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目的探讨《糖尿病量化运动处方》对糖尿病、高血压患者血压的影响。方法选择2008-01-2010-10在柳州市宏力社区卫生服务中心就诊的2型糖尿病和(或)高血压患者共115例(男性42例、女性73例),年龄(62.5±7.2)岁。按照参与运动治疗与否分为对照组(维持原来的生活方式及运动习惯,n=54)和治疗组(按照《糖尿病量化运动处方》中的处方4.2光盘模板进行运动,每天1次,每周5～6次,n=61)。治疗组又分为单纯糖尿病组(n=15)、单纯高血压组(n=16)及糖尿病合并高血压组(合并组,n=30)。观察对照组连续2月的血压变化及治疗组经12月运动处方治疗前后的收缩压、舒张压、脉压、平均动脉压、脉压/平均动脉压及脉压指数的变化,分析运动前后收缩压差值与年龄、性别、体质量指数、运动前血压、疾病情况的相关性。结果治疗组运动2月后,收缩压[(127.5±9.6)比(135.3±11.2)mmHg]及舒张压[(80.2±7.2)比(83.7±8.1)mmHg]均有下降,差异有统计学意义(P<0.05);治疗组继续干预至12月,糖尿病组、高血压组及合并组收缩压分别下降(7.6±8.9)、(15.8±7.5)、(13.3±7.8)mmHg(P<0.05),高血压组、合并组的舒张压下降(5.8±2.1)、(5.3±6.3)mmHg(P<0.01),而糖尿病组舒张压与运动前比较差异无统计学意义。与运动前比较,运动12月后治疗组脉压、平均动脉压、脉压/平均动脉压及脉压指数均下降(均P<0.05);将运动前脉压、舒张压与运动前后收缩压的差值进行拟合线性回归,其回归系数分别为0.5及0.6。结论在原有降压药物治疗的基础上长期、规律地进行《糖尿病量化运动处方》治疗有助于降低血压,特别对于运动前以收缩压升高为主的高血压患者降压效果明显。
Objective To investigate the effect of “Diabetes Quantitative Exercise Prescription” on blood pressure in patients with diabetes mellitus and hypertension. Methods A total of 115 type 2 diabetic and / or hypertensive patients (42 male and 73 female) were enrolled in the Hongli Community Health Service Center of Liuzhou City from January 2008 to October 2010 with a mean age of 62.5 ± 7.2 years . Participants were divided into control group (keeping original life style and exercise habit, n = 54) and treatment group (according to prescription 4.2 CD template in DM exercise prescription), once a day, weekly 5 to 6 times, n = 61). The treatment group was further divided into simple diabetic group (n = 15), simple hypertensive group (n = 16) and diabetic hypertensive group (combined group, n = 30). The change of blood pressure in the control group for two months and the changes of systolic pressure, diastolic pressure, pulse pressure, mean arterial pressure, pulse pressure / mean arterial pressure and pulse pressure index in the treatment group before and after the December exercise prescription were observed. The relationship between pressure difference and age, sex, body mass index, pre-exercise blood pressure and disease status. Results After 2 months of exercise, systolic blood pressure (127.5 ± 9.6) and (135.3 ± 11.2) mmHg and diastolic blood pressure (80.2 ± 7.2) and (83.7 ± 8.1) mmHg in the treatment group decreased significantly, with statistical significance (P <0.05). The systolic blood pressure in diabetic group, hypertension group and combined group decreased by (7.6 ± 8.9), (15.8 ± 7.5), (13.3 ± 7.8) mmHg , Diastolic blood pressure (5.8 ± 2.1) and (5.3 ± 6.3) mmHg in the combined group (P <0.01), but no significant difference was found between the diastolic blood pressure and the pre-exercise group in the diabetic group. Compared with those before exercise, the pulse pressure, mean arterial pressure, pulse pressure / mean arterial pressure and pulse pressure index of the treatment group decreased after 12 months of exercise (all P <0.05). The pre-exercise pulse pressure, diastolic pressure and systolic pressure Of the difference between the fitted linear regression, the regression coefficients were 0.5 and 0.6. Conclusion The long-term and regular treatment of “Diabetes Mellitus Exercise Prescription” on the basis of the original antihypertensive drug treatment can help reduce blood pressure, especially for patients with hypertension before exercise who have elevated systolic blood pressure.