目的了解中老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者少肌性肥胖(sarcopenic obesity,SO)患病率及不同诊断方法之间的一致性。方法采用系统随机抽样法选取2016年1月至2018年3月于北京地区9家医院内分泌科就诊的≥50岁T2DM患者,使用生物阻抗法进行身体成分检测;根据2022年欧洲临床营养与代谢学会(European Society for Clinical Nutrition and Metabolism,ESPEN)和欧洲肥胖研究协会(European Association for the Study of Obesity,EASO)方法定义SO,另外3种方法通过肌少症和肥胖的组合进行诊断。肌少症使用2019年亚洲肌少症工作组(Asian Working Group for Sarcopenia,AWGS)建立的标准来定义,肥胖通过体脂(percent of body fat,PBF)、腰围(waist circumference,WC)和体质量指数(body mass index,BMI)来定义。卡方检验进行率的比较,Cohens kappa统计分析比较4种方法的诊断一致性。结果共纳入1125例T2DM受试者,男性586例,年龄[61.2(55.3,67.4)]岁;女性539例,年龄[62.0(56.3,68.1)岁]。使用ESPEN/EASO共识、AWGS+PBF、AWGS+WC和AWGS+BMI标准,中老年T2DM患者SO患病率分别为41.6%、20.4%、30.1%和18.8%。4种方法之间的诊断一致性存在异质性(κ:0.109~0.655)。ESPEN/EASO共识与AWGS+PBF诊断一致性良好(κ:0.655),AWGS+体脂与AWGS+BMI诊断一致性良好(κ:0.637),AWGS+WC与AWGS+BMI(κ:0.359)、与AWGS+PBF诊断一致性中等(κ:0.330)。结论中老年T2DM患者SO患病率高,患病率和诊断一致性在不同诊断方法中存在差异,ESPEN/EASO的共识诊断率最高,AWGS+BMI诊断率最低,ESPEN/EASO共识与AWGS+体脂具有良好的诊断一致性。
Objective To observe the clinical effect of fire needle combined with Linggui Bafa for post-herpetic neuralgia （PHN）. Methods One hundred and twenty patients were randomly divided into an observation group and a con...
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Objective To observe the clinical effect of fire needle combined with Linggui Bafa for post-herpetic neuralgia （PHN）. Methods One hundred and twenty patients were randomly divided into an observation group and a control group with 60 cases each. For observation group, fire needle was applied to prick Zusanli （足三里 ST 36）, Yanglingquan （阳陵泉 GB 34）, Taichong （太冲 LR 3）, Sanyinjiao （三阴交 SP 6） and partial Ashi points around the lesion, and Linggui Bafa was combined to perform acupuncture therapy, once every other day, 10 times as a course of treatment; for the control group, only fire needle was applied. After 2 courses of treatment, the comparison of the value of visual analogue scale （VAS） and the total effective rate for the two groups were carried out. Results The VAS value of the observation group after treatment was obviously lower than that before treatment （2.28±2.08 vs 6.12±1.96） and that of the control group （2.28±2.08 vs 3.62±2.90）, there were significant differences （all P〈0.01）. The total effective rate of the observation group was obviously higher than that of the control group [93.3% （56/60） vs 76.7% （46/60）], the difference between the two groups was statistically significant （P〈0.05）. Conclusion The effect of fire needle combined with Linggui *** for PHN is obviously superior to that of single fire needle therapy.
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