中医辨证施食在2型糖尿病管理模式中的应用
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摘要
目的:强化中医辨证施食,探索2型糖尿病(T2DM)慢病管理的新模式。方法:将T2DM患者90例辨证分为阴虚热盛证14例、气阴两虚证45例、阴阳两虚证4例、血瘀气滞证27例,采取健康讲座、糖友会等形式进行交流,在中医辨证施食的基础上予以个性化饮食指导,观察辨证施食管理前后患者血糖、血脂、糖化血红蛋白等代谢指标与BMI、腰围、臀围变化情况及中医证候积分变化情况。结果:除阴阳两虚证外,其余三类中医证候积分均较管理前减少,差异有统计学意义(P<0.05);患者血糖、血脂、糖化血红蛋白等代谢指标及BMI、腰围、臀围较管理前下降,差异有统计学意义(P<0.05)。结论:中医辨证施食的饮食管理可有效帮助患者控制血糖,改善糖、脂代谢,控制体质量,缓解阴虚热盛证、气阴两虚证及血瘀气滞证患者症状。
Objective: To explore the new mode for chronic disease management of type two diabetes mellitus(T2 DM) by strengthening syndrome differentiation and diet. Methods: Ninety patients were differentiated and classified into 14 cases of Yin-deficiency excessive-heat pattern, 45 cases of Qi-Yin dual deficiency pattern, four cases of Yin-Yang dual deficiency pattern and 27 cases of blood-stasis Qi-stagnation pattern, they communicated by health talks, DM patients meeting and others, they were given individualized diet based on syndrome differentiation and diet,the changes of TCM syndrome scores, the changes of BMI, waistline, hipline, and the metabolic indexes including blood glucose, blood lipid, glycosylated hemoglobin and others were observed before and after the management.Results: Except Yin-Yang dual-deficiency pattern, the scores of TCM syndrome scales of the other three syndromes reduced compared with before management, and the difference had statistical meaning(P <0.05); the metabolic indexes including blood glucose, blood lipid, glycosylated hemoglobin and others, BMI, waistline and hipline lowered compared with before management, and the difference had statistical meaning(P<0.05). Conclusion: Syndrome differentiation and diet management could effectively help the patients control blood glucose, glucose and lipid metabolism, body weight, relieve the symptoms of the patients of Yin-deficiency excessive-heat pattern, Qi-Yin dual deficiency pattern and blood-stasis Qi-stagnation pattern.
Objective: To explore the new mode for chronic disease management of type two diabetes mellitus(T2 DM) by strengthening syndrome differentiation and diet. Methods: Ninety patients were differentiated and classified into 14 cases of Yin-deficiency excessive-heat pattern, 45 cases of Qi-Yin dual deficiency pattern, four cases of Yin-Yang dual deficiency pattern and 27 cases of blood-stasis Qi-stagnation pattern, they communicated by health talks, DM patients meeting and others, they were given individualized diet based on syndrome differentiation and diet,the changes of TCM syndrome scores, the changes of BMI, waistline, hipline, and the metabolic indexes including blood glucose, blood lipid, glycosylated hemoglobin and others were observed before and after the management.Results: Except Yin-Yang dual-deficiency pattern, the scores of TCM syndrome scales of the other three syndromes reduced compared with before management, and the difference had statistical meaning(P <0.05); the metabolic indexes including blood glucose, blood lipid, glycosylated hemoglobin and others, BMI, waistline and hipline lowered compared with before management, and the difference had statistical meaning(P<0.05). Conclusion: Syndrome differentiation and diet management could effectively help the patients control blood glucose, glucose and lipid metabolism, body weight, relieve the symptoms of the patients of Yin-deficiency excessive-heat pattern, Qi-Yin dual deficiency pattern and blood-stasis Qi-stagnation pattern.
引文
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[15]董杰.社区干预对高血压患者的影响[J].中外医疗,2008,27(21):159-160.
[2]关北芳,姚崇华,赵冬.我国多省市心血管病趋势及决定因素的人群监测(中国MONICA方案)Ⅱ.人群危险因素监测结果[J].中华心血管病杂志,1997,25(4):255-259.
[3]叶任高,陆再英.内科学[M].6版.北京:人民出版社,2004:787.
[4]孙建琴,沈秀华,陈霞飞.食物血糖指数与糖尿病防治[J].肠内与肠外营养,2005,12(5):311-314.
[5]中华医学会糖尿病学分会.中国2型糖尿病防治指南[J].中国医学前沿杂志,2015,7(3):26-86.
[6]胡绍文,郭瑞林.实用糖尿病学[M].3版.北京:人民军医出版社,2009:69-75.
[7]中华人民共和国卫生部药政局.新药(中药)治疗消渴病(糖尿病)临床研究的技术指导原则[J].中国医药学报,1990,5(4):76-77.
[8]潘明政,郭赛珊.糖尿病证型及其实质的临床研究[J].安徽中医学院学报,2002,21(2):58-60.
[9]徐明.糖尿病管理综述[J].健康天地:学术版,2010,4(9):46-47.
[10]任启芳,徐亚梅,胡守紫,等.糖尿病患者饮食治疗认知水平调查及分析[J].中华全科医学,2008,9(6):957-958.
[11]Heacock PM,Hertzler SR,Wolf BW.Fructose prefeeding reduces the glycemic response to a high-glycemic index,starchy food in humans[J].The Journal of Nutrition,2002,132(9):2601-2604.
[12]蓝玉娟.高血压患者社区干预的效果评价[J].中国医药指南,2009,7(9):247-248.
[13]何长蓉.慢病管理模式对高血压患者的影响[J].中国医药导报,2012,9(13):177-178.
[14]张云峰,徐连美.86例高血压患者社区干预疗效分析[J].中国现代医生,2008,46(17):159.
[15]董杰.社区干预对高血压患者的影响[J].中外医疗,2008,27(21):159-160.