内科综合减重方案治疗肥胖型2型糖尿病的临床观察

摘要

Objective To observe the clinical efficacy of synthetical internal medicine treatment for weight loss on obese patients with type 2 diabetes.Methods Sixty obese patients with type 2 diabetes were randomly divided into control group(n=30) and observation group(n=30).Both groups were orally administered metformin.The diet and exercise treatment was performed in the control group according to the patients′willingness.And the synthetical internal medicine treatment for weight loss was performed in the observation group,including acupoint catgut embedding therapy,diet and exercise control.The changes in glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG), postprandial 2-hour blood glucose(P2hBG),body weight,body mass index(BMI),waist circumference and waist to hip ratio(WHR) were observed before treatment,4,8 and 12 weeks after treatment,respectively.And the levels of fasting insulin(FINS),insulin sensitivity index (IAI),insulin resistance index(HOMA-IR),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL) and high density lipoprotein(HDL) were also recorded before and after treatment.Results With the advance of therapy time,FBG,P2hBG,HbA1c,body weight,BMI,waist circumference and WHR improved gradually in two groups(P<0.05),and these indices in the observation group improved more obviously(P<0.05).FINS,IAI,HOMA-IR,LDL,HDL,TC and TG improved after treatment in two groups (P<0.05),and the improvement was more remarkable in the observation group (P<0.05).Conclusion For obese patients with type 2 diabetes,the synthetical internal medicine treatment for weight loss can improve their blood glucose,serum lipid and islet function,which is an effective and safe therapy.%目的 观察内科综合减重方案治疗肥胖型2型糖尿病的临床效果. 方法 选取肥胖型2型糖尿病患者60例,采用随机数字表法分为对照组和观察组,每组30例,两组均给予二甲双胍口服,对照组患者根据自己意愿进行饮食、运动治疗;观察组予内科综合减重方案,包括穴位埋线、饮食、运动控制. 观察治疗前、治疗后4周、8周、12周时糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2h血糖(P2hBG)、体重、体重指数(BMI)、腰围、腰臀比(WHR)变化及治疗前后空腹胰岛素水平(FINS)、胰岛素敏感指数(IAI)、胰岛素抵抗指数(HOMA-IR)、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)变化. 结果 随着治疗时间的延长,两组FBG、P2hBG、HbA1c、体重、BMI、腰围、WHR逐渐改善(P<0.05),并且治疗后观察组上述指标改善更为明显(P<0.05);治疗后两组FINS、IAI、HOMA-IR、HDL、LDL、TC、TG均改善(P<0.05),但观察组改善更为明显(P<0.05). 结论 内科综合减重方案治疗肥胖型2型糖尿病患者能明显改善患者血糖、血脂以及胰岛功能,是一种安全有效的治疗方案.