实用医学杂志 ›› 2022, Vol. 38 ›› Issue (18): 2346-2351.doi: 10.3969/j.issn.1006⁃5725.2022.18.017

• 临床研究 • 上一篇    下一篇

整合医学模式下2型糖尿病个性化干预的临床效果研究 

王宇琴1 朱永星2 冉隆梅1 刘敏华1 张兵1 赵航1    

  1. 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)

  • 出版日期:2022-09-25 发布日期:2022-09-25
  • 通讯作者: 赵航 E⁃mail:18811438749@163.com
  • 基金资助:
    广州市科技计划项目(编号:201803010061)

Clinical effect of personalized intervention for patients with type 2 diabetes with holistic integrative medi⁃ cine

WANG Yuqin*,ZHU Yongxing,RAN Longmei,LIU Minhua,ZHANG Bing,ZHAO Hang.   

  1. Department of GeriatricsGuangzhou First Peoples HospitalGuangzhou 510180China

  • Online:2022-09-25 Published:2022-09-25
  • Contact: ZHAO Hang E⁃mail:18811438749@163.com

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 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。

关键词:

整合医学, 2型糖尿病, 个性化干预, 中老年人

Abstract:

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 significant improvement in glucose metabolism in severe patients is also found. It provide ideas for further optimization of diabetes prevention and control programs.

Key words:

holistic integrative medicine, type 2 diabetes, personalized intervention, middle?aged and elderly people