CAJ | 학술논문

目的观察在常规药物治疗基础上辅以步行运动对高血压合并2型糖尿病患者糖代谢、动态血压及生活质量的影响.方法应用计步器筛选出62例在我科门诊或住院治疗且步行运动量＜5000步/d的高血压合并2型糖尿病患者,采用随机数字表法将其分为运动组(32例)及对照组(30例).2组患者均给予常规药物(包括缬沙坦、二甲双胍、阿卡波糖)治疗,运动组患者在此基础上每天步行10000步以上(对其运动持续时间及运动强度不作限定),对照组仍按照日常习惯生活.于入选时、干预3个月后观察2组患者空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、胰岛素敏感性(HOMA-IS)、动态血压参数及生活质量变化情况.结果 2组患者分别经3个月干预后,发现运动组患者FPG[(5.41±1.23) mmol/L]、HbA1c[(6.16 ±0.87)％]、FINS[(8.72±2.43) mIU/L]、HOMA-IR[(2.27±1.41)、HOMA-IS[(0.0182 ±0.0034)]、动态血压参数[24h收缩压为(126±13) mmHg,24h舒张压为(72±8) mmHg,白天收缩压为(132±8)mmHg,白天舒张压为(74.4 ±8.3)mmHg,夜间收缩压为(123.1±8.7) mmHg,夜间舒张压为(70.5±6.1) mmHg]及生活质量评分[生理功能为(87.2±11.5)分,生理职能为(73.0±14.3)分,总体健康为(78.6±15.5)分,生命活力为(68.4 ±18.8)分,情感职能为(68.7 ±20.4)分,精神健康为(78.6 ±19.4)分]均较入选时及对照组明显改善(P＜0.05),其间差异均具有统计学意义(P＜0.05).结论在常规药物治疗基础上每天步行10000步以上可进一步改善缺乏运动的轻度高血压合并2型糖尿病患者糖代谢及动态血压参数,对提高患者生活质量具有重要意义.
목적 관찰재상규약물치료기출상보이보행운동대고혈압합병2형당뇨병환자당대사、동태혈압급생활질량적영향.방법 응용계보기사선출62례재아과문진혹주원치료차보행운동량＜5000보/d적고혈압합병2형당뇨병환자,채용수궤수자표법장기분위운동조(32례)급대조조(30례).2조환자균급여상규약물(포괄힐사탄、이갑쌍고、아잡파당)치료,운동조환자재차기출상매천보행10000보이상(대기운동지속시간급운동강도불작한정),대조조잉안조일상습관생활.우입선시、간예3개월후관찰2조환자공복혈당(FPG)、당화혈홍단백(HbA1c)、공복이도소(FINS)、이도소저항지수(HOMA-IR)、이도소민감성(HOMA-IS)、동태혈압삼수급생활질량변화정황.결과 2조환자분별경3개월간예후,발현운동조환자FPG[(5.41±1.23) mmol/L]、HbA1c[(6.16 ±0.87)％]、FINS[(8.72±2.43) mIU/L]、HOMA-IR[(2.27±1.41)、HOMA-IS[(0.0182 ±0.0034)]、동태혈압삼수[24h수축압위(126±13) mmHg,24h서장압위(72±8) mmHg,백천수축압위(132±8)mmHg,백천서장압위(74.4 ±8.3)mmHg,야간수축압위(123.1±8.7) mmHg,야간서장압위(70.5±6.1) mmHg]급생활질량평분[생리공능위(87.2±11.5)분,생리직능위(73.0±14.3)분,총체건강위(78.6±15.5)분,생명활력위(68.4 ±18.8)분,정감직능위(68.7 ±20.4)분,정신건강위(78.6 ±19.4)분]균교입선시급대조조명현개선(P＜0.05),기간차이균구유통계학의의(P＜0.05).결론 재상규약물치료기출상매천보행10000보이상가진일보개선결핍운동적경도고혈압합병2형당뇨병환자당대사급동태혈압삼수,대제고환자생활질량구유중요의의.
Objective To explore the effects of walking exercise on glycometabolism,dynamic blood pressure and the quality of life of patients with both hypertension and type 2 diabetes on the basis of conventional drug treatment.Methods Sixty-two patients with both hypertension and diabetes who could support taking walking exercise of more than 5,000 steps/d were randomly divided into a walking exercise group (32 cases) and a control group (30 cases).Both groups were given conventional drug treatment (including valsartan,acarbose and metformin).Those in the walking exercise group took more than 10,000 steps/d of aerobic exercise while the patients in the control group were just given normal community care.This continued for a period of 3 months.Fasting plasma glucose (FPG),glycated hemoglobin-A1C (HbA1c),fasting insulin (FINS),the homeostasis model of assessment for insulin resistence index (HOMA-IR),the homeostasis model of assessment for insulin sensitivity (HOMA-IS),dynamic blood pressure parameters and quality of life were observed.Results In the walking exercise group,the FPG,HbA1c,FINS,HOMA-IR,HOMA-IS,dynamic blood pressure and quality of life indicators were all significantly different after 3 months of daily walking exercise compared with either baseline or the control group.Conclusion Accompanied by conventional drug therapy,10,000 steps/d of walking exercise can improve the glucose metabolism,dynamic blood pressure and quality of life of patients suffering from mild hypertension and type 2 diabetes.