻炼,其作用机制可能是通过提高基础胰岛素分泌和改善胰岛素抵抗而实现。
Objective: To evaluate the clinical efficacy of the Baduanjin exercise prescription on type 2 diabetes with qi and yin deficiency syndrome, and to explore its mechanism. Methods: Randomized method is used in this clinical trial, patients who met the diagnostic criteria of type 2 diabetes mellitus, syndrome of deficiency of qi and yin syndrome were randomly divided into treatment group(the Baduanjin exercise prescription group) and control group(walking exercise group), each group was given corresponding treatment. The main observation index are HOMA-β and HOMA-IR index, fasting and postprandial blood glucose and glycated hemoglobin, TCM syndrome integral, blood lipid levels as a secondary index. The course of treatment was 12 weeks.Results: After treatment, in the treatment group, the HOMA-β increased, the HOMA-IR decreased, fasting blood glucose(FBG)and glycosylated hemoglobin(HbA1 C) decreased, which was significantly better than that in the control group(P<0.01). The total effective rate of the treatment group was 92.31%, which was better than that of the control group(76.92%, P<0.05). The scores of TCM syndromes and triglycerides were significantly lower than that of the control group(P<0.01). Conclusion: The Baduanjin exercise prescription can reduce the levels of FBG, HbA1 C and triglyceride in type 2 diabetes mellitus, thereby improving the function of islet beta cells in type 2 diabetes mellitus.
Objective: To evaluate the clinical efficacy of the Baduanjin exercise prescription on type 2 diabetes with qi and yin deficiency syndrome, and to explore its mechanism. Methods: Randomized method is used in this clinical trial, patients who met the diagnostic criteria of type 2 diabetes mellitus, syndrome of deficiency of qi and yin syndrome were randomly divided into treatment group(the Baduanjin exercise prescription group) and control group(walking exercise group), each group was given corresponding treatment. The main observation index are HOMA-β and HOMA-IR index, fasting and postprandial blood glucose and glycated hemoglobin, TCM syndrome integral, blood lipid levels as a secondary index. The course of treatment was 12 weeks.Results: After treatment, in the treatment group, the HOMA-β increased, the HOMA-IR decreased, fasting blood glucose(FBG)and glycosylated hemoglobin(HbA1 C) decreased, which was significantly better than that in the control group(P<0.01). The total effective rate of the treatment group was 92.31%, which was better than that of the control group(76.92%, P<0.05). The scores of TCM syndromes and triglycerides were significantly lower than that of the control group(P<0.01). Conclusion: The Baduanjin exercise prescription can reduce the levels of FBG, HbA1 C and triglyceride in type 2 diabetes mellitus, thereby improving the function of islet beta cells in type 2 diabetes mellitus.
引文
[1]Wang L,et al.Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013.JAMA,2017,317(24):2515-2523
[2]YU Xu,Limin Wang,Guang Ning,et al.Prevalence and control of diabetes in Chinese adults.JAMA,2013,310(9):948-958
[3]O,Hagan C,De Vito G,Boreham C A G.Exercise prescription in the treatment of type 2 diabetes mellitus.Sports Medicine,2013,43(1):39-49
