有氧运动联合抗阻训练对青少年2型糖尿病患者糖脂代谢的影响

发布时间：2018-06-05 01:58

本文选题：糖尿病 + 有氧运动　；参考：《河北医科大学》2017年硕士论文

【摘要】：目的:探讨有氧运动联合抗阻训练对青少年2型糖尿病患者血糖、血脂、血压、体质量指数、腰臀比等方面的影响。糖尿病由多种病因引起,遗传、社会、环境及生活方式等因素共同影响着疾病的发生及发展。研究报道,青少年随着体力活动减少,超重、肥胖现象日益增多,在世界范围内,青少年2型糖尿病发病率以12.0/10万和24.3/10万的速度平稳增长,对健康产生严重影响,逐渐成为全球公共卫生问题,迫切要求建立完善的糖尿病检测系统,寻找有效的早期预防及干预手段,减少疾病对患者造成的痛苦和经济负担,延缓或防止并发症的发生与发展,提高健康水平。最新研究发现:运动可增强骨骼肌中的过氧化物酶体增殖物激活受体γ辅助激活因子的活性,从而促进骨骼肌纤连蛋白组件FNDC5mRNA的表达,加速肌肉因子分泌,诱导白色脂肪棕色化,最终改善胰岛素抵抗、调节糖脂代谢、增加能量消耗。有氧运动以增强吸入、运送和利用氧气为目的,机体耗氧量与吸氧量大致相等,具有持续时间长、有韵律性、运动强度低等特点。抗阻运动是指在运动过程中针对某一肌肉群施加一定阻力的无氧运动,又称力量运动或阻力运动,主要包括克服弹性物体运动、利用力量训练器械、负重抗阻运动、对抗性运动等。抗阻运动可有效防止肌肉力量和体积的减小,从而增加胰岛素受体数量及敏感性,提高血糖控制能力。本研究旨在探讨有氧运动联合抗组训练干预方式是否能够改善青少年2型糖尿病患者的血糖和血脂,防止糖尿病并发症的进展,改善患者的预后及转归。方法:1研究对象选取2015年08月~2016年08月在河北医科大学第二医院内分泌科住院的青少年2型糖尿病患者为研究对象,共45例,年龄13~20岁,其中男性24例,女性21例。2研究方法采用便利抽样的方法,按照住院患者的病案号将45例研究对象分为对照组23例,干预组22例。两组患者均接受糖尿病综合教育管理方案,指导其正确的饮食、用药、血糖监测和复诊时间,并发放《青少年2型糖尿病患者健康指导手册》,出院后两组患者分别建立微信群,并接受5次电话随访。研究团队成员每周在微信群中上传糖尿病相关知识及一些生活小贴士,随时针对患者的具体问题给予个体化指导。按电话随访内容表(见附录)进行定期电话随访,鼓励患者科学饮食、合理运动,督促患者按时服药、定期监测血糖等。如电话随访中患者提出疾病治疗问题,则需与专科医师协商后再对患者进行指导。在此基础上应用运动干预方式,对照组采用有氧运动方案,干预组采用有氧运动联合抗阻训练方案,干预12周后,观察两组患者血糖、血脂水平以及血压、体质量指数、腰臀比有无统计学差异。3统计学处理录入数据采用epidata3.1软件,spss21.0软件进行统计分析,计量资料做正态性检验,满足正态分布的结果用均数±标准差(x±s)表示,采用两样本均数比较的t检验;不满足正态分布的结果用中位数±四分位间距(m±qr)表示,采用秩和检验中两独立样本非参数检验的mann-whitneyz检验方法;对等级资料采用秩和检验;计数资料采用四格表或r×c表的卡方检验;检验方法采用双侧检验,检验水准a=0.05。结果:1两组研究对象性别、年龄、文化程度、病程等一般资料比较(t=-0.411,x2=0.033,z=0.794,z=-0.372),差异无统计学意义(p0.05)。两组患者一般资料均衡、可比。2干预前,两组患者在空腹血糖(fpg)、餐后2小时血糖(2hpg)、糖化血红蛋白(hba1c)、总胆固醇(tc)、甘油三脂(tg)、低密度脂蛋白胆固醇(ldl-c)及高密度脂蛋白胆固醇(hdl-c)比较,差异无统计学意义(p0.05)。干预后,fpg、2hpg和hba1c的改善,干预组优于对照组(t=-3.147,t=-3.460,t=-2.718),差异有统计学意义(p0.01);血脂中的tc、tg降低和hdl-c升高,干预组优于对照组(z=-3.157,z=-3.339,Z=-3.524),差异有统计学意义(P0.01),血脂中的LDL-C降低(Z=-1.775),两组比较差异无统计学意义(P0.05)。3干预前后两组患者在体质量指数(BMI)、腰臀比(WHR)、收缩压和舒张压方面比较(干预前:Z=-0.104,Z=-0.717,Z=-0.914,Z=-0.574;干预后Z=-0.026,Z=-0.733,Z=-1.301,Z=-0.832),差异均无统计学意义(P0.05)。结论:1有氧运动联合抗阻训练能更好地控制青少年2型糖尿病患者血糖和糖化血红蛋白水平。2有氧运动联合抗阻训练能更好地控制青少年2型糖尿病患者总胆固醇、甘油三酯和高密度脂蛋白水平,但是低密度脂蛋白无显著影响。3对青少年2型糖尿病患者进行有氧运动联合抗阻训练干预是有效的。
[Abstract]:Objective: To investigate the effects of aerobic exercise combined with resistance training on blood glucose, blood lipid, blood pressure, body mass index, waist hip ratio and other factors in adolescents with type 2 diabetes. Diabetes is affected by many factors, heredity, society, environment and lifestyle. Less, overweight, and obesity are increasing. In the world, the incidence of type 2 diabetes is steadily increasing with the speed of 12.0/10 Vanward 24.3/10 million. It has a serious impact on health, and has gradually become a global public health problem. It is urgent to establish a perfect diabetes detection system to find effective early prevention and intervention measures to reduce the incidence of diabetes. The latest research has found that exercise can enhance the activity of peroxisome proliferator activated receptor gamma assistant activator in skeletal muscle and promote the expression of FNDC5mRNA in skeletal muscle fibronectin component and accelerate muscle cause. Subsecreting, inducing white fat browning, eventually improving insulin resistance, regulating glycolipid metabolism, and increasing energy consumption. Aerobic exercise is aimed at enhancing inhalation, transporting and utilizing oxygen. The body's oxygen consumption is roughly equal to oxygen absorption, long lasting, rhythmic, and low exercise intensity. Resistance movement refers to the movement process. The anaerobic exercise, which applies certain resistance to a certain muscle group, is also called force movement or resistance movement, mainly including overcoming the movement of elastic objects, using strength training instruments, bearing resistance and resistance movement, antagonistic movement, etc.. Resistance movement can effectively prevent muscle strength and volume reduction, thus increasing the number and sensitivity of insulin receptor, and increasing the sensitivity of insulin receptor. The purpose of this study is to explore whether aerobic exercise combined with anti group training intervention can improve blood glucose and blood lipids in type 2 diabetics, prevent the progression of diabetic complications, and improve the prognosis and prognosis of patients. 