有氧运动联合抗阻运动对糖尿病周围神经病变患者的影响

Effects of aerobic exercise combined with resistance exercise on patients with diabetic peripheral neuropathy

目的:探讨有氧运动联合抗阻运动对糖尿病周围神经病变(DPN)患者的影响。方法:选择2018年6月至2019年10月在南通大学第六附属医院就诊的DPN患者60例,将其按随机数字表法分为对照组、有氧运动组和联合运动组各20例。三组患者均接受常规药物治疗及饮食指导。对照组不增加任何运动干预,有氧运动组采用中等强度持续功率自行车训练,40 min/次,1次/d,3次/周;联合运动组在有氧运动基础上增加弹力带抗阻运动,40 min/次,1次/d,3次/周。12周后进行疗效评价。观察指标包括空腹血糖、糖化血红蛋白(HbA1c)、神经传导速度及Pro-Kin 254平衡仪中睁眼、闭眼平衡功能测试。结果:运动干预前,三组患者上述指标差异均无统计学意义 (均 P>0.05 )。运动干预后,有氧运动组空腹血糖、HbA1c、腓总神经运动神经传导速度、腓总神经感觉神经传导速度、Pro-Kin 254平衡仪闭眼测试中运动轨迹长度和椭圆面积均显著优于对照组[(6.26±0.28)比(6.76±0.68)mmol/L、(5.75±0.42)%比(6.48±0.37)%、(45.36±8.78)比(42.16±6.78)m/s、(38.75±8.14)比(35.45±8.34)m/s、(513±39)比(613±71)mm、(678±58)比(1024±98)mm 2](均 P<0.05);联合运动组上述指标[(6.03±0.36)mmol/L、(5.27±0.35)%、(49.51±9.76)m/s、(42.87±7.18)m/s、(425±38)mm、(535±47)mm 2]均显著优于其他两组,且Pro-Kin 254平衡仪睁眼测试中运动轨迹长度和椭圆面积也均显著优于其他两组[(316±21)比(395±18)、(436±28)mm和(689±33)比(782±30)、(824±70)mm 2](均 P<0.05)。 结论:有氧运动联合抗阻运动较单纯有氧运动能够更好地改善DPN患者血糖及HbA1c水平,同时增加神经传导速率,改善静态平衡能力。

Objective To explore the effects of aerobic exercise combined with resistance exercise on patients with diabetic peripheral neuropathy(DPN).Methods A total of 60 patients with DPN in Sixth Affiliated Hospital of Nantong University from June 2018 to October 2019 were selected,and randomly divided into control group(20 cases),aerobic exercise group(20 cases)and combined training group(20 cases).Three groups all received the routine medication management and dietary guide.The control group had no other intervention.The aerobic exercise group received moderate intensity cycle ergometer,40 min/time,once a day,three times a week.In addition to the moderate intensity aerobic exercise,patients in the combined training group conducted resistance exercise with elastic belt,40 min/time,once a day,three times a week.The curative effect was evaluated after 12 weeks,which included fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),nerve conduction velocity and static balance function of eye-opened and eye-closed condition in Pro-Kin 254 balance assessment equipment.Results Before exercise intervention,there were no significant differences in any measurements among the three groups(all P>0.05).After exercise intervention,the FBG,HbA1c,motor nerve conduction velocity of common peroneal nerve,sensory nerve conduction velocity of common peroneal nerve,sway length and area in the eye closed test of Pro-Kin254 balance assessment in the aerobic exercise group were significantly better than those in the control group[(6.26±0.28)vs.(6.76±0.68)mmol/L,(5.75±0.42)%vs.(6.48±0.37)%,(45.36±8.78)vs.(42.16±6.78)m/s,(38.75±8.14)vs.(35.45±8.34)m/s,(513±39)vs.(613±71)mm,(678±58)vs.(1024±98)mm2](all P<0.05);the above indexes of the combined training group[(6.03±0.36)mmol/L,(5.27±0.35)%,(49.51±9.76)m/s,(42.87±7.18)m/s,(425±38)mm,(535±47)mm2]were significantly better than those in the other two groups,the sway length and area in the eye open test of Pro-Kin254 balance assessment were also significantly superior to those in the other two groups[(316±21)vs.(395±18),(436±28)mm and(689±33)vs.(782±30),(824±70)mm2](all P<0.05).Conclusion Aerobic exercise combined with resistance exercise can better improve the levels of blood glucose and HbA1c,increase nerve conduction rate and improve static balance ability compared with simple aerobic exercise in patients with DPN.