营养、运动疗法对衰弱综合征合并糖尿病患者的治疗效果分析
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摘要
目的探讨衰弱综合征合并糖尿病(DM)患者予以营养、运动疗法联合常规药物治疗后对血糖、胰岛素、血脂水平的影响。方法 85例衰弱综合征合并DM患者随机分为研究组(n=43)和对照组(n=42),对照组给予常规药物治疗,研究组同时给予营养、运动疗法综合干预。治疗前后检测血糖、胰岛功能、血脂指标水平及评估衰弱综合征症状。结果治疗后研究组空腹血糖(FPG)、餐后2 h血糖(2 hFPG)、糖化血红蛋白(HbA1c)、C-肽(C?P)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL?C)分别为[(4.36±1.34)mmol/L、(7.32±1.41)mmol/L、(6.54±1.79)%、(1.97±0.60)ng/L、(1.36±0.42)mmol/L、(4.50±0.82)mmol/L、(2.64±0.19)mmol/L],显著低于对照组[(5.47±1.91)mmol/L、(8.27±2.20)mmol/L、(7.43±1.60)%、(2.08±0.51)ng/L、(1.59±0.35)mmol/L、(5.39±0.69)mmol/L、(3.14±0.21)mmol/L];空腹胰岛素(INS)、高密度脂蛋白胆固醇(HDL?C)分别为[(35.29±5.66)μIU/mL、(1.21±0.19)mmol/L],显著高于对照组[(31.92±6.71)μIU/mL、(1.11±0.17)mmol/L],差异均有统计学意义(P<0.05)。Fried衰弱症状学量表评分中,研究组5项指标阳性率下降幅度显著大于对照组(P<0.05)。结论营养、运动疗法联合常规药物治疗衰弱综合征合并DM,可有效改善患者糖脂代谢、胰岛功能及减轻衰弱症状。
Objective To explore the effects of nutrition,exercise therapy combined with routine medication on the levels of blood glucose,insulin and blood lipid in patients with asthenic syndrome complicated with diabetes mellitus(DM).Methods 85 cases of patients with asthenic syndrome complicated with DM were randomly divided into the study group(n=43)and the control group(n=42). The control group was given routine medication and diet control,and the study group was given nutrition and exercise therapy interventions. The levels of blood glucose,pancreatic islet function,blood lipid were detected before and after treatment,and the asthenic symptoms were assessed. Results After treatment,the levels of fasting plasma glucose(FPG),postprandial 2 h blood glucose(2 hFPG),glycosylated hemoglobin(HbA1 c),and C?peptide(C?P),triglyceride(TG),total cholesterol(TC)and low density lipoprotein cholesterol(LDL?C)were(4.36±1.34)mmol/L,(7.32±1.41)mmol/L,(6.54±1.79)%,(1.97±0.60)ng/L,(1.36±0.42)mmol/L,(4.50±0.82)mmol/L,and(2.64±0.19)mmol/L,in the study group respectively,were significantly lower than those in the control group[(5.47±1.91)mmol/L,(8.27±2.20)mmol/L,(7.43 ± 1.60)%,(2.08 ± 0.51)ng/L,(1.59 ± 0.35) mmol/L,(5.39 ± 0.69)mmol/L and(3.14 ± 0.21) mmol/L,respectively];the levels of fasting insulin(INS)and high density lipoprotein cholesterol(HDL?C)were(35.29±5.66)μIU/mL and(1.21±0.19)mmol/L,respectively,weresignificantlyhigherthanthoseinthecontrolgroup[(31.92±6.71)μIU/mLand(1.11±0.17)mmol/L,respectively](P<0.05). In the Fried Weakness Symptoms Scale score,the decreases of positive rates of five indexes in the study group were significantly greater than those in the control group(P<0.05). Conclusion Nutrition,exercise therapy combined with routine medication for asthenic syndrome complicated with DM could effectively improve the glucose and lipid metabolism and pancreatic islet function,and reduce the asthenic syndromes.
