高强度间歇有氧训练与持续中等强度有氧训练对2型糖尿病患者的疗效观察

Efficacy of high intensity interval aerobic training and continuous moderate intensity aerobic training in patients with type 2 diabetes mellitus

目的:本研究通过在心肺运动试验指导下研究高强度间歇有氧训练(HIIT)对2型糖尿病患者身体质量指数(BMI)、生化指标、心肺功能及生活质量的影响。方法:本研究招募2型糖尿病患者共90例,随机分为3组:HIIT组、持续中强度有氧训练(CME)组及对照组各30例。对照组给予常规糖尿病饮食、运动宣教及规范药物治疗;HIIT组在对照组基础上进行每周5d,为期12周的高强度间歇有氧训练;CME组在对照组基础上进行每周5d,持续12周的持续中强度有氧训练。治疗前后评估患者BMI、生化指标、心肺功能、生活质量等指标。结果:治疗前,3组患者BMI、生化指标、心肺耐力、生活质量指标均无显著性差异。与治疗前相比,治疗后对照组各项指标无统计学差异;治疗后12周HIIT组除甘油三酯(TG)、CME组除总胆固醇(TC)外,余各项指标均较治疗前显著改善(P<0.05)。治疗12周后,HIIT组BMI、空腹血糖(FBG)、糖化血红蛋白(HbA1C)、空腹血清胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-IR)、TG、峰值摄氧量(VO_(2)peak)、无氧阈(AT)、最大代谢当量(METs)、糖尿病生活质量特异性量表(DSQL)总分、生理维度、心理/精神维度方面等指标及CME组HOMA-IR、VO_(2)peak、DSQL总分、生理维度、心理/精神维度方面指标均明显优于对照组(均P<0.05),且HIIT组HbA1c较CME组明显改善(P<0.05)。结论:高强度间歇有氧训练能改善2型糖尿病患者血糖水平、胰岛素抵抗、心肺功能及生活质量,且在心肺运动试验的指导下,进行运动强度个体化的有氧训练,其安全性可以得到进一步保证,值得在临床治疗中推广。

Objective:To study the effects of high-intensity interval aerobic training(HIIT)on body mass index(BMI),biochemical indexes,cardiopulmonary function and quality of life in type 2 diabetic patients under the guidance of cardiopulmonary exercise test(CME).Methods:A total of 90 patients with type 2 diabetes were randomly divided into three groups:HIIT group,CME group and control group.All enrolled patients were evaluated at baseline prior to the start of the trial.Control group received routine diabetic diet,exercise education and standard drug treatment;HIIT group was given HIIT,5 days a week for 12 weeks,based on the control group;CME group was subjected go continuous moderate-intensity aerobic training,5 days a week for 12 weeks,in addition to the control group.BMI,biochemical indexes,cardiopulmonary function,quality of life and other indicators of the patients were evaluated again after the trial.Results:Before treatment,there were no significant differences in BMI,biochemical indexes,cardiopulmonary endurance and quality of life indexes among 3 groups.There were no significant differences in the indicators in the control group before and after treatment.After 12 weeks of treatment,all other indexes in HIIT group except TG and CME group except TC were significantly improved compared with those before treatment(all P<0.05).After 12 weeks of treatment,BMI,FBG,HbA1c,FINS,HOMA-IR,TG,VO_(2)peak,AT,METS,total score of DSQL,physiological dimension,psychological dimension and mental dimension in HIIT group were significantly better than those in the control group(all P<0.05).HbA1c in HIIT group was significantly improved compared with those in CME group(P<0.05).Conclusion:HIIT can improve the blood glucose level,insulin resistance,cardiopulmonary function and quality of life in diabetic patients,and the safety of individual aero-bic training of exercise intensity can be further guaranteed under the guidance of CME,and it is worthy of promotion in clinical treatment.