本文關(guān)鍵詞： 2型糖尿病 抗阻運(yùn)動(dòng) 有氧運(yùn)動(dòng) 心血管風(fēng)險(xiǎn) Framingham危險(xiǎn)評(píng)分 冠心病 缺血性心血管病　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:在糖尿病飲食的基礎(chǔ)上,對(duì)2型糖尿病患者實(shí)施抗阻和有氧運(yùn)動(dòng)訓(xùn)練,比較抗阻運(yùn)動(dòng)和有氧運(yùn)動(dòng)改善患者的冠心病(CHD)10年風(fēng)險(xiǎn)、10年缺血性心血管病(ICVD)危險(xiǎn)效果的差異;以及評(píng)價(jià)抗阻運(yùn)動(dòng)對(duì)2型糖尿病患者血糖、血脂、血漿同型半胱氨酸(Hcy)、血清胱抑素C(CysC)等代謝指標(biāo)的影響。方法:對(duì)80例2型糖尿病患者進(jìn)行糖尿病飲食宣教,隨后將其隨機(jī)分成抗阻運(yùn)動(dòng)組和有氧運(yùn)動(dòng)組,每組各40例,抗阻運(yùn)動(dòng)組和有氧運(yùn)動(dòng)組每周各運(yùn)動(dòng)3次,每次50min,總計(jì)6個(gè)月,強(qiáng)度達(dá)到中等強(qiáng)度。結(jié)果:參與研究的患者共80例,完成研究69人,剔除4名不合格患者,最終獲得65例患者數(shù)據(jù),其中抗阻運(yùn)動(dòng)組32例,有氧運(yùn)動(dòng)組33例。干預(yù)前,兩組在基線資料方面具有可比性(P0.05)。6個(gè)月運(yùn)動(dòng)干預(yù)后,抗阻組與有氧組組間比較,腰圍、肌肉量、Hcy前后差值d(運(yùn)動(dòng)后數(shù)值減去運(yùn)動(dòng)前數(shù)值)的變化有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組組內(nèi)比較,抗阻運(yùn)動(dòng)組,肌肉量(P0.001)、HDL-C 水平(P=0.021),HbA1c(P=0.026)、空腹胰島素水平(P=0.026)、Hcy 濃度(P0.001),Framingham 危險(xiǎn)評(píng)分(P=0.029)和 CHD 10 年風(fēng)險(xiǎn)(P=0.017)有統(tǒng)計(jì)學(xué)意義;有氧運(yùn)動(dòng)組,在腰圍(P=0.001)、腰臀比(P=0.032),空腹血糖水平(P=0.006)、HbA1c(P0.001)、HDL-C(=0.026)、TC(P=0.020)和 Cys C 濃度(P=0.021)、Framingham 危險(xiǎn)評(píng)分(P 0.003)和 CHD 10 年風(fēng)險(xiǎn)(P=0.002)有統(tǒng)計(jì)學(xué)意義。結(jié)論:1.組間比較發(fā)現(xiàn),與有氧運(yùn)動(dòng)相比,抗阻組在提高患者肌肉量和Hcy濃度方面優(yōu)于有氧組;與抗阻組相比,有氧組在減少腰圍方面優(yōu)于抗阻組。2.6個(gè)月后,兩組雖然在改善ICVD綜合危險(xiǎn)評(píng)分和10年ICVD危險(xiǎn)方面無統(tǒng)計(jì)學(xué)差異,但是都有下降趨勢(shì),且抗阻組優(yōu)于有氧組。3.組內(nèi)比較發(fā)現(xiàn),抗阻運(yùn)動(dòng)和有氧運(yùn)動(dòng)對(duì)患者餐后2h血糖、胰島素抵抗、ICVD綜合危險(xiǎn)評(píng)分和1 0年ICVD危險(xiǎn)的作用效果均無統(tǒng)計(jì)學(xué)意義,但均有改善趨勢(shì)。4.6個(gè)月的抗阻運(yùn)動(dòng)和有氧運(yùn)動(dòng)均能有效提高HDL-C水平,降低HbA1c,改善Framingham危險(xiǎn)評(píng)分和CHD 10年風(fēng)險(xiǎn)。5.6個(gè)月的抗阻運(yùn)動(dòng)可有效地提高肌肉量、降低空腹胰島素水平和Hcy濃度。6個(gè)月的有氧運(yùn)動(dòng)可有效降低腰圍、腰臀比,空腹血糖水平、TC和CysC濃度。6.抗阻運(yùn)動(dòng)在改善HbA1c、HDL-C和CHD10年風(fēng)險(xiǎn)方面,與有氧運(yùn)動(dòng)作用相似;但抗阻運(yùn)動(dòng)在肌肉量增長(zhǎng),空腹胰島素水平和Hcy濃度降低方面具有明顯優(yōu)勢(shì),因而對(duì)于老年人,除了能增加肌肉量,還能降低Hcy濃度,減少動(dòng)脈粥樣硬化疾病與腦卒中風(fēng)險(xiǎn),若沒有明顯的運(yùn)動(dòng)禁忌癥,抗阻運(yùn)動(dòng)是值得推薦的運(yùn)動(dòng)方式。
[Abstract]:Objective: on the basis of diabetic diet, the patients with type 2 diabetes mellitus were trained with resistance and aerobic exercise to compare the effects of resistance exercise and aerobic exercise on improving the risk of coronary heart disease (CHD) for 10 years and the risk of ischemic cardiovascular disease (ICVD) in 10 years. To evaluate the effects of resistance exercise on blood glucose, blood lipid, plasma homocysteine cystatin and serum cystatin CysC in patients with type 2 diabetes mellitus. Methods: 80 patients with type 2 diabetes mellitus were given diet education. Then they were randomly divided into resistance exercise group (n = 40) and aerobic exercise group (n = 40). The resistance exercise group (n = 40) and aerobic exercise group (n = 40) were given 50 mins of exercise three times a week