康复运动对肥胖2型糖尿病患者糖脂代谢指标及胰岛功能的影响  

Effects of rehabilitation exercise therapy on the glucose and lipid metabolism indexes and islet function in obese patients with type 2 diabetes

作　　者：谈力欣[1] 崔杰[2] 韩明璇 张茹 王晓昆 魏莎 刘思思 焦骞 TAN Lixin;CUI Jie;HAN Mingxuan(Rehabilitation Department for Diabetes Mellitus,The Second Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050000,China;不详)

机构地区：[1]河北省石家庄市第二医院糖尿病康复科,050000 [2]河北省石家庄市第二医院中医科,050000 [3]河北省医学情报研究所

出　　处：《河北医药》2021年第3期361-364,共4页Hebei Medical Journal

基　　金：河北省中医药管理局科研计划项目(编号:2019417)。

摘　　要：目的探讨康复运动对肥胖或超重2型糖尿病(T2DM)患者糖脂代谢指标及胰岛功能的影响。方法选取糖化血红蛋白(HbA1c)≤8.5%、BMI≥24.0 kg/m2的2型糖尿病患者随机分为康复运动治疗组(治疗组)和自由运动治疗组(对照组),每组30例。治疗组在严格饮食控制的基础上予以12周的康复运动治疗;对照组在饮食控制基础上自由活动。所有参与试验患者佩戴瞬感扫描式葡萄糖监测系统。观察运动前后患者空腹及餐后血糖、血糖波动性的变化,以最大血糖波动幅度(LAGE)、餐后血糖波动幅度(PPGE)、全天血糖波动标准差(SDBG)反映血糖波动,测定HbA1c评价血糖控制稳定性;观察2组患者胰岛功能及胰岛素抵抗指数、血脂谱的变化。结果治疗组患者体重、BMI、基础代谢率、脂肪率、肌肉率等各项指标与治疗前比较,均有明显改善(P<0.05);对照组体重、BMI、基础代谢率、脂肪率与治疗前比较均有所改善,差异有统计学意义(P<0.05)。治疗组与对照组比较,治疗组各项指标改善更为明显(P<0.05)。2组患者治疗前后空腹及餐后血糖均较前有明显下降(P<0.05),治疗组与对照组比较,差异无统计学意义(P>0.05)。对照组治疗前后血糖波动性较前改善,但差异无统计学意义(P>0.05);治疗组治疗前后血糖波动性均得到了明显改善(P<0.05),明显优于对照组(P<0.05)。2组治疗前后患者胰岛功能及胰岛素抵抗指数、血脂均较前有明显改善(P<0.05);治疗组与对照组比较,改善更为明显,差异有统计学意义(P<0.05)。结论康复运动治疗有利于T2DM患者的空腹及餐后血糖的管理,有利于血糖稳定性的控制,可以明显改善患者胰岛功能,改善胰岛素抵抗,调节血脂。Objective To investigate the effects of rehabilitation exercise on the glucose and lipid metabolism indexes and islet function in obese or overweight patients with type 2 diabetes mellitus(T2DM).Methods A total of 60 patients with T2DM and with glycosylated hemoglobin(HbA1c)≤8.5%and BMI≥24.0kg/m2 were randomly divided into rehabilitation exercise treatment group(treatment group)and free exercise treatment group(control group),with 30 cases in each group.The patients in treatment group were treated by 12-week rehabilitation exercise on the basis of strict diet control,however,the patients in control group were treated by free exercise management on the basis of diet control.All the patients participated in the test wore a flash glucose monitoring system.The changes in fasting blood glucose(FBG),postprandial blood glucose(PBG)and blood glucose fluctuations of patients before and after exercise were observed.The largest amplitude of glycemic excursions(LAGE),the postprandial glucose excursion(PPGE),and 24h standard deviation of blood glucose(SDBG)were used to reflect blood glucose fluctuations.HbAlc was measured to evaluate stability of blood sugar control.The changes of pancreatic islet function,insulin resistance index and blood lipid profile in the two groups were observed.Results The body weight,BMI,basal metabolic rate,fat rate,and muscle rate and other indicators in both groups were significantly improved,as compared with those before treatment(P<0.05),moreover,the improvement degree in treatment group was more significant than that in control group(P<0.05).Moreover the levels of FBG and PBG in both groups were significantly decreased(P<0.05),however,there were no significant differences between the two groups(P>0.05).The pancreatic islet function,insulin resistance index,and blood lipids in both groups were significantly improved after treatment(P<0.05),moreover,the improvement degree in treatment group was more significant than that in control group(P<0.05).Conclusion Rehabilitation exercise therapy is c

关 键 词：糖尿病 2型 康复运动 糖化血红蛋白 胰岛素抵抗 血脂 

分 类 号：R587.1[医药卫生—内分泌]