Objective To explore the effects of nutrition,exercise therapy combined with routine medication on the levels of blood glucose,insulin and blood lipid in patients with asthenic syndrome complicated with diabetes mellitus(DM).Methods 85 cases of patients with asthenic syndrome complicated with DM were randomly divided into the study group(n=43)and the control group(n=42). The control group was given routine medication and diet control,and the study group was given nutrition and exercise therapy interventions. The levels of blood glucose,pancreatic islet function,blood lipid were detected before and after treatment,and the asthenic symptoms were assessed. Results After treatment,the levels of fasting plasma glucose(FPG),postprandial 2 h blood glucose(2 hFPG),glycosylated hemoglobin(HbA1 c),and C?peptide(C?P),triglyceride(TG),total cholesterol(TC)and low density lipoprotein cholesterol(LDL?C)were(4.36±1.34)mmol/L,(7.32±1.41)mmol/L,(6.54±1.79)%,(1.97±0.60)ng/L,(1.36±0.42)mmol/L,(4.50±0.82)mmol/L,and(2.64±0.19)mmol/L,in the study group respectively,were significantly lower than those in the control group[(5.47±1.91)mmol/L,(8.27±2.20)mmol/L,(7.43 ± 1.60)%,(2.08 ± 0.51)ng/L,(1.59 ± 0.35) mmol/L,(5.39 ± 0.69)mmol/L and(3.14 ± 0.21) mmol/L,respectively];the levels of fasting insulin(INS)and high density lipoprotein cholesterol(HDL?C)were(35.29±5.66)μIU/mL and(1.21±0.19)mmol/L,respectively,weresignificantlyhigherthanthoseinthecontrolgroup[(31.92±6.71)μIU/mLand(1.11±0.17)mmol/L,respectively](P<0.05). In the Fried Weakness Symptoms Scale score,the decreases of positive rates of five indexes in the study group were significantly greater than those in the control group(P<0.05). Conclusion Nutrition,exercise therapy combined with routine medication for asthenic syndrome complicated with DM could effectively improve the glucose and lipid metabolism and pancreatic islet function,and reduce the asthenic syndromes.
引文
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[8]贺娟,周珺,罗晓红.糖尿病周围神经病变相关血清标记物研究进展[J].中国临床研究,2018,31(5):682-684.
[9]白银涛,孙亚威,谭子新,等.老年代谢综合征各组分及RBP4与糖尿病患病的关系[J].中国热带医学,2016,16(1):84-86.
[10]贾文文,戴付敏,Julie Elliot,等.老年糖尿病患者合并衰弱的相关研究进展[J].中华护理杂志,2017,52(6):697-701.
[11]Murea M,Lenchik L,Register TC,et al.Psoas and paraspinous muscle index as a predictor of mortality in African American men with type 2 diabetes mellitus[J].J Diabetes Complications,2018,32(6):558-564.
[12]聂双双,李海鹰,王双.衰弱综合征与老年糖尿病[J].实用老年医学,2017,31(3):203-207.
[13]汪亚男,徐娟兰,宋红玲,等.运动疗法在衰弱综合征患者中的应用现状[J].中国康复理论与实践,2017,23(5):558-562.
[14]吴艳,杨建全.运动疗法联合西药、膳食营养对老年糖尿病患者负性情绪和依从性的影响[J].中国老年学杂志,2017,37(15):3756-3758.
[15]胡安梅,陶晓春,魏书侠,等.营养及康复干预对衰弱与衰弱前期老人的作用[J].中国老年学杂志,2017,37(14):3613-3615.
[2]吴永华,杨丽君,张俐.老年衰弱、肌少症与营养[J].实用老年医学,2017,31(4):403-407.
[3]曾朝霞,梁杰.老年冠心病患者合并衰弱综合征的影响因素研究[J].中国全科医学,2017,20(19):2347-2352,2357.
[4]孙凯旋,刘永兵,薛谨,等.维生素D与老年衰弱综合征的关系[J].中华临床医师杂志:电子版,2017,11(5):798-801.
[5]Makary MA,Segev DL,Pronovost PJ,et al.Frailty as a predictor of surgical outcomes in older patients[J].J Am Coll Surg,2010,210(6):901-908.
[6]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[M].北京:北京大学医学出版社,2014.
[7]庞乐,张绍敏,吴锦晖.老年衰弱综合征的相关研究进展[J].实用老年医学,2016,30(5):356-360.
[8]贺娟,周珺,罗晓红.糖尿病周围神经病变相关血清标记物研究进展[J].中国临床研究,2018,31(5):682-684.
[9]白银涛,孙亚威,谭子新,等.老年代谢综合征各组分及RBP4与糖尿病患病的关系[J].中国热带医学,2016,16(1):84-86.
[10]贾文文,戴付敏,Julie Elliot,等.老年糖尿病患者合并衰弱的相关研究进展[J].中华护理杂志,2017,52(6):697-701.
[11]Murea M,Lenchik L,Register TC,et al.Psoas and paraspinous muscle index as a predictor of mortality in African American men with type 2 diabetes mellitus[J].J Diabetes Complications,2018,32(6):558-564.
[12]聂双双,李海鹰,王双.衰弱综合征与老年糖尿病[J].实用老年医学,2017,31(3):203-207.
[13]汪亚男,徐娟兰,宋红玲,等.运动疗法在衰弱综合征患者中的应用现状[J].中国康复理论与实践,2017,23(5):558-562.
[14]吴艳,杨建全.运动疗法联合西药、膳食营养对老年糖尿病患者负性情绪和依从性的影响[J].中国老年学杂志,2017,37(15):3756-3758.
[15]胡安梅,陶晓春,魏书侠,等.营养及康复干预对衰弱与衰弱前期老人的作用[J].中国老年学杂志,2017,37(14):3613-3615.