耳穴及生活方式预防2型糖尿病的随机对照试验研究
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摘要
目的:探讨耳穴及生活方式对2型糖尿病前期人群的预防效果。方法:选取2017年5月至2018年3月在顺义区中医院接受体检的2型糖尿病前期人群92例进行观察,按照随机数表法分为对照组和观察组,每组46例,对照组给予常规干预,观察组在对照组的基础上给予耳穴压豆干预治疗。比较2组2型糖尿病前期人群干预前后的糖化血红蛋白(Hb A1c)、体质量指数(BMI)、空腹血糖(FPG)、餐后2 h血糖(P2 h PG)、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)及低密度脂蛋白(LDL)变化情况,以及干预1年后糖尿病转归情况。结果:与干预前比较,对照组仅FPG与P2 h PG较干预前均显著降低,观察组FPG、P2 h PG、TC、HDL及Hb A1c较干预前显著降低,而LDL显著升高,差异均有统计学意义(P <0. 05);干预后2组比较,观察组FPG、P2 h PG、TC、LDL及Hb A1c降低更显著,而LDL升高更显著,差异有统计学意义(P <0. 05);干预后观察组糖尿病转化率2. 17%(1/46),对照组糖尿病转化率13. 04%(6/46),差异有统计学意义(P <0. 05)。结论:耳穴压豆联合生活方式干预可更有效地改善2型糖尿病期人群的血糖及血脂水平,有效降低。
Objective: To study the prevention outcomes of auricular acupuncture and lifestyle in treating Type 2 Diabetes. Methods: A total of 92 patients with prediabetes type 2 during physical examination in Beijing Hospital of Traditional Chinese Medicine in Shunyi District from May 2017 to March 2018 were selected. According to the random number table method,patients were divided into the control group and the observation group,with 46 cases each. The control group was received routine intervention. Additionally the observation group was treated with auricular point pressure bean. The changes of Hb A1 c,BMI,FPG,P2 h PG,SBP,DBP,TC,TG,HDL,and LDL before and after intervention in type 2 diabetics were compared between the 2 groups. The outcomes were also contracted after 1 year of intervention. Results: Groups were compared before and after intervention. FPG and P2 h PG of the control group were significantly lower than before. FPG,P2 h PG,TC,HDL,and Hb A1 c of the observation group were significantly lower than before the intervention,while LDL was significantly higher. There was statistical difference in the groups( P <0. 05); After intervention FPG,P2 h PG,TC,LDL,and Hb A1 c decreased more significantly in the observation group,while LDL increased significantly( P < 0. 05); a total of 2. 17% patients of the observation group converted to diabetes mellitus after intervention( 1/46). The control group converted to diabetes at the rate of 13. 04%( 6/46). The differences between the groups were significant( P < 0. 05). Conclusion: Auricular acupuncture combined with lifestyle intervention can improve blood glucose and lipid levels in type 2 diabetics more effectively than routine intervention,and effectively reduce the conversion rate of diabetes.
Objective: To study the prevention outcomes of auricular acupuncture and lifestyle in treating Type 2 Diabetes. Methods: A total of 92 patients with prediabetes type 2 during physical examination in Beijing Hospital of Traditional Chinese Medicine in Shunyi District from May 2017 to March 2018 were selected. According to the random number table method,patients were divided into the control group and the observation group,with 46 cases each. The control group was received routine intervention. Additionally the observation group was treated with auricular point pressure bean. The changes of Hb A1 c,BMI,FPG,P2 h PG,SBP,DBP,TC,TG,HDL,and LDL before and after intervention in type 2 diabetics were compared between the 2 groups. The outcomes were also contracted after 1 year of intervention. Results: Groups were compared before and after intervention. FPG and P2 h PG of the control group were significantly lower than before. FPG,P2 h PG,TC,HDL,and Hb A1 c of the observation group were significantly lower than before the intervention,while LDL was significantly higher. There was statistical difference in the groups( P <0. 05); After intervention FPG,P2 h PG,TC,LDL,and Hb A1 c decreased more significantly in the observation group,while LDL increased significantly( P < 0. 05); a total of 2. 17% patients of the observation group converted to diabetes mellitus after intervention( 1/46). The control group converted to diabetes at the rate of 13. 04%( 6/46). The differences between the groups were significant( P < 0. 05). Conclusion: Auricular acupuncture combined with lifestyle intervention can improve blood glucose and lipid levels in type 2 diabetics more effectively than routine intervention,and effectively reduce the conversion rate of diabetes.
