| 摘要: | 背景與目的：第二型糖尿病的形成與其合併症的發展和體內抗氧化系統、代謝系統、自律神經系統失衡相關。這些失衡現象也引起衰老、體內慢性發炎及各種慢性疾病。糖尿病的高普及率、高死亡率、佔用世界龐大醫療費，讓糖尿病成為全球嚴重健康問題之一。過去許多研究顯示，遠紅外線在調節人體各系統方面有諸多效益：止痛、促進傷口癒合、消除淋巴水腫、平衡自律神經系統、提升體內抗氧化酶、降低體內自由基等。本研究目的為探討遠紅外線介入是否能改善第二型糖尿病患體內抗氧化系統、代謝系統及自律神經系統，為糖尿病患帶來穩定之病程以延緩併發症發展。 研究設計與方法：以雲嘉南地區50〜85歲糖尿病患為對象，隨機分派實驗組與對照組各32人，實驗前測後，以遠紅外線介入實驗組及以無遠紅外線效果之儀器介入對照組，4個月後再進行後測。分析糖尿病患者體內總和抗氧化能力、糖化血色素、空腹血糖、空腹胰島素、胰島素阻抗、心律變異、老人憂鬱狀況等項目之變化。 結果與結論：遠紅外線介入能有效降低糖化血色素(實驗組前測中位數7.8%、後測中位數7.5%， p=0.001；對照組前測中位數7.8%、後測中位數7.7%， p=0.022)、降低空腹胰島素(實驗組前測中位數11 mU/L、後測中位數9.1 mU/L，p=0.032；對照組前測中位數12.7 mU/L、後測中位數10.8 mU/L，p=0.373)、降低胰島素阻抗(實驗組前測中位數3.66、後測中位數2.85，p=0.023；對照組前測中位數3.86、後測中位數3.33 ，p=0.583) 、提升心率變異HRV(實驗組前測中位數23 ms、後測中位數26 ms， p=0.019；對照組前測中位數35 ms，後測中位數38 ms， p=0.914)，達到顯著上的差異。此外，體內總和抗氧化能力(實驗組前測中位數0.81 mmol/L、後測中位數0.85 mmol/L，p=0.313；對照組前測中位數0.77 mmol/L、後測中位數0.79 mmol/L， p=0.592)及空腹血糖(實驗組前測中位數135.5 mg/dL、後測中位數131.5 mg/dL ，p=0.262；對照組前測中位數137 mg/dL 、後測中位數147 mg/dL， p=0.417)所得結果顯示實驗組優於對照組，但未達統計上的顯著。交感神經活性LF%以及副交感神經活性HF%方面也未達顯著，老人憂鬱量表指標在二組間未顯示差異也皆未達顯著。
BACKGROUND & OBJECTIVE: The formation of type 2 diabetes and the development of comorbidities and complications are related to the irregulated antioxidant system, metabolic system, and autonomic nervous system. These irregulated circumstances may induce aging, chronic inflammation and various chronic diseases. Diabetes is one of the most prominent medical problems and cause huge health expenditures due to its high prevalence rate and high mortality rate. Many previous studies have shown that far infrared has many benefits in regulating various human systems, such as pain relieving, wound healing, lymphedema alleviating, autonomic nervous system balancing, antioxidant enzymes enhancing, and free radicals reducing in the bodies. The purpose of this study is to investigate whether far-infrared intervention can improve the antioxidant system, metabolic system and autonomic nervous system in patients with type 2 diabetes, and result in a stable disease process and postpone the development of complications. DESIGN and METHODS: We recruited diabetic patients in Yunjianan area from age 50 to 85 years old, totally 64 patients, randomly assigned 32 patients to the experimental group and the control group respectively. All pre-test physiological data and questionnaire data were collected before the experiment. The experimental group patients were intervened with far infrared rays and the control group patients with instruments without far infrared rays. After 4 months intervention, performed the post-test. We analyzed the change of total antioxidant capacity, glycosylated hemoglobin, fasting blood glucose, insulin, insulin resistance, heart rhythm variability, and depression in the elderly in diabetic patients. RESULTS: Far-infrared intervention can significantly reduce HbA1c (the median value of the experiment group in pre-test is 7.8% and that in post-test is 7.5%, P-value=0.001; for the median value of the control group for pre-test is 7.8% and that for post-test is 7.7%, p-value = 0.022), reduce insulin level (the median value of the experiment group for pre-test is 11 mU/L and the post-test is 9.1 mU/L, P-value=0.032; for the median value of the control group for pre-test is 12.7 mU/L and the post-test is 10.8 mU/L, p-value = 0.373), reduce insulin resistance (the median value of the experiment group for pre-test is 3.66 and the post-test is 2.85, P-value=0.023; for the median value of the control group for pre-test is 3.87 and the post-test is 3.33, p-value = 0.583), and increase heart rate variability HRV (the median value of the experiment group is 23 ms for pre-test and 26 ms for post-test, P-value=0.019; the median value of the control group is 35 ms for pre-test and 38 ms for post-test , p-value = 0.914) in experiment group. The effect of improving total antioxidant capacity (TAC) (the median value of the experiment group for pre-test is 0.81 mmol/L and the post-test is 0.85 mmol/L, P-value=0.313; for the median value of the control group for pre-test is 0.77 mmol/L and the post-test is 0.79 mmol/L, p-value = 0.592), and reducing fasting blood glucose (the median value of the experiment group for pre-test is 135.5 mg/dL and the post-test is 0 131.5 mg/dL, P-value=0.262; for the median value of the control group for pre-test is 137 mg/dL and the post-test is 147 mg/dL, p-value = 0.417) revealing better results in in experiment group﹐but not statistically significant for the control group.The difference of LF% and HF% are not significant between two groups. No significant difference was observed between the two groups on the Elderly Depression Scale indicators. |