[4]Connelly J,Kirk A,Masthoff J,et al.The use of technology to promote physical activity in type 2 diabetes management:A systematic review.Diabetic Medicine,2013,30(12):1420-1432
[5]王军力,肖国强,曹姣,等.运动训练和白藜芦醇改善2型糖尿病大鼠脂代谢异常的SIRT1机制研究.西安体育学院学报,2013,30(1):108-114
[6]翘璇,楼青青,张丹毓,等.抗阻力运动在2型糖尿病治疗中的研究进展.中华护理杂志,2012,47(4):367-369
[7]翁建平,陆菊明,贾伟平,等.中国2型糖尿病防治指南.中华糖尿病杂志,2014, 6(7):447-498
[8]高彦彬.络病与糖尿病慢性并发症.北京中医药大学学报(中医临床版),2008,15(3):17-18
[9]杨继鹏,刘璟莹,吕纹良,等.健身气功八段锦治疗2型糖尿病疗效的Meta分析.中华中医药杂志,2015,30(4):1307-1313
[10]张函菲,贾冕,肖永华,等.中医特色运动处方防治糖尿病探索//中华医学会、中华医学会糖尿病学分会.中华医学会糖尿病学分会教育管理研讨会暨2014国际糖尿病教育管理论坛会议摘要集.中华医学会、中华医学会糖尿病学分会,2014:1
[11]顾素萍,郑金珏,范梦迪,等.胰岛β细胞功能的主要影响因素和评价指标.中国医师杂志,2014,16(2):164-166
[12]刘建平.临床试验样本含量的计算.中国中西医结合杂志,2003,23(7):536-538
[13]牛鹏,王爱民,张玲,等.八段锦对2型糖尿病患者血糖控制效果的影响.中华护理杂志,2012,47(8):701-703
[14]易文明,刘铜华.论滋阴解毒法治疗2型糖尿病.中华中医药杂志,2015,30(7):2393-2394
[15]Zheng G,Huang M,Li S,et al.Effect of Baduanjin exerciseon cognitive function in older adults with mild cognitiveimpairment:Study protocol for a randomised controlled trial.BMJ Open,2016,6(4):602-615
[16]Zou Liye,Jeffer Eidi SasaKi,Wang Huiru,et al.A systematic review and meta-analysis Baduanjin Qigong for health benefits:Randomized controlled trials.Evidence-Based Complementary and Alternative Medicine,2017,3:1-17
[17]Liu Xin,M.Ed,YVETTE.D,et al.A Qualitative review of the role of Qigong in the management of diabetes.The Journal of Alternative and Complementary Medicine,2007,3(4):427-433
[18]贾伟平,项坤三,陈蕾.上海地区40岁以上自然人群中胰岛素抵抗现况及特征分析.上海医学,2001,24(4):199-202
[2]YU Xu,Limin Wang,Guang Ning,et al.Prevalence and control of diabetes in Chinese adults.JAMA,2013,310(9):948-958
[3]O,Hagan C,De Vito G,Boreham C A G.Exercise prescription in the treatment of type 2 diabetes mellitus.Sports Medicine,2013,43(1):39-49
[4]Connelly J,Kirk A,Masthoff J,et al.The use of technology to promote physical activity in type 2 diabetes management:A systematic review.Diabetic Medicine,2013,30(12):1420-1432
[5]王军力,肖国强,曹姣,等.运动训练和白藜芦醇改善2型糖尿病大鼠脂代谢异常的SIRT1机制研究.西安体育学院学报,2013,30(1):108-114
[6]翘璇,楼青青,张丹毓,等.抗阻力运动在2型糖尿病治疗中的研究进展.中华护理杂志,2012,47(4):367-369
[7]翁建平,陆菊明,贾伟平,等.中国2型糖尿病防治指南.中华糖尿病杂志,2014, 6(7):447-498
[8]高彦彬.络病与糖尿病慢性并发症.北京中医药大学学报(中医临床版),2008,15(3):17-18
[9]杨继鹏,刘璟莹,吕纹良,等.健身气功八段锦治疗2型糖尿病疗效的Meta分析.中华中医药杂志,2015,30(4):1307-1313
[10]张函菲,贾冕,肖永华,等.中医特色运动处方防治糖尿病探索//中华医学会、中华医学会糖尿病学分会.中华医学会糖尿病学分会教育管理研讨会暨2014国际糖尿病教育管理论坛会议摘要集.中华医学会、中华医学会糖尿病学分会,2014:1
[11]顾素萍,郑金珏,范梦迪,等.胰岛β细胞功能的主要影响因素和评价指标.中国医师杂志,2014,16(2):164-166
[12]刘建平.临床试验样本含量的计算.中国中西医结合杂志,2003,23(7):536-538
[13]牛鹏,王爱民,张玲,等.八段锦对2型糖尿病患者血糖控制效果的影响.中华护理杂志,2012,47(8):701-703
[14]易文明,刘铜华.论滋阴解毒法治疗2型糖尿病.中华中医药杂志,2015,30(7):2393-2394
[15]Zheng G,Huang M,Li S,et al.Effect of Baduanjin exerciseon cognitive function in older adults with mild cognitiveimpairment:Study protocol for a randomised controlled trial.BMJ Open,2016,6(4):602-615
[16]Zou Liye,Jeffer Eidi SasaKi,Wang Huiru,et al.A systematic review and meta-analysis Baduanjin Qigong for health benefits:Randomized controlled trials.Evidence-Based Complementary and Alternative Medicine,2017,3:1-17
[17]Liu Xin,M.Ed,YVETTE.D,et al.A Qualitative review of the role of Qigong in the management of diabetes.The Journal of Alternative and Complementary Medicine,2007,3(4):427-433
[18]贾伟平,项坤三,陈蕾.上海地区40岁以上自然人群中胰岛素抵抗现况及特征分析.上海医学,2001,24(4):199-202