摘要
目的评价中医优化治疗方案干预糖尿病前期的临床疗效。方法选取广州中医药大学深圳医院(福田)内分泌科门诊以及福田区9家社区康复中心的糖尿病前期的患者,在生活方式干预基础上,根据患者随访期间的暴露因素(是否接受中医药治疗)分为中医优化治疗组和生活方式干预组,定期随访2组12、24、48周的糖尿病发生率、转为正常率和次要疗效指标:空腹血糖(FBG)、餐后2小时血糖(2 h PG)、糖化血红蛋白(HbA1c),体质量指数(BMI),血清总胆固醇(TC)、三酰甘油(TG),对中医优化治疗组进行辨证分型,观察并比较随访期间2组肝功能、血常规、心电图。结果纳入统计患者385例,中医优化治疗组192例,生活方式干预组193例,2组基线各项资料无明显统计学差异。中医优化治疗组转糖尿病率为27.60%(53/192),生活方式干预组为44.04%(85/193),RR=0.63,中医优化方案较生活方式干预,降低糖尿病发生风险可达36%。中医优化治疗组转正常率为50%(96/192),生活方式干预组为32.8%(63/193),RR=1.52,采用中医优化方案患者的糖尿病血糖转归率较仅采用生活方式干预的患者血糖转归率高出52%。同时中医优化治疗方案可以控制糖脂代谢,其差异较对照组有统计学意义。随访期间2组未见肝功能、血常规异常及严重不良事件。结论中医优化治疗方案干预应用于糖尿病前期人群,可以降低糖尿病的发病风险,提高糖尿病前期患者血糖转归率,有效改善患者的糖脂代谢。
Objective To evaluate the clinical efficacy of the optimized treatment plan of traditional Chinese medicine in the intervention of prediabetes.Methods Patients with prediabetes in the Department of Endocrinology of the Shenzhen Hospital(Futian)and 9 community rehabilitation centers in Futian District were selected as the research subjects.On the basis of lifestyle intervention,according to the exposure factors during the follow-up period(whether recieving the treatment of traditional Chinese medicine),they were divided into the TCM optimized treatment group and the lifestyle intervention group.The patients in the 2 groups were regularly followed up in the 12th,24th and 48th week for observing the incidence of diabetes,the rate of converting to normal and the secondary effi cacy indexes:fasting blood glucose(FBG),2 hour postprandial blood glucose(2 h PG),glycosylated hemoglobin(HbA1c),body mass index(BMI),serum total cholesterol(TC),triacylglycerol(TG).The TCM treatment group was divided into diff erent types according to the result of syndrome diff erentiation,and liver function,blood routine and electrocardiogram were observed and compared between the two groups during the follow-ups.Results A total of 385 patients were included in the statistics,including 192 patients in the TCM optimization treatment group and 193 patients in the lifestyle intervention group.There was no signifi cant diff erence in the baseline data between the two groups.The conversion rate of the TCM optimization treatment group was 27.60%(53/192),and that of the lifestyle intervention group was 44.04%(85/193),RR=0.63,that is,compared with the lifestyle intervention,the TCM optimization plan could reduce the risk of diabetes by 36%.The normalization rate of the TCM optimization treatment group was 50%(96/192),and that of the lifestyle intervention group was 32.8%(63/193),RR=1.52,that is,the diabetic blood glucose outcome rate of the patients with the optimized TCM program was 52%higher than that of the patients with lifestyle intervention alone.At the same time,the optimized treatment plan of traditional Chinese medicine could control glucose level and lipid metabolism,and the diff erence was statistically signifi cant compared with the control group.During the follow-up period,there were no abnormal liver function,blood routine,and serious adverse events in the two groups.Conclusion The application of the TCM optimized treatment program in the prediabetic population can reduce the risk of diabetes,imporve the blood glucose outcome of prediabetic patients,and eff ectively improve the glucose level and lipid metabolism.
作者
朴春丽
王涵
吴学敏
王丽
顾成娟
赵晓华
赖杏荣
张琦
PIAO Chunli;WANG Han;WU Xuemin;WANG Li;GU Chengjuan;ZHAO Xiaohua;LAI Xingrong;ZHANG Qi(Shenzhen Hospital of Guangzhou University of Chinese Medicine<Futian>,Shenzhen 518000,China;Changchun University of Chinese Medicine,Changchun 130117,China)
出处
《吉林中医药》
2021年第7期884-889,共6页
Jilin Journal of Chinese Medicine
基金
深圳市卫生计生系统社区卫生研究项目(SZSW2018007)。
