中医传统运动处方治疗代谢综合征的临床观察

发布时间：2018-01-12 13:10

本文关键词：中医传统运动处方治疗代谢综合征的临床观察　出处：《北京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：背景:随着现代社会人口老龄化,生活方式的改变,代谢综合征的发病率逐年增加,已经成为全球公共卫生议题,严重威胁人类健康。不良生活方式对代谢综合征的发生及发展有密切关系,久坐少动是文明社会中生活方式的特点,诸多研究强调运动对代谢综合征的积极作用,探索有效的运动方式,于代谢综合征的防治是一项必要的研究。目的:本研究以代谢综合征患者为研究对象,应用一套中医传统运动处方的进行治疗,将此治疗方法推广至临床实践,以期控制疾病进展、疏导情志、提高患者生活质量,提高临床上治疗代谢综合征的疗效。方法:根据首都国医名师吕仁和教授及台湾省太极拳协会理事长陈汉玉老师的传统运动养生经验,选择,制定一套中医传统运动处方。将该运动处方用于干预代谢综合征患者,进行12周临床运动试验,用前后对照的方式,观察其在控制体重、调节血糖、改善胰岛素抵抗、调节血脂及改善中医症状等各方面的作用。结果:经过12周中医传统运动锻炼后,BMI下降0.19±0.47kg/m2,腰围减少1.26±1.83cm,腰臀比下降0.02±0.17,并且腰围和腰臀比男性改善较女性明显,患者未有明显的饮食干预,呈现较平稳安全的下降趋势。空腹血糖下降0.83±0.94mmol/L,达标率从42%提升到85%,糖化血红蛋白下降0.33±0.56%,达标率由42%提升到57%,说明中医传统运动对于血糖的控制有较理想的效果。干预前后31例患者空腹胰岛素虽无明显变化,但对胰岛素分泌水平较高的患者有明显疗效,治疗前后空腹胰岛素下降13.69±14.18mU/L,说明中医传统运动可改善胰岛素抵抗现象,缓解高胰岛素血症。血脂方面,治疗后甘油三酯总体下降0.20±0.61mmol/L,超标患者下降0.64±0.58mmol/L,由此可见中医传统运动对降低甘油三酯有明显疗效。12周的干预对于总体低密度脂蛋白未见明显改善,总体下降0.13±0.49mmol/L,但对于低密度脂蛋白超标患者,则下降0.29±0.38mmol/L,前后有显著差异,说明中医传统运动具有降低低密度脂蛋白的作用。该试验中总胆固醇及高密度脂蛋白前后无统计学意义,可能与患者未积极配合其他生活方式干预或治疗时间不足有关。中医症状方面,整体有明显疗效,33个症状中有27个得到改善。经过12周中医传统运动治疗后,中医症状积分下降4.81 ±3.62,疗效最明显的症状为心悸、倦怠乏力、腰背痛、手足心热、大便干燥、胸胁痛、多食易饥、口苦、肢体疼痛、小便频多,其次为浮肿、口渴喜饮、失眠、眩晕、胸闷等。结论:经31例患者试验前后对照,发现中医传统运动对于控制身体质量指数及腰围、改善胰岛素抵抗、降低空腹血糖及糖化血红蛋白,调节血脂代谢,并能缓解代谢综合征的中医临床症状。证实中医传统运动能延缓代谢综合征疾病发展,改善相关指标及其症状。
[Abstract]:Background: with the aging of population and the change of life style, the incidence of metabolic syndrome is increasing year by year, which has become a global public health issue. Bad lifestyle is closely related to the occurrence and development of metabolic syndrome. Sedentary and less active is the characteristic of lifestyle in civilized society. Many studies emphasize the positive effect of exercise on metabolic syndrome, and explore the effective exercise mode, and it is necessary to study the prevention and treatment of metabolic syndrome. Objective: this study focused on the patients with metabolic syndrome. A set of traditional Chinese medicine exercise prescription was used to treat the patients, and the treatment method was extended to clinical practice, in order to control the progress of the disease, dredge feelings, improve the quality of life of patients. Methods: according to the traditional exercise experience of Professor Lu Renhe, a famous medical teacher in the capital country, and teacher Chen Hanyu, chairman of Taijiquan Association of Taiwan Province. To establish a set of traditional Chinese medicine exercise prescription. The exercise prescription was used to intervene the patients with metabolic syndrome. The 12-week clinical exercise test was carried out to observe the control of body weight and blood sugar regulation. Results: after 12 weeks of traditional Chinese medicine exercise, BMI decreased 0.19 卤0.47 kg / m2. Waist circumference decreased 1.26 卤1.83 cm, waist-to-hip ratio decreased 0.02 卤0.17, waist circumference and waist-hip ratio improved significantly in males than in females, and there was no significant dietary intervention. The fasting blood glucose decreased by 0.83 卤0.94 mmol / L, the standard rate increased from 42% to 85 and the glycosylated hemoglobin decreased by 0.33 卤0.56%. The rate of reaching the standard was raised from 42% to 57, indicating that traditional Chinese medicine exercise had a better effect on the control of blood glucose. There was no significant change in fasting insulin in 31 patients before and after intervention. Before and after treatment, fasting insulin decreased 13.69 卤14.18mU / L, indicating that traditional Chinese medicine exercise can improve the phenomenon of insulin resistance. To relieve hyperinsulinemia, triglyceride decreased by 0.20 卤0.61mmol / L after treatment, and patients with hyperinsulinemia decreased by 0.64 卤0.58mmol / L after treatment. It can be seen that traditional Chinese medicine exercise has a significant effect on triglyceride reduction. 12 weeks of intervention on the overall low density lipoprotein did not significantly improve, the overall decline of 0.13 卤0.49 mmol / L. However, in patients with low density lipoprotein (LDL) over standard, the decrease was 0.29 卤0.38 mmol / L, and there was significant difference between the two groups. It shows that traditional Chinese medicine exercise has the effect of reducing low density lipoprotein. There is no statistical significance before and after total cholesterol and high density lipoprotein in this experiment. Patients may not actively cooperate with other lifestyle intervention or treatment of insufficient time related. Traditional Chinese medicine symptoms, the overall effect is obvious. After 12 weeks of traditional Chinese medicine exercise treatment, the TCM symptom score decreased by 4.81 卤3.62. The most obvious symptoms were palpitation, fatigue and low back pain. Hot hands and feet, dry stool, chest pain, more hunger, bitter mouth, limb pain, frequent urination, followed by swelling, thirst, insomnia, vertigo, chest tightness, etc. Conclusion: 31 patients before and after the trial control. It is found that traditional Chinese medicine exercise can control body mass index and waist circumference, improve insulin resistance, reduce fasting blood glucose and glycosylated hemoglobin, regulate blood lipid metabolism. It is proved that traditional Chinese medicine exercise can delay the development of metabolic syndrome disease and improve the related indexes and symptoms.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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