·糖尿病临床研究·

　　【摘要】 目的 观察运动对T2DM患者餐后血糖的影响，优化运动治疗处方。方法 选择54例T2DM患者，随机分为餐后非运动组与运动组,每组各27例，非运动组进行静息试验，运动组按照三因素(餐后开始运动时间A、运动持续时间B、运动强度C)三水平正交设计进行运动锻炼。以餐后150 min内餐后血糖曲线下面积(AUC)为评价指标。 结果 (1)运动组和非运动组AUC分别是(589.66±31.89) mmol/L·min和(616.34±36.48)mmol/L·min，t=3.473，P=0.001(2)A因素3水平(A1：餐后10min;A2：餐后20min;A3：餐后30min)中以A2最佳(F=4.983，P=0.018)。B因素3水平(B1：持续20 min;B2：持续30 min;B3：持续40 min)中以B3最佳(F=5.122，P=0.016)。C因素的3水平(C1：4 km/h速度步行，C2 ：6 km/h，C3 ：8 km/h)对AUC的影响,差异无统计学意义(F=1.590，P=0.229)。 结论 运动可改善糖代谢，餐后20 mim开始以4 km/h的步行速度,运动40 min可能是T2DM运动治疗的较好处方，但需个体化调节运动参数。

　　【关键词】 糖尿病,2型;运动治疗;血糖;正交设计

Experimental study on the optimized exercise prescription with three factors and three levels in the orthogonal design for T2DM patients WANG Yu-zhong, ZHANG Fu-hua, XU Wan-ling. Luohe Medical College, Luohe 462002, China

　　【Abstract】 Objective To observe the influence of physical exercises on postprandial plasma glucose and to optimize exercise prescription for T2DM patients. Methods The 54 T2DM patients were randomized into non-exercise and exercise groups with 27 in each. The non-exercise group participated the resting trial, and the exercise group did the physical exercises according to the orthogonal design with three factors (A, the starting time of postprandial exercise; B, lasting time in exercise; C, exercise intensity) and three levels in it. The area under plasma glucose curve (AUC) within postprandial 150 minutes was taken as the evaluation indicator. Results (1). AUC in the exercise and non-exercise groups were (589.66±31.89) and (616.34±36.48)mmol/L·min respectively(t=3.473, P=0.001). (2). A2 was the best among the three levels of A factor (A1: postprandial 10 minutes, A2: postprandial 20 minutes, A3: postprandial 30 minutes), (F=4.983, P=0.018). B3 was the best among the three levels of B factor (B1: lasting 20 minutes, B2: lasting 30 minutes, B3: lasting 40 minutes), (F=5.122, P=0.016). There were no significant differences in the AUC among the three levels of C factor (C1: 4 km/h walking speed, C2: 6 km/h, C3: 8 km/h), (F=5.122, P=0.229). Conclusion Exercise can improve glycometabolism. The best exercise prescription for T2DM patients is that to start the exercise 20 minutes after meal, at a 4km/h walking speed, and lasting 40 minutes. It needs to be regulated according to the individual conditions of patients.

　　【Key words】 Diabetes mellitus, Type 2; Exercise therapy; Plasma glucose; Orthogonal design