中医干预糖耐量受损的临床研究。
Clinical research of traditional Chinese medical intervention on impaired glucose tolerance.
机构信息
School of Traditional Chinese Medicine, Capital Medical University, China.
出版信息
Am J Chin Med. 2013;41(1):21-32. doi: 10.1142/S0192415X1350002X.
To identify a safe and effective Impaired Glucose Tolerance (IGT) intervention program using Traditional Chinese Medicine (TCM) supported by Standard Health Care Advice (SHCA) for the evidence-based TCM intervention in IGT and evidence-based prevention of type 2 diabetes. A total of 510 IGT patients were randomly assigned into either control or TCM intervention group (255 patients for each group). The control group received standard health care according to SHCA. The intervention group also received TCM intervention in addition to standard health care. The study was conducted over a three-year follow-up. At the end of three years follow-up, accumulative incidence and average annual incidence rate of diabetes in the control group was 43.86% and 14.62% respectively. Accumulative incidence and average annual incidence rate of diabetes in the TCM intervention group was 22.17% and 7.39% respectively. Compared with the control treatment, TCM intervention can reduce the relative risk of IGT patients progressing to type 2 diabetes by 49.45% and absolute risk by 21.69%. In the TCM intervention group, oral glucose tolerance test (OGTT), 2 h glucose, glycated hemoglobin, insulin resistance and body mass index were all significantly improved when compared to the control group. No significant side effect was observed during the follow-up in the TCM group. The SHCA-supported TCM intervention can reduce the conversion rate of IGT to diabetes and improve insulin resistance; therefore, it is a safe and effective IGT intervention strategy.
目的
采用中医支持的标准保健建议（SHCA），寻找安全有效的糖耐量受损（IGT）干预方案，为 IGT 的中医干预和 2 型糖尿病的循证预防提供循证依据。
方法
将 510 例 IGT 患者随机分为对照组和中医干预组（每组 255 例）。对照组按照 SHCA 接受标准保健。干预组在接受标准保健的基础上还接受中医干预。研究进行了 3 年的随访。3 年随访结束时，对照组糖尿病累积发生率和年均发生率分别为 43.86%和 14.62%；中医干预组分别为 22.17%和 7.39%。与对照组相比，中医干预可使 IGT 患者进展为 2 型糖尿病的相对危险度降低 49.45%，绝对危险度降低 21.69%。与对照组相比，中医干预组口服葡萄糖耐量试验（OGTT）、2 h 血糖、糖化血红蛋白、胰岛素抵抗和体重指数均有显著改善。在中医组随访期间未观察到明显的不良反应。SHCA 支持的中医干预可降低 IGT 向糖尿病的转化率，并改善胰岛素抵抗；因此，这是一种安全有效的 IGT 干预策略。
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