太极拳运动对老年2型糖尿病患者的干预作用

Tai Chi therapy for elderly patients with type 2 diabetes mellitus: a randomized controlled trial

目的 评价太极拳结合西医常规疗法治疗老年 2 型糖尿病的疗效.方法 将符合纳入标准的108例患者按照随机数字表法分为2组,每组54例.在常规治疗基础上,对照组增加每周3次的规律步行,研究组增加每周3次的太极拳练习.2组均治疗12周.分别于治疗前后进行中医症状评分,分别采用己糖激酶法和HPLC法检测FPG、HbA1c,采用糖尿病生活质量特异性表(Diabetes Mellitus Specific Quality of Life Scale, DSQL)评价生活质量,采用中文版慢病管理自我效能量表(Self-Efficacy for Managing Chronic Disease 6-Item Scale, SES6G)评估患者对疾病管理的自我效能,采用老年抑郁量表(Geriatric Depression Scale, GDS)评价患者的抑郁程度.结果 治疗后,研究组中医症状评分[(1.79±1.21)分比(2.86± 1.66)分,t=-3.401]、DSQL评分[(50.40±10.88)分比(56.00±10.85)分,t=-2.156]、GDS评分[(5.63±0.71)分比(6.08±0.91)分,t=-2.515]均低于对照组(P<0.05),SES6G评分[(7.54±0.59)分比(6.89±0.39)分, t=-5.987]高于对照组(P<0.01);研究组治疗后FPG差值[(-0.97±1.54)mmol/L比(-0.28±1.74)mmol/L, t=-2.092]高于对照组(P<0.05).结论 太极拳结合西医常规疗法可改善老年 2 型糖尿病患者的临床症状和负面情绪,增强患者疾病管理能力,有效调控血糖并提高生活质量.

Objective To observe the effect of Tai Chi combined with conventional western medicine therapy for elderly patients with type2 diabetes mellitus. Methods According to randomized controlled design, 108 patients were divided into two groups ,with 54 in each group. Patients in control group were treated with conventional western medicine therapy and regular walk (three times per week), while the patients in the observation group were treated with conventional western medicine therapy and Tai Chi (three times per week), both groups were treated for 12 weeks. Before and after treatments, diabetes symptoms scale was used to assess disease conditions, FPG and HbA1c were detected separately by methods of HK (hexokinase) and High Performance Liquid Chromatography (HPLC), Diabetes mellitus Specific Quality of Life scale (DSQL) were used to assess the quality of life, Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6G) was used to assess patients’ self-management ability, and Geriatric Depression Scale was used to assess patients' depression emotions. Results After treatments, the clinical symptoms scores (1.79 ± 1.21 vs. 2.86 ± 1.66, t=-3.401), the DSQL scores (50.40 ± 10.88 vs. 56.00 ± 10.85, t=-2.156), the GDS scores (5.63 ± 0.71 vs. 6.08 ±0.91, t=-2.515) of observation group were significantly lower than that of control group (P<0.01 or P<0.05), and the SES6G scores (7.54 ± 0.59 vs. 6.89 ± 0.39, t=-5.987) of observation group were significantly higher than that of control group (P<0.01);after treatments, the D-value of FPG (-0.97 ± 1.54 mmol/L vs.-0.28 ± 1.74 mmol/L, t=-2.092) was significantly higher than that of control group (P<0.05). Conclusions The Tai Chi combined with conventional western medicine therapy could alleviate clinical symptoms and negative emotions, improve disease management and quality of life, regulate blood glucose of elderly patients with type 2 diabetes mellitus.