整合医学模式下2型糖尿病个性化干预的临床效果研究  

Clinical effect of personalized intervention for patients with type 2 diabetes with holistic integrative medicine

作　　者：王宇琴[1] 朱永星 冉隆梅[1] 刘敏华[1] 张兵[1] 赵航 WANG Yuqin;ZHU Yongxing;RAN Longmei;LIU Minhua;ZHANG Bing;ZHAO Hang(Department of Geriatrics,Guangzhou First People′s Hospital,Guangzhou 510180,China;不详)

机构地区：[1]广州市第一人民医院老年病科,广州510180 [2]广东糖胖健康研究院,广州510620

出　　处：《实用医学杂志》2022年第18期2346-2351,共6页The Journal of Practical Medicine

基　　金：广州市科技计划项目(编号:201803010061)。

摘　　要：目的研究整合医学模式下2型糖尿病个性化干预的临床效果。方法随机选择30例来自广州市社区的中老年患者。多学科联合开展健康教育并实施个性化干预,比较干预前后血糖等生化指标、血压水平及焦虑、抑郁和生理感受等指标的变化。结果干预4~12个月后,13例全部停用降糖药,15例部分停药,2例用药不变。干预后患者的血糖、糖化血红蛋白和血压的平均水平均显著下降(P<0.05),其中干预前后空腹血糖分别为9.2、6.9 mmol/L,餐后2 h血糖分别为12.3、7.7 mmol/L;糖化血红蛋白分别为7.7%、6.4%。经干预后36.7%的患者达到糖尿病缓解水平,20%的患者停用降糖药3个月后空腹血糖、餐后2 h血糖、糖化血红蛋白均达到正常水平,未达缓解水平的患者的糖代谢也显著好转(P<0.05)。合并血压高的人群中75%(9/12)停用降压药3个月后仍血压正常。同时发现患者的焦虑、抑郁及生理感受也得到了显著改善(P<0.05)。结论整合医学模式个性化干预能显著改善中老年2型糖尿病患者的糖代谢、心理状态、生理机能和血压高情况,轻中症患者可望短期内实现糖尿病缓解甚至逆转,重症患者的糖代谢也明显好转,这将为进一步优化糖尿病防控方案提供思路。Objective To study the clinical effects of personalized interventions on patients with type 2 diabetes mellitus with holistic integrative medicine(HIM).Methods Thirty middle⁃aged and elderly patients with type 2 diabetes from communities in Guangzhou who volunteered to participate in the project were randomly selected.A multidisciplinary approach of health education and personalized intervention was used.The changes in patients'blood glucose biochemical indexes,blood pressure,anxiety,depression,physiological feelings and blood pressure levels before and after the intervention were compared.Results After 4~12 months of intervention,all glucose⁃lowering drugs were stopped in 13 patients;partially stopped in 15 patients,and 2 patients remained the same medication.The mean levels of biochemical indicators including fasting glucose(9.2 mmol/L and 6.9 mmol/L,respectively),2⁃hour postprandial glucose(12.3 mmol/L and 7.7 mmol/L,respectively)and glycated hemoglobin(7.7%and 6.4%,respectively)before and after the intervention were significantly decreased(P<0.05).After the intervention,36.7%of the patients reached the remission level of diabetes,20%reached the normal level of fasting glucose,2⁃hour postprandial glucose and glycated hemoglobin after stopping the hypoglycemic drugs for 3 months,and the glucose metabolism of the patients who did not reach the remission level also improved signif⁃icantly(P<0.05).Seventy⁃five percent(9/12)of those with combined high blood pressure had normal blood pres⁃sure after 3 months of discontinuation of antihypertensive drugs.Significant improvements in anxiety,depression and physiological perception indicators were also found(P<0.05).Conclusion Personalized intervention in the mode of HIM can significantly improve glucose metabolism,psychological status,physiological function and high blood pressure in middle⁃aged and elderly patients with type 2 diabetes.Remission or even reversal of diabetes can be expected within a short period of time in mild or moderate patients and s

关 键 词：整合医学 2型糖尿病 个性化干预 中老年人 

分 类 号：R459.4[医药卫生—治疗学]