1 subjects were selected in the second hospital of Hebei Medical University, 08 months, 2015, and 08 months of ~2016. A total of 45 patients with type 2 diabetes in the secretory department were studied, with a total of 45 cases of age 13~20 years, of which 24 were male and 21 in women, with a convenient sampling method. 45 subjects were divided into 23 cases in the control group and 22 in the intervention group according to the case number of the hospitalized patients. The comprehensive education management scheme for diabetes was accepted in all the two groups. Guide the correct diet, medication, blood glucose monitoring and visit time, and release the health guidance manual for patients with type 2 diabetes. After discharge, the two groups of patients set up WeChat group and received 5 telephone follow-up. The team members uploaded the knowledge of diabetes and some life tips in the WeChat group every week, at any time to the patients. Specific questions are given individualized guidance. Follow up the telephone follow up table (see Appendix) for regular telephone follow-up, encourage patients to eat scientifically, exercise rationally, urge the patients to take medicine on time, and regularly monitor blood sugar. Using exercise intervention, the control group adopted aerobic exercise program, the intervention group adopted aerobic exercise combined with resistance training program. After 12 weeks, the blood glucose, blood lipid level, blood pressure, body mass index and waist hip ratio were observed in the two groups..3 statistics were used to deal with data using epidata3.1 software and spss21.0 software. In the analysis, the measurement data are tested in normality, and the results of normal distribution are expressed with mean number + standard deviation (x + s), and the t test is used to compare the average number of two samples; the result of the normal distribution is expressed by the median of four division spacing (M + QR), and the non parametric test of two independent samples in the rank sum test is used. The rank sum test was used. The counting data were checked with four grid or R x C table. The test method adopted bilateral test and test level a=0.05. results: 1 two groups of subjects' sex, age, education level, course of disease, and other general data (t=-0.411, x2=0.033, z= 0.794, z=-0.372), the difference was not statistically significant (P0.05). Two groups of patients were general. Data balance, before.2 intervention, two groups of patients in the fasting blood glucose (FPG), 2 hours postprandial blood glucose (2hPG), glycated hemoglobin (HbA1c), total cholesterol (TC), glycerin three fat (TG), low density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), the difference was not statistically significant (P0.05). The prognosis, FPG, 2hPG and HbA1c improved, dry. The pre group was better than the control group (t=-3.147, t=-3.460, t=-2.718), the difference was statistically significant (P0.01), the TC, TG and HDL-C in the blood lipid were lower and HDL-C increased. The intervention group was better than the control group (z=-3.157, z=-3.339, Z=-3.524), the difference was statistically significant (P0.01), the two groups had no statistical significance (two) before and after intervention. Group patients were compared with body mass index (BMI), waist to hip ratio (WHR), systolic pressure and diastolic pressure (before intervention: Z=-0.104, Z=-0.717, Z=-0.914, Z=-0.574; Z=-0.026, Z=-0.733, Z=-1.301, Z=-0.832) after intervention (P0.05). Conclusion: 1 aerobic exercise combined with resistance training can better control the blood sugar of type 2 diabetes patients. Combined with glycosylated hemoglobin level.2 aerobic exercise combined with resistance training can better control total cholesterol, triglycerides, and high density lipoprotein levels in adolescents with type 2 diabetes, but low density lipoprotein has no significant effect on.3 for aerobic exercise in adolescents with type 2 diabetes.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1

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