【摘要】：目的：本研究應(yīng)用狀態(tài)醫(yī)學(xué)的方法,評(píng)估2型糖尿病患者臨床狀態(tài),給予中西醫(yī)治療及心理干預(yù),通過(guò)調(diào)整患者臨床狀態(tài),希望能達(dá)到更好地控制血糖,并能恢復(fù)患者良好的心理健康水平與社會(huì)功能的目的,為臨床治療糖尿病提供新的思路與方法。方法：將66例符合標(biāo)準(zhǔn)的2型糖尿病患者,隨機(jī)分為西藥對(duì)照組及狀態(tài)醫(yī)學(xué)試驗(yàn)組,脫落3例,最后納入統(tǒng)計(jì)33例,對(duì)照組31例,采用西藥基礎(chǔ)降糖藥物治療；試驗(yàn)組32例,在對(duì)照組的基礎(chǔ)上,加用中藥治療及心理治療。觀察時(shí)間為3個(gè)月,分別于入組前、2周后、3個(gè)月后評(píng)估血糖指標(biāo)(空腹血糖、餐后2h血糖、糖化血紅蛋白)、宗氏抑郁自評(píng)量表(SDS)、宗氏焦慮自評(píng)量表(SAS)、糖尿病人生存質(zhì)量特異性量表(DSQL)、中華健康狀況量表(TCM-HSS)的得分變化。結(jié)果：運(yùn)用狀態(tài)醫(yī)學(xué)方法的試驗(yàn)組取得良好的效果：1.在血糖指標(biāo)控制方面,兩組的空腹血糖(FBG)、餐后2h血糖(PBG)、糖化血紅蛋白(HbAlc)的改善情況均明顯好于治療前(P0.05),但試驗(yàn)組治療效果明顯好于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。2.心理量表方面,試驗(yàn)組SAS與SDS量表得分顯著低于治療前(P0.01),且明顯低于對(duì)照組得分(P0.01)。3.在生存質(zhì)量改善方面,試驗(yàn)組在身體、心理、社會(huì)、治療以及總評(píng)分5個(gè)維度得分比治療前都有明顯降低(P0.05)且優(yōu)于對(duì)照組,具有統(tǒng)計(jì)學(xué)意義(P0.01),對(duì)照組僅在身體維度比治療前得分明顯降低(P0.05)。4.在中醫(yī)癥狀療效比較方面,試驗(yàn)組在精力、疼痛、大便、睡眠、體質(zhì)、情緒及健康自評(píng)等方面得分比治療前都有明顯降低(P0.05),且上述6個(gè)方面(除疼痛項(xiàng)目)治療后得分低于對(duì)照組(P0.05)。結(jié)論：運(yùn)用狀態(tài)醫(yī)學(xué)方法能使2型糖尿病病人的血糖情況得到有效控制,且能較好改善抑郁、焦慮癥狀,提高生活質(zhì)量,是治療2型糖尿病的有效方法,具有推廣價(jià)值。
[Abstract]:Objective: to evaluate the clinical status of patients with type 2 diabetes mellitus by using the method of state medicine, and to give traditional Chinese and western medicine treatment and psychological intervention, in order to control blood glucose better by adjusting the clinical status of patients. It can restore the good mental health level and social function of the patients and provide new ideas and methods for the clinical treatment of diabetes mellitus. Methods: 66 patients with type 2 diabetes were randomly divided into western medicine control group and state medicine trial group. 33 cases were included in statistics and 31 cases in control group. Experimental group 32 cases, on the basis of the control group, plus Chinese medicine treatment and psychological treatment. The blood glucose index (fasting blood glucose, postprandial 2 h blood glucose, glycosylated hemoglobin) and the Zong's depression self-rating scale (SDS), the Zongs anxiety scale (SAS),) were evaluated before, 2 weeks and 3 months respectively Changes of (DSQL), Chinese Health status scale (TCM-HSS) in Diabetic patients with quality of Life (QOL). Results: the experimental group using state medicine method achieved good results: 1. In the control of blood glucose index, the improvement of (PBG), glycosylated hemoglobin (HbAlc) at 2h postprandial blood glucose of (FBG), in both groups was better than that before treatment (P0.05), but the effect of treatment in the experimental group was better than that in the control group. The difference was statistically significant (P0.05). The scores of SAS and SDS in the test group were significantly lower than those before treatment (P0.01) and significantly lower than those in the control group (P0.01). In terms of improving quality of life, the scores of five dimensions of body, psychology, society, treatment and total score in the experimental group were significantly lower than those before treatment (P0.05) and better than that in the control group (P0.01). The control group only in the body dimension than before treatment scores significantly decreased (P0.05). The scores of energy, pain, defecation, sleep, physique, mood and health self-evaluation in the experimental group were significantly lower than those before treatment (P0.05). The scores of the above 6 aspects (except pain items) after treatment were lower than those in the control group (P0.05). Conclusion: the application of state medicine can effectively control the blood glucose of type 2 diabetic patients, and can improve the depression, anxiety and quality of life. It is an effective method for the treatment of type 2 diabetes, and it is worth popularizing.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R587.1

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