康复运动与老年2型糖尿病胃排空关系

Effects of rehabilitation exercise and prescription training on gastric emptying in elderly patients with type 2 diabetes

目的观察康复运动对老年2型糖尿病胃排空的影响。方法将华东医院80例老年糖尿病患者随机分成4组，（康复运动＋口服促动力药组；康复运动组；口服促动力药组及对照组。在人选时及完成2年随访后均给予^99mITc标记的试餐，各测定一次固相胃排空时间。每6个月对患者空腹及餐后血糖进行一次评价。结果（1）第1、2、3组经随访两年后固相GET1／2胃排空时间与随访前相比降低，差异有统计学意义（P〈0．05）。第4组经随访两年后固相GET1／2胃排空时间与试验前相比，差异无统计学意义（P〉0．05）。（2）各组患者空腹血糖均比治疗前有下降，第2组治疗2年时空腹血糖值较治疗前差异有统计学意义（P〈0．05）。第1组经治疗18个月及2年时空腹血糖值较治疗前差异有统计学意义（P〈0．05）。（3）各组患者餐后2h血糖均比治疗前有下降，第2、3组治疗2年后餐后2h血糖值较治疗前差异有统计学意义（P〈0．05）。第1组治疗18个月及2年时餐后2h血糖值较治疗前差异有统计学意义（P〈0．05）。对照前治疗前后差异无统计学意义。结论胃排空与血糖控制互相影响，初步明确合适的康复运动联合促动力药能改善部分老年糖尿病患者胃排空，有利于血糖控制，减少并发症的发生。

Objective To observe the effects of rehabilitation exercise and prescription training on gastric emptying in elderly patients with type 2 diabetes. Methods Eighty elderly patients with type 2 diabetes were equally randomized to rehabilitation exercise＋Mosapride group, rehabilitation exercise group, Mosapride group, and control group. Gastric half emptying time （GET1/2） of solid meals radiolabelled with ^99mTc by nucleology was monitored before and after the study. Blood glucose was measured at a 6-month interval during a 2-year follow-up period. Results GET1/2 improved significantly in rehabilitation group, Mosapride group and rehabilitation＋Mosapride group after 2-year treatment （P〈0.05）. Fast blood glucose in reha- bilitation group, and rehabilitation＋Mosapride group decreased significantly. Post prandial blood glucose in rehabilitation group, Mosapride group and rehabilitation＋Mosapride group also decreased significantly. The Results of control group were not decreased significantly. Conclusion Gastric emptying and blood glucose control affect each other. Appropriate rehabilitation exercise in combination with use of prokinetic agents helps improve gastric emptying and control blood glucose in elderly patients with type 2 diabetes.