太極操改善肥胖的第二型糖尿病患者生化指標

The Effect of Tai Chi Exercise on Biochemical Profiles in Obese type 2 diabetic patients

目的：這項研究目的在驗證肥胖的第二型糖尿病患者經過一個簡化及柔和的太極操訓練後的效應。研究方法：以台中市某醫院新陳代謝科第二型中度肥胖糖尿病人為本研究之樣本，以隨機方式分成太極操及一般運動組，個別請老師指導，一個星期三次，每次一小時，持續進行1 2個禮拜。在不改變其他生活作息包括飲食和藥物等狀況下，我們以兩組獨立樣本t檢定方式做統計並做迴歸分析比較。結果：在12個星期以後，實驗組的糖化血紅素數值略為減少( 8 . 9 ± 2 . 7 ％ ： 8 . 3 ± 2 . 2 ％ ， P = 0 . 0 4 4 ) 。身體質量指數( 3 3 . 5 ± 4 . 8 ： 31.3±4.2，P=0.038) 和血清油脂濃度，包括三酸甘油酯(214±47m g/d L：171±34m g/d L、P=0.012)和高密度脂蛋白膽固醇(38±16m g/d L：45±18m g/ dL，P=0.023)顯示有重大改善。高敏感性C反應型蛋白濃度也減少了(0.39±0.19m g/d L：0.22±0.15 mg/dL，P=0.014)。在常規運動小組則未顯示以上效益。結論：當由專家指導及監督，太極操運動是高效率和安全的，並且可以幫助改進許多參數例如身體質量指數、血清油脂值、高敏感性C反應型蛋白。週期性監測包括血糖、血壓、心率、呼吸、體重變化和不適症狀可以幫助防止運動傷害。簡單，柔和的太極操運動可以作為第二型糖尿病患者即使肥胖也可以進行的每日運動鍛煉。

Objective : This study aimed to validate the effects of a simplified, gentle form of Tai Chi Chuan in obese type 2 diabetic patients. Design : Randomized, controlled trial. Setting : Department of Metabolism and Endocrinology at Hospital, Taichung, Taiwan. Subjects : Hospital-based obese type 2 diabetic patients (aged 40-70, body mass index 30-35) were randomly selected and divided into Tai Chi exercise and conventional exercise groups. Interventions : After receiving instruction in Tai Chi, this group and the conventional exercise group practiced three times a week, including one practice session lasting up to 1 hour, for 12 weeks. Outcome measures : Hemoglobin A1C, serum lipid profile, insulin levels and high sensitive C-reactive protein were measured as were the physical parameters of body weight and body mass index. Diet and medications of participants were monitored carefully as biochemical and physical conditions were analyzed. Results : After 12 weeks, hemoglobin A1C values of the Tai Chi group did decrease (8.9±2.7%: 8.3±2.2%, P=0.044). Body mass index (33.5±4.8: 31.3±4.2, P=0.038) and serum lipids, including triglycerides (214±47 mg/dL: 171±34 mg/dL, P=0.012) and high density lipoprotein cholesterol (38±16 mg/dL: 45±18 mg/dL, P=0.023) showed significant improvements. High sensitive C-reactive protein also decreased (0.39±0.19 mg/dL: 0.22±0.15 mg/dL, P=0.014). No improvements were seen in BMI or lipid and oxidative stress profiles in the conventional exercise group. Conclusion : Tai Chi exercise practiced by obese diabetic patients is efficient and safe when supervised by professionals and helps improve parameters such as body mass index, lipid profile, and high sensitive C-reactive protein. Periodic monitoring of blood glucose, blood pressure, heart rate, breathing, physical fitness and symptoms of discomfort in patients who exercise helps prevent injury. Simple, gentle “Tai Chi exercise” can be suggested as regular daily exercise for type 2 diabetic patients even when they are obese.