饮食干预对糖尿病合并肺结核患者临床疗效的影响

Clinical effect influence of dietary intervention on patients with diabetes mellitus combining with pulmonary tuberculosis

目的探讨饮食干预对糖尿病合并肺结核患者临床疗效的影响。方法将72例糖尿病合并肺结核患者随机分为干预组和对照组。调查患者原有饮食习惯,干预组制订个性化饮食治疗方案,对照组采用传统的健康教育进行饮食指导,比较两组治疗前后空腹和餐后2 h血糖的控制情况、干预前后胸腔积液吸收状况及病灶变化、干预前与2个月时的痰阳性例数。结果干预组空腹血糖及餐后2 h血糖显著低于对照组(P<0.001),胸腔积液显著减少或消失症状及痰菌转阴率显著高于对照组,差异有统计学意义(χ2=1.797,P=0.002),两组的结核病灶显著缩小或闭合所占比例比较,差异无统计学意义(χ2=1.532,P=0.216),2个月时痰菌转阴率显著高于对照组,差异有统计学意义(χ2=4.600,P=0.032)。结论饮食干预对糖尿病的控制和肺结核的康复有良好疗效。

Objective To explore the clinical effect influence of dietary intervention on promotion of patients with dia-betes mellitus and pulmonary tuberculosis. Methods 72 patients with diabetes mellitus and pulmonary tuberculosis were randomly divided into intervention group and control group.The original dietary habits in all participants were in-quired.In the intervention group,the individualized dietary therapeutic regimen was established,while in the control group,patient’s diet was guided by conventional health education.The situations of blood glucose control before and after treatment,in fasting,and 2 h after a meal,absorption of pleural effusion before and after intervention,focus change and number of positive cases in sputum before intervention and 2 months after intervention were compared. Results The fasting blood glucose and 2 h postprandial blood glucose in the intervention group were both obviously lower than that in the control group,with statistical difference （P〈0.001）.Obvious decrease in pleural effusion or symptom disappear-ance,and negative conversion ratio of bacterium from sputum were both remarkably higher than those in the control group,with statistical difference （χ2=1.797,P=0.002）.there was no statistical difference in proportion of pulmonary tuber-culosis focus greatly shrinking or closing between two groups （χ2=1.532,P=0.216）.The negative conversion ratio of bac-terium from sputum in 2 months was obviously higher than that in the control group（χ2=4.600,P=0.032）. Conclusion Di-etary intervention obtains favorable effects on the control of diabetes mellitus and rehabilitation of pulmonary tuberculosis.