目的观察中医综合方案治疗糖耐量减低(IGT)的临床疗效。方法将80例IGT患者随机分为2组,对照组40例予常规饮食、运动等糖尿病健康教育,治疗组40例在对照组治疗基础上根据体质特点给予个体化的中医食疗保健、传统运动保健操、情志调摄保...目的观察中医综合方案治疗糖耐量减低(IGT)的临床疗效。方法将80例IGT患者随机分为2组,对照组40例予常规饮食、运动等糖尿病健康教育,治疗组40例在对照组治疗基础上根据体质特点给予个体化的中医食疗保健、传统运动保健操、情志调摄保健等中医干预措施。2组均治疗12周。观察2组治疗前后餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA_1c)变化,比较2组疗效。结果有效率治疗组87.5%,对照组67.5%,2组有效率比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。2组治疗后2 h PG、Hb A1c均低于本组治疗前(P<0.05),且治疗组降低较对照组更明显(P<0.05)。结论基于中医体质理论和中医养生理论基础上的中医食疗保健、传统运动保健操、情志调摄保健等中医干预措施,对于改善IGT患者的临床症状和血糖水平具有显著疗效。展开更多
Glycogen storage diseases(GSDs),also referred to as glycogenoses,are inherited metabolic disorders of glycogen metabolism caused by deficiency of enzymes or transporters involved in the synthesis or degradation of gly...Glycogen storage diseases(GSDs),also referred to as glycogenoses,are inherited metabolic disorders of glycogen metabolism caused by deficiency of enzymes or transporters involved in the synthesis or degradation of glycogen leading to aberrant storage and/or utilization.The overall estimated GSD incidence is 1 case per 20000-43000 live births.There are over 20 types of GSD including the subtypes.This heterogeneous group of rare diseases represents inborn errors of carbohydrate metabolism and are classified based on the deficient enzyme and affected tissues.GSDs primarily affect liver or muscle or both as glycogen is particularly abundant in these tissues.However,besides liver and skeletal muscle,depending on the affected enzyme and its expression in various tissues,multiorgan involvement including heart,kidney and/or brain may be seen.Although GSDs share similar clinical features to some extent,there is a wide spectrum of clinical phenotypes.Currently,the goal of treatment is to maintain glucose homeostasis by dietary management and the use of uncooked cornstarch.In addition to nutritional interventions,pharmacological treatment,physical and supportive therapies,enzyme replacement therapy(ERT)and organ transplantation are other treatment approaches for both disease manifestations and longterm complications.The lack of a specific therapy for GSDs has prompted efforts to develop new treatment strategies like gene therapy.Since early diagnosis and aggressive treatment are related to better prognosis,physicians should be aware of these conditions and include GSDs in the differential diagnosis of patients with relevant manifestations including fasting hypoglycemia,hepatomegaly,hypertransaminasemia,hyperlipidemia,exercise intolerance,muscle cramps/pain,rhabdomyolysis,and muscle weakness.Here,we aim to provide a comprehensive review of GSDs.This review provides general characteristics of all types of GSDs with a focus on those with liver involvement.展开更多
文摘目的探讨利拉鲁肽基于核因子κB(nuclear factor-κB,NF-κB)/核苷酸结合寡聚化结构域样受体蛋白(nucleotide-binding oligomerization domain-like receptor protein 3,NLRP3)通路对超重/肥胖糖尿病前期患者的作用。方法选取2020年4月至2021年3月杭州市中医院收治的超重/肥胖糖尿病前期患者60例,根据随机数字表法将其分为对照组和观察组,每组各30例。对照组患者进行生活方式干预,观察组患者在此基础上给予利拉鲁肽皮下注射。两组患者均干预12周。比较两组患者干预前后的体质量指数(body mass index,BMI)、血糖相关指标[糖化血红蛋白(glycosylated hemoglobin,HbA1c)、空腹血糖(fasting blood glucose,FBG)、餐后2h血糖(2h postprandial blood glucose,2hPBG)、空腹胰岛素(fasting insulin,FINS)、餐后2h胰岛素(2h postprandial insulin,2hPINS)、稳态模型评估的胰岛素抵抗(homeostasis model assessment of insulin resistance,HOMA-IR)指数]、血脂指标[三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)]、炎症因子[白细胞介素(interleukin,IL)-1β、IL-6、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]、NF-κB、NLRP3蛋白表达水平。结果观察组患者的BMI、FBG、2hPBG、FINS、2hPINS、HbA1c、HOMA-IR指数、TG、TC、LDL-C、IL-6、IL-1β、TNF-α及NF-κB、NLRP3蛋白表达水平均显著低于同期对照组(P<0.05),HDL-C显著高于同期对照组(P<0.05)。观察组患者的IL-6、IL-1β、TNF-α与HOMA-IR指数均呈正相关(r=0.615,0.327,0.343,P<0.05)。结论利拉鲁肽通过抑制NF-κB/NLRP3通路减轻炎症反应,可降低超重/肥胖糖尿病前期患者的体质量,改善糖脂代谢紊乱。
文摘目的观察中医综合方案治疗糖耐量减低(IGT)的临床疗效。方法将80例IGT患者随机分为2组,对照组40例予常规饮食、运动等糖尿病健康教育,治疗组40例在对照组治疗基础上根据体质特点给予个体化的中医食疗保健、传统运动保健操、情志调摄保健等中医干预措施。2组均治疗12周。观察2组治疗前后餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA_1c)变化,比较2组疗效。结果有效率治疗组87.5%,对照组67.5%,2组有效率比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。2组治疗后2 h PG、Hb A1c均低于本组治疗前(P<0.05),且治疗组降低较对照组更明显(P<0.05)。结论基于中医体质理论和中医养生理论基础上的中医食疗保健、传统运动保健操、情志调摄保健等中医干预措施,对于改善IGT患者的临床症状和血糖水平具有显著疗效。
文摘Glycogen storage diseases(GSDs),also referred to as glycogenoses,are inherited metabolic disorders of glycogen metabolism caused by deficiency of enzymes or transporters involved in the synthesis or degradation of glycogen leading to aberrant storage and/or utilization.The overall estimated GSD incidence is 1 case per 20000-43000 live births.There are over 20 types of GSD including the subtypes.This heterogeneous group of rare diseases represents inborn errors of carbohydrate metabolism and are classified based on the deficient enzyme and affected tissues.GSDs primarily affect liver or muscle or both as glycogen is particularly abundant in these tissues.However,besides liver and skeletal muscle,depending on the affected enzyme and its expression in various tissues,multiorgan involvement including heart,kidney and/or brain may be seen.Although GSDs share similar clinical features to some extent,there is a wide spectrum of clinical phenotypes.Currently,the goal of treatment is to maintain glucose homeostasis by dietary management and the use of uncooked cornstarch.In addition to nutritional interventions,pharmacological treatment,physical and supportive therapies,enzyme replacement therapy(ERT)and organ transplantation are other treatment approaches for both disease manifestations and longterm complications.The lack of a specific therapy for GSDs has prompted efforts to develop new treatment strategies like gene therapy.Since early diagnosis and aggressive treatment are related to better prognosis,physicians should be aware of these conditions and include GSDs in the differential diagnosis of patients with relevant manifestations including fasting hypoglycemia,hepatomegaly,hypertransaminasemia,hyperlipidemia,exercise intolerance,muscle cramps/pain,rhabdomyolysis,and muscle weakness.Here,we aim to provide a comprehensive review of GSDs.This review provides general characteristics of all types of GSDs with a focus on those with liver involvement.