二甲双胍联合不同形式运动治疗2型糖尿病疗效观察  

Clinical efficacy of metformin combined with different forms of exercise for the treatment of type 2 diabetes mellitus

作　　者：侯小丽[1] 吴述光[2] 潘静[1] 曹在新 邹慧[1] 陈莉[1] HOU Xiaoli;WU Shuguang;PAN Jing;CAO Zaixin;ZOU Hui;CHEN Li(Department of Endocrinology,Xinxiang First People's Hospital,Xinxiang 453000,Henan Province,China;Department of Respiratory and Critical Care Medicine,Xinxiang Central Hospital,Xinxiang 453000,Henan Province,China;Department of Rheumatology and Immunology,Huojia County People′s Hospital,Xinxiang 453800,Henan Province,China)

机构地区：[1]新乡市第一人民医院内分泌科,河南新乡453000 [2]新乡市中心医院呼吸与危重症医学科,河南新乡453000 [3]获嘉县人民医院风湿免疫科,河南获嘉453800

出　　处：《新乡医学院学报》2025年第5期384-390,共7页Journal of Xinxiang Medical University

基　　金：2020年度河南省医学科技攻关计划联合共建项目(编号:HGJ20200966)。

摘　　要：目的探讨二甲双胍联合不同方式运动治疗2型糖尿病(T2DM)的临床疗效。方法选择2020年5月至2021年1月新乡市第一人民医院收治的90例T2DM患者为研究对象。根据治疗方案将患者分为对照组、观察组1和观察组2,每组30例。3组患者均给予二甲双胍进行降糖治疗和个体化糖尿病食谱干预。在此基础上,对照组患者给予常规生活方式指导(糖尿病膳食指导及个体化运动方式指导,建议患者每周至少进行150 min中等强度运动),观察组1患者根据微信群督导信息进行每日2~3次餐后有氧或低强度抗阻运动或有氧加抗阻运动,观察组2患者根据微信群督导信息每日进行餐后1次有氧运动或有氧加低强度抗阻运动(弹力带联合快步走),共干预治疗6个月。分别于治疗前及治疗3、6个月时采集3组患者肘静脉血,分离血清,应用全自动生化分析仪检测3组患者空腹血糖(FBG)、餐后2 h血糖(2 h PG)、三酰甘油(TG)、总胆固醇(TCH)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、同型半胱氨酸(HCY)水平;应用全自动特定蛋白即时分析仪检测3组患者糖化血红蛋白(HbA1c)水平;采用电化学发光免疫分析法检测3组患者血清25-羟基维生素D[25(OH)D]水平。结果治疗前3组患者的FBG、2 h PG、HbA1c、25(OH)D、TCH、TG、HDL、LDL、HCY水平比较差异均无统计学意义(P>0.05)。对照组患者各时间点的FBG、2hPG、TG、TCH、HDL、LDL、HCY与治疗前比较差异无统计学意义(P>0.05);对照组患者治疗3、6个月时HbA1c水平显著低于治疗前(P<0.05),25(OH)D水平显著高于治疗前(P<0.05);对照组患者治疗6个月时的HbA1c水平显著低于治疗3个月时(P<0.05)。观察组1和观察组2患者治疗3、6个月时的FBG、2 h PG、HbA1c、TCH、TG水平显著低于治疗前,25(OH)D、HDL水平显著高于治疗前(P<0.05);2组患者各时间点LDL、HCY水平比较差异均无统计学意义(P>0.05)。观察组1治疗6个月时的HbA1c水平显著Objective To investigate the clinical efficacy of metformin combined with different exercise methods for the treatment of type 2 diabetes mellitus(T2DM).Methods A total of 90 T2DM patients admitted to the Xinxiang First People′s Hospital of Xinxiang City from May 2020 to January 2021 were included and divided into a control group,an observation group 1 and an observation group 2 according to the treatment plan,with 30 cases in each group.All patients were given metformin for hypoglycemic treatment and intervened by an individualized diabetic diet.In addition,patients in the control group were also given routine lifestyle guidance(guidance for diabetic dietary and individualized exercise modes;it was suggested that patients should do at least 150 minutes of moderate intensity exercise per week).Patients in the observation group 1 were asked to do aerobic or low-intensity resistance exercise or aerobic plus resistance exercise 2 to 3 times a day after meals according to the information sent to the Wechat supervision group.Patients in the observation group 2 were told to do aerobic exercise or aerobic plus low-intensity resistance exercise(elastic band combined with brisk walking)once a day after meals according to the information sent to the Wechat supervision group.All the patients received intervention treatment for a total of 6 months.Cubital venous blood was collected before treatment,3 and 6 months after treatment,and serum was separated.The levels of fasting blood glucose(FBG),2-hour postprandial blood glucose(2 h PG),triglyceride(TG),total cholesterol(TCH),high density lipoprotein(HDL),low density lipoprotein(LDL)and homocysteine(HCY)in 3 groups were detected by an automatic biochemical analyzer.The glycosylated hemoglobin(HbA1c)level of patients in 3 groups was detected by an automatic specific protein real-time analyzer.The levels of serum 25-hydroxyvitamin D[25(OH)D]in 3 groups were detected by electrochemical luminescence immunoassay.Results Before treatment,there were no significant differences in FBG

关 键 词：2型糖尿病 运动方式 运动时间 餐后高血糖 糖化血红蛋白 

分 类 号：R587.1[医药卫生—内分泌]