裸燕麦对2型糖尿病合并高血压患者血压的影响研究

Effect of Naked Oat on Blood Pressure of Patients With Type-2 Diabetes Mellitus Associated With Hypertension

背景医学营养疗法对2型糖尿病合并高血压患者的疾病管理具有重要作用,但具体营养干预措施尚不统一。目的在结构化膳食控制结合健康教育的基础上,探讨全胚芽裸燕麦(NOG)对2型糖尿病合并高血压患者血压的影响。方法采用自身前后对照和多组平行对照的方法,以电话、广告途径在全国范围内招募符合纳入标准的受试者59例。采用随机数字表法将其分为A组(20例)、B组(n=20)和C组(n=19),其中A组给予结构化膳食控制及健康教育干预,B组和C组在A组的基础上分别给予50 g、100 g NOG干预,于每日早、晚两餐采用NOG粥代替能量相同的其他主食,干预28 d。干预前采集基线指标,并根据WHO标准,将所有受试者分为正常体质量〔18.5kg/m2<体质指数(BMI)<25.0 kg/m2〕、超重(25.0 kg/m2≤BMI<30.0 kg/m2)、肥胖(BMI≥30.0 kg/m2)。于干预前及干预第28天测量所有受试者的收缩压(SBP)及舒张压(DBP)。结果 3组受试者性别、年龄、病程、空腹血糖(FBG)、餐后2 h血糖(PBG)、糖化血红蛋白、BMI比较,差异均无统计学意义(P>0.05)。自身前后对照:3组受试者干预第28天SBP、DBP均分别低于同组干预前,差异有统计学意义(P<0.05)。组间比较:3组受试者干预前后SBP变化值比较,差异有统计学意义(F=4.12,P=0.02);DBP变化值比较,差异无统计学意义(F=0.24,P=0.79)。双因素方差分析:3组受试者SBP干预前后变化值组间与BMI间无交互作用(P>0.05),干预措施对SBP的影响有统计学意义(P<0.05),BMI对SBP的影响无统计学意义(P>0.05);3组受试者DBP干预前后变化值组间与BMI间无交互作用(P>0.05),干预措施对DBP的影响无统计学意义(P>0.05),BMI对DBP的影响无统计学意义(P>0.05)。结论裸燕麦摄入及结构化膳食控制对2型糖尿病合并高血压患者均具有降血压效果,两者结合优于单纯的结构化膳食控制,且对SBP降低效果更明显。裸燕麦的降血压效果不受BMI的影响。

Background Medical Nutrition Therapy（ MNT） plays a significant role in the disease management of patients with type 2 diabetes mellitus（ T2DM） associated with hypertension; but specific nutritional interventions have not been unified yet. Objective To observe the effect of naked oat with whole germ（ NOG） on blood pressure of T2 DM patients associated with hypertension on the basis of structured diet control combined with health education. Methods A total of 59 subjects who met the inclusion criteria were enrolled by phone calls and advertisement throughout the country using self pre and post control and multigroup parallel control. The subjects were divided into group A（ n = 20）,group B（ n = 20） and group C（ n = 19） by random number table; the subjects of group A were given structured diet control and health education; the subjects of group B and C were given 50 g and 100 g NOG respectively on the basis of structured diet control and health education,and were given NOG porridge replacing other staple food with equal energy at breakfast and supper for 28 days. Before intervention,baseline indicators were collected and all the subjects were divided into the normal body mass（ 18. 5 kg / m2 〈BMI〈 25. 0 kg /m2）,overweight（ 25. 0 kg/m2≤BMI 30. 0 kg/m2） and obesity（ BMI ≥30. 0 kg/m2） according to WHO criteria. The systolic blood pressure and diastolic blood pressure of all the subjects were measured before intervention and on the 28 th day of intervention. Results The three groups were not significantly different in gender,age,course of disease, fasting blood-glucose（ FBG）,postprandial blood glucose 2 h（ PBG）,glycosylated hemoglobin and BMI（ P 〉0. 05）. The three groups had lower SBP and DBP on the 28 th day of intervention than those before intervention（ P 〈0. 05）,and the change values of SBP were significantly different among the three groups（ F = 4. 12, P = 0. 02）. While the change values of DBP were not significantly different among the three groups（ F = 0. 24, P = 0. 79）. The change values of SBP of the three groups after intervention had no interaction effect with different BMI values（ P 〉0. 05）; the effect of intervention on SBP was significant（ P 〉0. 05）; the effect of BMI on SBP was not significant（ P 〉0. 05）. The change values of DBP of the three groups after intervention had no interaction effect with different BMI values（ P 〉0. 05）; the effect of intervention on DBP was not significant（ P 〉0. 05）; the effect of BMI on DBP was not significant（ P 〉0. 05）. Conclusion NOG intake and structured diet control can reduce blood press of patients with type-2 diabetes mellitus associated with hypertension and the combination of the two factors is better than structured diet control alone and can reduce the systolic pressure more obviously. The antihypertensive effect of NOG is not interfered by BMI.