for a total of 6 months. Results: 80 patients participated in the study. Data of 65 patients were obtained, including 32 cases of resistance exercise group and 33 cases of aerobic exercise group. Before intervention, the baseline data of the two groups were comparable (P 0.05). After 6 months of exercise intervention, there was no significant difference between the two groups in terms of baseline data. There was significant difference in waist circumference, muscle volume and Hcy before and after exercise between resistance group and aerobic group (P 0.05). The levels of HDL-C, fasting insulin level and CHD 10-year risk factor P0. 029 and P0. 017 in aerobic exercise group were significantly higher than those in P0. 021, P0. 026, P0. 026, P0. 001 and P0. 029). There were statistical significance in the waist circumference (P = 0.001), waist / hip ratio (P = 0.032), fasting blood glucose level (P = 0.006), HbA1cn (P 0.001), HDL-C (0.026) and Cys C (P ~ (0.021) Cys risk score P 0.003) and CHD (n = 10), P 0.002). Conclusion: compared with exercise, there is a significant difference between the two groups. The resistance group was superior to the aerobic group in improving the muscle mass and Hcy concentration of the patients, and the aerobic group was superior to the resistance group in reducing waist circumference compared with the resistance group. 2.6 months later, Although there was no significant difference between the two groups in improving the comprehensive risk score of ICVD and the risk of ICVD in 10 years, there was a downward trend in both groups, and the resistance group was better than the aerobic group .3.The results showed that resistance exercise and aerobic exercise had significant effects on 2 h postprandial blood glucose. The comprehensive risk score of insulin resistance and the effect of 10 years of ICVD risk had no statistical significance, but there was a trend of improvement. 4.6 months of resistance exercise and aerobic exercise could effectively increase the level of HDL-C. Reducing HbA1c, improving Framingham risk score and CHD 10 years risk. 5.6 months of resistance exercise can effectively increase muscle mass, reduce fasting insulin level and Hcy concentration. 6 months aerobic exercise can effectively reduce waist circumference, waist to hip ratio. Fasting blood glucose level TC and CysC concentration. 6. Resistance exercise is similar to aerobic exercise in improving HDL-C and CHD10 annual risk, but resistance exercise has obvious advantages in increasing muscle mass, decreasing fasting insulin level and decreasing Hcy concentration. Therefore, for the elderly, in addition to increase muscle mass, but also reduce the concentration of Hcy, reduce the risk of atherosclerosis and stroke, if there is no obvious exercise contraindication, resistance to exercise is a recommended exercise mode.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.5

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