引文
[1]孟祥云,郭树明,杨丽霞.中药植物多糖对2型糖尿病胰岛素抵抗的作用机制研究进展[J].中国实验方剂学杂志,2017,23(8):220-225.
[2]罗祖纯,戴霞,麻晓君,等.有氧和抗阻运动对糖尿病前期人群Hb A1c及血糖的影响[J].重庆医学,2017,46(8):1148-1150.
[3]周翔海,张秀英,罗樱樱,等.2型糖尿病及糖尿病前期简易决策树模型外部验证的研究[J].中国糖尿病杂志,2014,22(4):297-301.
[4]Lew KN,Mclean Y,Byers S,et al.Combined Diabetes Prevention and Disease Self-Management Intervention for Nicaraguan Ethnic Minorities:A Pilot Study[J].Prog Community Health Partnersh,2017,11(4):357-366.
[5]谢君辉,刘倩,杨雁,等.湖北某地区农村人群2型糖尿病及糖尿病前期横断面调查[J].华中科技大学学报:医学版,2014,43(2):162-167.
[6]El-Maghrabey M,Mine M,Kishikawa N,et al.A novel dual labeling approach enables converting fluorescence labeling reagents into fluorogenic ones via introduction of purification tags.Application to determination of glyoxylic acid in serum[J].Talanta,2018,180:323-328.
[7]中华医学会内分泌学分会.中国成人2型糖尿病预防的专家共识[J].中华内分泌代谢杂志,2014,30(4):277-283.
[8]谷枫,刘耀文,张晓亮,等.中国糖调节受损患者药物干预效果的比较分析[J].国际药学研究杂志,2017,44(8):765-771.
[9]Golan R,Kloog I,Almog R,et al.Environmental exposures and fetal growth:the Haifa pregnancy cohort study[J].BMC Public Health,2018,18(1):132.
[10]曹玉梅,曹秀娟,黄瑞华,等.黄芪注射液联合阿托伐他汀治疗早期糖尿病肾病的临床效果[J].中国医药,2016,11(4):543-546.
[11]黄国庆,杨军,戴新建,等.103例2型糖尿病以及糖尿病前期合并阻塞型睡眠呼吸暂停综合征的中医证候分析[J].中华中医药杂志,2014,29(9):2987-2990.
[12]Carniciu AL,Fazzari MJ,Tabibian P,et al.Corneal abrasion following anaesthesia for non-ocular surgical procedures:A case-controlled study[J].J Perioper Pract,2017,27(11):247-253.
[13]李小可,周义浪,赵丹丹,等.肾气丸类方干预糖尿病前期与早期糖尿病血糖漂移的理论与应用分析[J].世界中医药,2015,10(5):793-797.
[14]刘金刚,郑成竹,王勇.中国肥胖和2型糖尿病外科治疗指南(2014)[J].中国实用外科杂志,2014,34(11):1005-1010.
[15]Klingelhutz AJ,Gourronc FA,Chaly A,et al.Scaffold-free generation of uniform adipose spheroids for metabolism research and drug discovery[J].Sci Rep,2018,8(1):523.
[16]王霞,何訸,周君,等.糖尿病前期患者血尿酸水平与餐后2h血糖水平相关性分析[J].四川大学学报:医学版,2015,46(5):750-753.
[17]Dissanayake AM,Wheldon MC,Ahmed J,et al.Extending Metformin Use in Diabetic Kidney Disease:A Pharmacokinetic Study in Stage 4 Diabetic Nephropathy[J].Kidney Int Rep,2017,2(4):705-712.
[18]黄凤,荣培晶,王宏才,等.耳甲迷走神经刺激干预35例糖耐量受损患者临床观察[J].中华中医药杂志,2010,25(12):2185-2186.
