摘要
目的 探讨运脾方联合穴位贴敷对2型糖尿病一级亲属中非糖尿病者的胰岛功能及非高密度脂蛋白/高密度脂蛋白(NHDL-C/HDL-C)、载脂蛋白B/载脂蛋白A-1(ApoB/ApoA-1)的影响。方法 该研究前瞻性选取2019年1月—2020年1月河北省中医院内分泌科门诊及住院的2型糖尿病一级亲属中非糖尿病者119例为本次研究对象,采用随机对照的方法分为观察组及对照组。对照组60例患者予以个体化的健康教育,观察组59例患者则在运脾方的基础上加以联合应用穴位贴敷进行治疗,于入组前后分别检测两组患者的血糖及胰岛功能、血压、血脂、血尿酸指标,同时记录体质量、腰围、身体体质量指数(BMI)指数指标,并对NHDL-C/HDL-C、ApoB/ApoA-I指标予以检测分析。结果 干预后两组患者的血糖、C肽以及胰岛素较干预前均有了显著改善,且干预后观察组患者的空腹血糖(FPG)、负荷后1 h血糖(1 hPG)、负荷后2 h血糖(2 hPG)、空腹C肽(FCP)、负荷后1 h C肽(1 h CP)、负荷后2 h C肽(2 h CP)、空腹胰岛素(FIns)、负荷后1 h胰岛素(1 h Ins)及负荷后2 h胰岛素(2 hIns)指标均显著低于对照组(P<0.05);同时,干预后两组患者的胰岛素抵抗指数(HOMA-IR)较干预前也有了显著改善,且干预后观察组患者的HOMA-IR显著低于对照组(P<0.05);干预后两组患者的血脂、血尿酸水平较干预前均有了显著改善,且干预后观察组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)以及血尿酸(UA)水平明显比对照组低,而高密度脂蛋白胆固醇(HDL-C)水平则比对照组高(P<0.05);干预后两组患者的收缩期血压(SBP)、收缩期血压(DBP)、BMI以及腰臀比指数(WHR)水平较干预前有了明显改善,且干预后观察组患者的SBP、DBP、BMI以及WHR水平显著优于对照组(P<0.05);干预后两组患者NHDL-C/HDL-C、ApoB/ApoA-1水平较干预前均显著降低(P<0.05),且干预后观察组NHDL-C/HDL-C、ApoB/ApoA-1水平均显著低于对照组(P<0.05)。结论 通过运脾方联合穴位贴敷治疗2型糖尿病一级亲属中非糖尿病者,可有效降低患者的血糖、血脂及血尿酸水平,改善胰岛功能和NHDL-C/HDL-C、ApoB/ApoA-1水平,进而有效预防糖尿病的发生,值得推广。
Objective To explore the effect of Yunpi Recipe(运脾方)combined with acupoint application on islet function,non high-density lipoprotein/high-density lipoprotein(NHDL-C/HDL-C)and apolipoprotein B/apolipoprotein A-1(ApoB/ApoA-1)in non-diabetic first-degree relatives of type 2 diabetes.Method:This study prospectively selected 119 non-diabetic patients among the first-degree relatives of type 2 diabetes who were outpatients and hospitalized in the Department of Endocrinology of the hospital from January 2019 to January 2020.They were divided into the observation group and the control group by using a randomized control method.Sixty patients in the control group were given individualized health education,and 59 patients in the observation group were treated with acupoint application on the basis of Yunpi Recipe.Before and after enrollment,the blood glucose,islet function,blood pressure,blood lipid,and blood uric acid indexes of the two groups were measured,and the body mass,waist circumference,and body mass index(BMI)were recorded,and NHDL-C/HDL-C and ApoB/ApoA-I were detected and analyzed.Results After the intervention,the blood glucose,C-peptide and insulin of the patients in the two groups were significantly improved compared with those before the intervention.Fasting blood glucose(FPG),blood glucose 1 h after load(1 hPG),blood glucose 2 h after load(2 hPG),fasting C-peptide(FCP),C-peptide 1 h after load(1 h CP),C-peptide 2 h after load(2 h CP),fasting insulin(FIns),insulin 1 h after load(1 h Ins)and insulin insulin 2 h after load(2 h Ins)were significantly lower than those in the control group(P<0.05).At the same time,the insulin resistance index(HOMA-IR)of the patients in the two groups after the intervention was significantly improved compared with that before the intervention,and the HOMA-IR of the patients in the observation group was significantly lower than that in the control group after the intervention(P<0.05).After intervention,the levels of blood lipid and blood uric acid in the two groups were significantly improved compared with those before the intervention.After intervention,the levels of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and blood uric acid(UA)in the observation group were significantly lower than those in the control group,while the levels of high-density lipoprotein cholesterol(HDL-C)were higher than those in the control group(P<0.05).After intervention,the levels of systolic blood pressure(SBP),systolic blood pressure(DBP),BMI and waist-hip ratio index(WHR)in the two groups were significantly improved compared with those before intervention,and after intervention,the levels of SBP,DBP,BMI and WHR in the observation group were significantly higher than those in the control group(P<0.05).After intervention,the levels of NHDL-C/HDL-C and ApoB/ApoA-1 in the two groups were significantly lower than those before intervention(P<0.05),and after intervention,the levels of NHDL-C/HDL-C and ApoB/ApoA-1 in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Treating non-diabetics among first-degree relatives of type 2 diabetes by Yunpi Recipe combined with acupoint application can effectively reduce the patients′blood sugar,blood lipid and blood uric acid levels,and improve the islet function and NHDL-C/HDL-C,ApoB/ApoA-1 level,and effectively prevent the occurrence of diabetes,it is worthy of promotion.
作者
武洁
张庚良
王敬
王英虎
WU Jie;ZHANG Gengliang;WANG Jing;WANGYinghu(Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050013,Hebei,China)
出处
《辽宁中医杂志》
CAS
2022年第12期121-125,共5页
Liaoning Journal of Traditional Chinese Medicine
基金
河北省中医药管理局项目(2021018)。
