应用生活质量标准评估中西医结合疗法治疗糖尿病的效应

Effect of integrated Chinese and western medicine in treating diabetes mellitus with the quality of life criterion

目的:探讨用生活质量来评价糖尿病临床疗效的必要性及中西医结合疗法改善糖尿病患者生活质量的优越性。方法:检索和参考相关文献,结合祖国医学理论、现代医学的诊疗特点及中西医结合医学的优势等对资料进行分析和归纳。结果:由于糖尿病是一种心身性疾病,其病情的严重程度和治疗效果与患者的心理和情绪密切相关且相互影响。同时由于糖尿病治疗过程的复杂性、治疗效果的不确切性、极易发生药物副作用、及糖尿病的慢性并发症对患者的身体健康危害严重等原因,以现有的以实验室指标为主要标准的评价体系不能全面地评价治疗方法的效果、不能正确指导临床治疗的方向、不能表达健康的全部内涵。并且由于中医学及西医学各有优缺点,如在诊断学方面,西医偏重于病因和生化,诊断精准,中医偏重于病机和证候、比较模糊;在病理学方面,西医对局部病变有细致而深入的研究,中医对整体的变化及趋势有较全面的认识;在治疗学方面,西医对代谢紊乱有较强的针对性,中医则从整体观念出发,强调阴平阳秘、预防传变的理论和思路,关注的是整个人体的健康发展等。在理论上运用中西医结合疗法提高糖尿病患者的生活质量的疗效,一定比单纯运用中医或单纯运用西医疗法要显著。结论:用生活质量来评价糖尿病的临床疗效、优化治疗方案及评估糖尿病患者的健康状况十分必要。运用中西医结合疗法提高糖尿病患者的生活质量具有优越性。

AIM： To investigate the necessity of quality of life on evaluating clinical effect of diabetes mellitus （DM） and the superiority of integrated Chinese and western medicine on improving the quality of life. METHODS： To sort and review related literatures, and then to analyze and summarize the data through connecting the medical theory of traditional Chinese medicine （TCM）, the characteristics of modem medicine and the superiority of integrated Chinese and western medicine. RESULTS： The high incidence, high fatality rate, the high disability, the high medical cost and no radically effective treatment were the characteris： ties of diabetes mellitus. DM is partly considered as a spirit-body disease, so its degree of severity and therapeutic efficacy were correlated closely with emotion and influence each other. Because of the complicate process of treating DM, the indefinite therapeutic efficacy, side effect of medicine, the harmful chronic complication to DM patients, the system of evaluation based on laboratory variables could neither evaluate the whole therapeutic efficacy, nor guide the clinical treatment, nor express the whole meaning of healS, and nor reflect the active mood of patients to living not only longer but also better. TCM and western medicine had each advantages and disad- vantages. In diagnosis, western medicine particularly focused on pathogene- sis and tests which were accurate, while TCM on symptom and pathogenesis with unclear diagnosis. In pathology, western medicine had a deep research on parts of pathological changes; otherwise, TCM realized the whole changes and tendency. In therapeutics, western medicine aimed at the metabolic disorder, but TCM stresses that the ＂yin is even and well while yang is firm＂ and ＂preventing the progress of a disease＂ was depending on the concept of the organism as a whole and it paid attention to the individual somatopsychic healthiness of a person. In theory, improving the quality of life of DM patients with integrated TCM and western medicine was better than that with only western medicine or with TCM simply. CONCLUSION： It is necessary to evaluate the curative effect, optimize the prescription and estimate the health with quality of life. Integrated TCM and western medicine is helpful to improving the quality of life of DM patients.