[19]Peuker E T,Filler T J.The nerve supply of the human auricle[J].Clinical Anatomy,2010,15(1):35-37.
[20]杨明,张广德,魏子孝.魏子孝教授运用“治未病”思想辨治糖尿病前期思路浅析[J].世界中医药,2017,12(4):846-849.
[2]罗祖纯,戴霞,麻晓君,等.有氧和抗阻运动对糖尿病前期人群Hb A1c及血糖的影响[J].重庆医学,2017,46(8):1148-1150.
[3]周翔海,张秀英,罗樱樱,等.2型糖尿病及糖尿病前期简易决策树模型外部验证的研究[J].中国糖尿病杂志,2014,22(4):297-301.
[4]Lew KN,Mclean Y,Byers S,et al.Combined Diabetes Prevention and Disease Self-Management Intervention for Nicaraguan Ethnic Minorities:A Pilot Study[J].Prog Community Health Partnersh,2017,11(4):357-366.
[5]谢君辉,刘倩,杨雁,等.湖北某地区农村人群2型糖尿病及糖尿病前期横断面调查[J].华中科技大学学报:医学版,2014,43(2):162-167.
[6]El-Maghrabey M,Mine M,Kishikawa N,et al.A novel dual labeling approach enables converting fluorescence labeling reagents into fluorogenic ones via introduction of purification tags.Application to determination of glyoxylic acid in serum[J].Talanta,2018,180:323-328.
[7]中华医学会内分泌学分会.中国成人2型糖尿病预防的专家共识[J].中华内分泌代谢杂志,2014,30(4):277-283.
[8]谷枫,刘耀文,张晓亮,等.中国糖调节受损患者药物干预效果的比较分析[J].国际药学研究杂志,2017,44(8):765-771.
[9]Golan R,Kloog I,Almog R,et al.Environmental exposures and fetal growth:the Haifa pregnancy cohort study[J].BMC Public Health,2018,18(1):132.
[10]曹玉梅,曹秀娟,黄瑞华,等.黄芪注射液联合阿托伐他汀治疗早期糖尿病肾病的临床效果[J].中国医药,2016,11(4):543-546.
[11]黄国庆,杨军,戴新建,等.103例2型糖尿病以及糖尿病前期合并阻塞型睡眠呼吸暂停综合征的中医证候分析[J].中华中医药杂志,2014,29(9):2987-2990.
[12]Carniciu AL,Fazzari MJ,Tabibian P,et al.Corneal abrasion following anaesthesia for non-ocular surgical procedures:A case-controlled study[J].J Perioper Pract,2017,27(11):247-253.
[13]李小可,周义浪,赵丹丹,等.肾气丸类方干预糖尿病前期与早期糖尿病血糖漂移的理论与应用分析[J].世界中医药,2015,10(5):793-797.
[14]刘金刚,郑成竹,王勇.中国肥胖和2型糖尿病外科治疗指南(2014)[J].中国实用外科杂志,2014,34(11):1005-1010.
[15]Klingelhutz AJ,Gourronc FA,Chaly A,et al.Scaffold-free generation of uniform adipose spheroids for metabolism research and drug discovery[J].Sci Rep,2018,8(1):523.
[16]王霞,何訸,周君,等.糖尿病前期患者血尿酸水平与餐后2h血糖水平相关性分析[J].四川大学学报:医学版,2015,46(5):750-753.
[17]Dissanayake AM,Wheldon MC,Ahmed J,et al.Extending Metformin Use in Diabetic Kidney Disease:A Pharmacokinetic Study in Stage 4 Diabetic Nephropathy[J].Kidney Int Rep,2017,2(4):705-712.
[18]黄凤,荣培晶,王宏才,等.耳甲迷走神经刺激干预35例糖耐量受损患者临床观察[J].中华中医药杂志,2010,25(12):2185-2186.
[19]Peuker E T,Filler T J.The nerve supply of the human auricle[J].Clinical Anatomy,2010,15(1):35-37.
[20]杨明,张广德,魏子孝.魏子孝教授运用“治未病”思想辨治糖尿病前期思路浅析[J].世界中医药,2017,12(4):846-849.