基于PRECIS-2模型的两种运动干预模式对2型糖尿病干预效果比较研究

A comparative Study on Efficacy of Two Exercise Intervention Models Based on Precis-2 Model for Type 2 Diabetes Mellitus

目的:分析比较同等运动量下不同强度的间歇训练和持续训练对2型糖尿病患者干预效果,并探讨其内在机制,以便为运动处方提供参考数据.方法:将33名2型糖尿病患者随机分成间歇训练组、持续训练组和空白对照组(CON),进行为期12周,每周3次不同强度,能量消耗相同的蹬骑自行车运动.各组在干预前后进行最大摄氧量(VO_(2)max)、体重(BM)、腰臀比(WHR)、身高体重指数(BMI)、空腹血糖(GLU)、糖化血红蛋白(HbA1c)、空腹胰岛素(FIN)、胰岛素敏感性(ISI)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)等测试.结果:间歇训练组患者在12周运动干预前后,BMI(前24.45±2.70,后24.01±2.81,P<0.05)、臀围(前97.09±5.38,后94.82±6.03,P<0.05)显著下降,VO_(2)max显著提升(前33.92±8.37,后38.69±7.11,P<0.05).组间比较表明,间歇训练可以更好地提高2型糖尿病患者的VO_(2)max,并维持患者的肌肉量(前48.37±7.63,后48.49±8.17,P<0.05),提高基础代谢(前1425.18±199.44,后1446.09±217.05,P<0.05);持续训练组患者在12周运动干预后TC指标显著下降(前4.68±1.01,后4.27±0.80,P<0.05),其余指标均无显著变化.经过12周运动干预,2型糖尿病患者的GLU、HbA1c、FIN、ISI指标中,两组运动干预组的改善效果均无显著差异.结论:经过12周的运动干预,间歇训练可以更好地改善2型糖尿病患者的健康体适能,提高患者心肺耐力,但对糖脂代谢等指标的改善效果无显著差异.持续训练仅在总胆固醇的改善效果中优于间歇训练.

Objective To analyze and compare the intervention effects of interval training and continuous training in the different intensities under the same amount of exercise on patients with type 2 diabetes,also to explore its internal mechanism,so as to provide experimental data reference for exercise prescription.Methods 33 patients with type 2 diabetes mellitus were randomly divided into interval training group(HIT),continuous training group(MICT)and blank control group(CON).The exercise intervention group received cycling exercise with the different intensity and same energy consumption 3 times a week for 12 weeks.VO_(2) max,body weight(BM),waist-to-hip ratio(WHR),body mass index(BMI),fasting blood glucose(GLU),glycated hemoglobin(HbA1c),fasting insulin(FIN),insulin sensitivity(ISI),total cholesterol(TC),triglyceride(TG)and low density lipoprotein(LDL-C),and high density lipoprotein(HDL-C)were measured in each group before and after intervention.Results After 12 weeks of exercise intervention,the difference of the HIP group before and after exercise intervention was compared with BMI(24.45±2.70,24.01±2.81,P<0.05),hip circumference(97.09±5.38,94.82±6.03,P<0.05)significantly decreased,cardiopulmonary endurance was significantly increased(33.92±8.37,8.69±7.11,P<0.05).After intervention,intergroup comparisons showed that interval training could better improve VO_(2) max and maintain muscle mass in patients with type 2 diabetes(P<0.05),and improve basal metabolism(P<0.05).In the MICT group,total cholesterol was significantly decreased after 12 weeks of exercise intervention(4.68±1.01,4.27±0.80,P<0.05).There was no significant change in other indexes.Conclusion After 12 weeks of exercise intervention,HIT can better improve the healthy physical fitness and cardiopulmonary endurance of patients with type 2 diabetes mellitus,but there was no significant difference in the improvement effect on glucose and lipid metabolism and other indicators.HIT was superior to MICT only in the improvement of total cholesterol.