运脾方对2型糖尿病患者一级亲属代谢影响的研究

Effect of Yunpi Formula(运脾方)on Metabolism of First-degree Relatives of Patients with Type 2 Diabetes Mellitus

目的 探究运脾方对2型糖尿病患者一级亲属代谢影响。方法 研究合计纳入河北省中医院内分泌科门诊及住院收治的119例2型糖尿病患者一级亲属(2019年1年-2020年1月),均为非糖尿病,并将受试者分成观察组与对照组(随机数字表法),对照组60例受试者均行个体化健康教育,观察组59例受试者均行个体化的健康教育+运脾方治疗,时间3个月,比较两组受试者治疗前后腰围及体质量指数(Body mass index, BMI)指标变化及空腹血尿酸指标变化、血压变化、糖代谢指标及脂代谢指标变化、治疗前后生活质量(the short-form 36 item health survey questionnaire, SF-36)指标变化及受试者对干预满意率情况、不良反应情况。随访2年,观察组脱落3例,剩余56例,对照组脱落2例,剩余58例,比较两组受试者糖尿病发生情况、冠心病及高血压、脑卒中等心脑血管疾病发生率。结果 两组受试者治疗前腰围及BMI指标、空腹血尿酸指标、收缩压及舒张压、空腹血糖(Fasting blood glucose, FBG)及空腹胰岛素(Fasting insulin, FINS)、胰岛素抵抗指数(Insulin resistance index, HOMA-IR)等血糖代谢指标、总胆固醇(Total cholesterol, TC)、甘油三酯(Triglyceride, TG)、高密度脂蛋白胆固醇(High density liptein cholesterol, HDL-C)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol, LDL-C)等脂代谢指标、SF-36指标等比较,P>0.05,治疗后各组受试者腰围及BMI指标、空腹血尿酸指标、收缩压及舒张压、FBG、FINS、HOMA-IR、TC、TG、HDL-C、LDL-C、SF-36评分等指标均改善,观察组受试者治疗后腰围及BMI指标、空腹血尿酸指标、收缩压及舒张压、FBG、FINS、HOMA-IR、TC、TG、HDL-C、LDL-C、SF-36评分等指标情况均优于对照组受试者;观察组受试者满意率(96.61%,57/59)高于对照组(83.33%,50/60)(P<0.05);两组均未出现不良反应(P>0.05);2年后,观察组受试者糖尿病发生率(5.36%,3/56)低于对照组(18.97%,12/58),脑卒中及冠心病、高血压病等其他心脑血管疾病发生率(5.36%,3/56)低于对照组(20.69%,12/58)(P<0.05)。结论 运脾方对2型糖尿病患者一级亲属代谢具有积极影响,可较好改善2型糖尿病患者一级亲属糖代谢、脂代谢等指标,受试者生活质量改善,十分认可,且还可预防糖尿病、高血压病、冠心病等心脑血管疾病,值得深入研究。

Objective To explore the effect of Yunpi Formula(运脾方)on the metabolism of first-degree relatives of patients with type 2 diabetes.Methods A total of 119 first-degree relatives of patients with type 2 diabetes(from January 2019 to January 2020)admitted to the Department of Endocrinology,Hebei Hospital of Traditional Chinese Medicine were included in this study.All of them were non-diabetic,and the subjects were divided into the observation group and the control group(random number table method).59 subjects in the observation group were treated with individualized health education+Yunpi Formula for 3 months.The waist circumference,body mass index(BMI),fasting blood uric acid,blood pressure,glucose metabolism and lipid metabolism of the two groups before and after treatment,the quality of life before and after treatment(the short-form 36 Item Health Survey Questionnaire,SF-36)index changes,the satisfaction rate with this intervention,and adverse reactions were compared.After 2 years of follow-up,3 cases fell off in the observation group and 56 cases remained,while 2 cases fell off in the control group and 58 cases remained.The incidence of diabetes,coronary heart disease,hypertension,stroke and other cardiovascular and cerebrovascular diseases were compared between the two groups.Results Before treatment,the waist circumference,BMI,fasting blood uric acid,systolic blood pressure and diastolic blood pressure,fasting blood glucose(FBG)and fasting insulin(FINS),insulin resistance index(HOMA-IR)and other indicators of blood glucose metabolism,total cholesterol(TC),triglyceride(TG),high density liptein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)of two groups were not significant(P<0.05).After treatment,waist circumference,BMI,fasting blood uric acid,systolic blood pressure,diastolic blood pressure,FBG,FINS,HOMA-IR,TC,TG,HDL-C,LDL-C,SF-36 score and other indicators were improved in both groups.And the waist circumference,BMI,fasting blood uric acid index,systolic blood pressure and diastolic blood pressure,FBG,FINS,HOMA-IR,TC,TG,HDL-C,LDL-C and SF-36 scores of the observation group were better than those of the control group.The satisfaction rate of the observation group(96.61%,57/59)was higher than that of the control group(83.33%,50/60)(P<0.05).There were no adverse reactions in the two groups(P>0.05).Two years later,the incidence of diabetes in the observation group(5.36%,3/56)was lower than that in the control group(18.97%,12/58),and the incidence of stroke,coronary heart disease,hypertension and other cardiovascular and cerebrovascular diseases in the observation group(5.36%,3/56)was lower than that in the control group(20.69%,12/58)(P<0.05).Conclusion Yunpi Formula has a positive effect on the metabolism of first-degree relatives of patients with type 2 diabetes.It can better improve the glucose metabolism,lipid metabolism and other indicators of first-degree relatives of patients with type 2 diabetes and improve the quality of life of subjects,which is highly recognized and can also prevent cardiovascular and cerebrovascular diseases such as diabetes,hypertension and coronary heart disease and is worthy of further study.