主动健康视角下糖尿病前期中西医结合治疗和管理的现状与挑战

摘要： 糖尿病前期作为糖尿病的早期阶段，与糖尿病、心血管疾病乃至死亡的风险增加密切相关，严重危害国民健康，是重大慢性病管理的核心内容。主动健康强调以个体健康为中心，具有预防性、自主性、精准性、个性化等特征，涵盖预防、诊断、治疗、康复等多个方面，是推进健康中国战略的重要策略。本文通过系统梳理国内外糖尿病前期和糖尿病预防的相关指南，发现主动健康理念在糖尿病前期的治疗和管理中应用广泛，涵盖生活方式调整（饮食、运动、体质量管理）、中医治疗（中药复方、中成药、代茶饮、针灸、穴位埋线、推拿按摩等）及西医治疗（二甲双胍、阿卡波糖、胰高血糖素样肽1受体激动剂等）等多个方面。中西医结合治疗糖尿病前期可以实现"整体调节"与"精准治疗"的有机结合；降低西药剂量、减轻毒副作用；降低医疗成本，使患者长期维持健康状态。然而，由于公众认知度和重视度偏低，缺乏可量化、标准化的生活方式临床实践指南和中西医结合治疗策略等，未来需借助社交媒体增强公众意识；开展高质量、大样本的整群随机对照试验，并据此制定切实可行的生活方式指导指南；结合现代科学技术阐释中医药的作用机制，以促进其在糖尿病前期治疗中的应用，实现中西医的有效融合，提升疾病的综合管理效率。

关键词: 糖尿病前期, 主动健康, 患者管理, 中西医结合, 糖尿病预防

Abstract:

As an early stage of diabetes, prediabetes is closely related to the increased risk of diabetes, cardiovascular disease, and even death, which seriously harms national health and has become the core of major chronic disease management. Proactive health emphasizes individual health as the center, with the characteristics of prevention, autonomy, precision, and personalization, covering prevention, diagnosis, treatment, rehabilitation, and other aspects, and is an important strategy to promote the strategy of Healthy China. Through systematic combing of relevant domestic and foreign guidelines, it was found that the concept of proactive health is widely used in the treatment and management of prediabetes, covering a variety of aspects such as lifestyle adjustment (diet, exercise, weight management), traditional Chinese medicine (Chinese herbal medicine compound, proprietary Chinese medicines, tea replacement, acupuncture, acupuncture point embedding, tuina massage, etc.), and western medicine (metformin, acarbose, glucagon-like peptide 1 receptor agonists, etc.). The combination of Chinese and western medicine in the treatment of pre-diabetes can achieve an organic integration of "overall regulation" and "precise treatment". This approach can reduce the dosage of western medicines, minimize toxic side effects, and lower medical costs, enabling patients to maintain a healthy state in the long term. However, due to the problems of low public awareness and attention and the lack of quantifiable and standardized clinical practice guidelines for lifestyle and treatment strategies combining TCM and western medicine, it is necessary to use social media to raise public awareness in the future, to carry out high-quality, large-sample, whole-population, randomized controlled trails, and to formulate practical guidelines for lifestyle guidance accordingly. Combining modern science and technology to explain the mechanism of Chinese medicine, to promote its application in the treatment of pre-diabetes, to realize the effective integration of Chinese and western medicine, to enhance the efficiency of comprehensive management of the disease.

Key words: Prediabetic state, Proactive health, Patient management, Integrated traditional Chinese medicine & western medicine, Diabetes prevention

引用本文

彭红叶,鲁春丽. 主动健康视角下糖尿病前期中西医结合治疗和管理的现状与挑战[J]. 中国全科医学, 2025, 28(13): 1573-1582. DOI: 10.12114/j.issn.1007-9572.2024.0242.

PENG Hongye,LU Chunli. The Current Status and Challenges of Integrative Chinese and Western Medicine in the Treatment and Management of Prediabetes from a Proactive Health Perspective[J]. Chinese General Practice, 2025, 28(13): 1573-1582. DOI: 10.12114/j.issn.1007-9572.2024.0242.

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