Abstract: Objective　To investigate the effective programs and intervention effect of aerobic exercise combined with situ squats in middle-aged patients with type 2 diabetes.Methods　A total of 56 middle-aged patients aged 45-59 years with type 2 diabetes were enrolled from the Hospital of Hubei University between March and September 2016.They were divided into the control group（20 cases，maintaining the original exercise habit），the aerobic exercise group（18 cases，aerobic exercise program）and the aerobic exercise combined with situ squats group（18 cases，aerobic exercise combined with situ squats resistance training program，and aerobic exercise plan was the same as the aerobic exercise group，situ squats resistance training scheme was determined by orthogonal tests）on the premise of gender，age，course of disease，BMI，medication and so on.Patients' general information was collected，and situ squat number of different loads，heart rate，intermittent time，sports time，time-glucose area under the curve（GAUC）of different squat combinations were examined.Fasting plasma glucose（FPG），glycosylated hemoglobin（HbA1c），insulin，C peptide and blood lipid were also determined before and after the intervention.Results　The number of squats，heart rate of patients in medium load and higher load groups were significantly higher，and their interval time and exercise time were also significantly longer than those in low load group（P<0.05）．The number of squats，heart rate in higher load group were significantly higher，and its interval time and exercise time were significantly longer than those in medium load group（P<0.05）．GAUC of M-5-45"（45 min after meal with medium load 5 groups）and L-5-60"（60 min after meal with low load 5 groups）was less than that in the control group（sitting after meal），L-3-30"（30 min after meal with low load 3 groups），M-3-45"（45 min after meal with medium load 3 groups），H-3-60"（60 min after meal with higher load 3 groups），L-4-45"（45 min after meal with low load 4 groups），M-4-60"（60 min after meal with medium load 4 groups），H-4-30"（30 min after meal with higher load 4 groups）and H-5-30"（30 min after meal with higher load 5 groups）（P < 0.05）．To sum up，the training program of aerobic exercise with situ squats was determined as the following：the exercise intensity was 30% or 50% of the maximum number of situ squats，5 groups；the exercise time was 20-30 min，and the interval time was 2-3 min；the exercise frequency was twice a week（Tuesday，Thursday）；the starting time of exercise was 30 to 45 minutes before the peak of blood glucose.After the intervention，FPG of the aerobic exercise group and aerobic exercise combined with situ squats group was lower than that of the control group（P<0.05）．FPG in the aerobic exercise group was significantly lower after intervention than before intervention（P<0.05）．FPG and c-peptide in the aerobic exercise combined with situ squats group after intervention were significantly lower than those before intervention（P<0.05）．After intervention，triglyceride（TG）and cholesterol（CHO）in the aerobic exercise group and aerobic exercise combined with situ squats group were much lower than those in the control group（P<0.05）．After intervention，high-density lipoprotein cholesterol（HDL-C）in the aerobic exercise combined with situ squats group was higher than that in the control group and the aerobic exercise group（P<0.05）．TG and CHO in the aerobic exercise group after intervention were much lower than those before intervention（P<0.05）．After intervention，TG and CHO in the aerobic exercise combined with situ squats group were lower than those before intervention，and HDL-C was higher than that before intervention（P<0.05）．Conclusion　Aerobic exercise combined with M-5-45"，L-5-60" situ squats in middle-aged patients with type 2 diabetes can be used as effective therapy when combined with resistance training in terms of improving the patient's FPG，blood lipid and enhancing the effect of islet cell function.Moreover its function in increasing HDL-C effect was much better than simple aerobic exercise.

Key words: Diabetes mellitus, type 2；Middle aged；Aerobic exercise；Resistance training；Situ squat

摘要： 目的　探讨有氧运动结合原地深蹲抗阻训练的有效方案及其对中年2型糖尿病患者的干预效果。方法　2016年3—9月选取于湖北大学校医院就诊的45~59岁中年2型糖尿病患者56例为研究对象。在均衡性别、年龄、病程、BMI、用药等因素的前提下将其分为对照组（20例，维持原有锻炼习惯）、有氧运动组（18例，采用有氧运动方案）和有氧运动结合原地深蹲组（18例，采用有氧运动结合原地深蹲抗阻训练方案，其中有氧运动方案同有氧运动组，原地深蹲抗阻训练方案通过原地深蹲正交试验确定）。收集患者一般资料，记录不同运动负荷原地深蹲患者深蹲次数、心率、间歇时间、运动时间，不同原地深蹲组合时间-血糖曲线下面积（GAUC），3组患者干预前后血糖、糖化血红蛋白（HbA1c）、胰岛素、C肽、血脂。结果　中等负荷、较大负荷原地深蹲患者深蹲次数、心率大于低负荷，间歇时间、运动时间长于低负荷（P<0.05）；较大负荷原地深蹲患者深蹲次数、心率大于中等负荷，间歇时间、运动时间长于中等负荷（P<0.05）。L-5-60"（餐后60 min低负荷5组）、M-5-45"（餐后45 min中等负荷5组）原地深蹲组合GAUC小于对照（餐后保持静坐）及L-3-30"（餐后30 min低负荷3组）、M-3-45"（餐后45 min中等负荷3组）、H-3-60"（餐后60 min较大负荷3组）、L-4-45"（餐后45 min低负荷4组）、M-4-60"（餐后60 min中等负荷4组）、H-4-30"（餐后30 min较大负荷4组）、H-5-30"（餐后30 min较大负荷5组）原地深蹲组合（P<0.05）。综上，确定有氧运动结合原地深蹲组的原地深蹲抗阻训练方案：运动方式为原地深蹲；运动强度为30%或50%最大原地深蹲次数，5组；运动时间为20~30 min，间歇时间为2~3 min；运动频率为2次/周（周二、四）；运动起始时间为血糖峰值前30~45 min。干预后，有氧运动组、有氧运动结合原地深蹲组患者血糖低于对照组（P<0.05）。有氧运动组干预后血糖低于干预前（P<0.05）；有氧运动结合原地深蹲组患者干预后血糖、C肽低于干预前（P<0.05）。干预后，有氧运动组、有氧运动结合原地深蹲组患者三酰甘油（TG）、胆固醇（CHO）低于对照组（P<0.05）；干预后，有氧运动结合原地深蹲组患者高密度脂蛋白胆固醇（HDL-C）高于对照组、有氧运动组（P<0.05）。有氧运动组患者干预后TG、CHO低于干预前（P<0.05）；有氧运动结合原地深蹲组患者干预后TG、CHO低于干预前，HDL-C高于干预前（P<0.05）。结论　有氧运动结合M-5-45"、L-5-60"原地深蹲可作为中年2型糖尿病患者的有氧运动结合原地深蹲抗阻训练的有效方案，其具有改善患者血糖、血脂及增强胰岛细胞功能的作用，且增加HDL-C的作用优于单纯有氧运动。

关键词: 糖尿病, 2型；中年人；需氧运动；抗阻训练；原地深蹲