八段錦調控糖尿病前期及糖尿病患者之飯後血糖及醣化血色素之文獻回顧

A Literature Review of Qigong Regulating Blood Glucose-Taking Baduanjin as an Example

2015年時18歲以上國人糖尿病盛行率為11.8％，每年以2.5萬名的速度持續增加，台灣糖尿病前期患者每年有3.2～8.8％變成第二型糖尿病（type 2 diabetes mellitus, T2DM），終生之患病時間較久，罹患糖尿病併發症之機率大幅增加。氣功是一種低強度至中強度之有氧運動，具有調控血糖之功能，本文搜尋近十年之隨機臨床研究，結果為無論是第二型糖尿病患或糖尿病前期患者，可看到練習八段錦之飯後血糖改善幅度皆較空腹血糖明顯，醣化血色素亦有不同程度之降低；訂定運動時間及運動強度，且經過培訓並考核之研究，調控血糖療效較佳；將八段錦與其他有氧運動或太極拳比較，其調控血糖之效較優。八段錦調降血糖之可能機轉包括與胰島素阻抗相關之內臟脂肪素（visfatin）、視黃醇結合蛋白（Retinol binding protein-4, RBP4）。目前臨床試驗結果皆指向八段錦是糖尿病或糖尿病前期患者選擇運動改善血糖之有效方法，但因研究偏小型或不完善需要進一步較嚴謹的實驗設計。

In 2015, the prevalence of diabetes among Taiwan people over the age of 18 was 11.8%, which continued to increase at a rate of 25,000 per year. In Taiwan, 3.2 to 8.8% of prediabetes patients became type 2 diabetes mellitus (T2DM) per year. The longer the illness, the greater the chance of developing complications of diabetes. Qigong is a low- to medium-intensity aerobic exercise with the function of regulating blood sugar. This article searches for randomized clinical studies in the past ten years. According to the results by the treatment of Baduanjin, both type 2 diabetes and pre-diabetic patients showed greater improvement in 2 hours postprandial blood glucose than that of fasting blood glucose, and the glycated hemoglobin was also reduced to varying degrees. Studies that have better efficacy at regulating blood glucose usually set exercise time and intensity, and most of its subjects were trained and assessed. Compared with other aerobic exercise or Tai Chi, Baduanjin is more efficient in regulating blood sugar. The possible mechanisms in blood glucose regulation of Baduanjin include visfatin and Retinol binding protein-4 (RBP4) which are both related to insulin resistance. Currently the clinical results of small or less perfect trials point to the fact that Baduanjin is an effective method to improve blood sugar in patients with diabetes or pre-diabetes.