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[size=24]饮食在澳大利亚对Ⅱ型糖尿病的影响——病例分析[/size]

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徐红
(澳大利亚针灸中医协会;维多利亚大学)
摘要 我们生活的社会环境,饮食和生活方式都会对我们的健康产生影响。糖尿病的发病在世界范围内已
经成为影响人们生活和致死的主要疾病之一。在澳大利亚,很多移民成为二型糖尿病的高发人群,他们的
饮食在二型糖尿病发病中起到了主要的作用,一些与饮食有关的文化和观念需要随环境和生活方式的变化
而改变,以适应阴阳和五行平衡的需要。本文通过病例分析提供临床实践证据,阐述饮食和文化观念改变
以及应用中药对二型糖尿病的重要性。人与社会,环境的和谐与适应直接关系到人类的健康与生活质量。
关键词 2 型糖尿病,饮食,环境,观念,中医药
The impact of diet on type Ⅱ diabetes in Australia – Case study
XuHong
( Australian Acupuncture and Chinese Medicine Association,AACMA; Victoria University,PO Box 99, Avondale
Heights, Vic 3034, Australia)
AbstractOur living and social environment, food, and life style all impact on our health. Diabetes has become one
of the major contributors to morbidly and death worldwide and is now considered to be at epidemic proportion. In
Australia, many people who are migrants are especially susceptible to type II diabetes. Their diet has been one of
the main factors which contributed to the development of type II diabetes and some of the culture and believe
orientated diet habits await to be changed to reflect the body’s needs and the balance of yin yang and elements.
This paper utilizes case study, presenting evidence of clinical practice, argues the importance of the change of diet
and culture beliefs, and the effect of Chinese herbal treatment in relation to type II diabetes. The harmonization
between human beings and the environment directly impact on peoples’ health and well-being.
Key words Type Ⅱ diabetes, diet, environment, beliefs, Chinese herbal medicine
Introduction
Our living environment, food, and life style all impact on our health. When there is a change of environment, our
food and life style should also be changed to reflect the body’s need and the balance of yin yang and elements.
Diabetes has become one of the major contributors to morbidly and death worldwide and is now considered to be
at epidemic proportion. About 85-95% of people with diabetes are diagnosed with type II (the largely
lifestyle-induced) diabetes[1]. Australia is the most obese country internationally and has a burgeoning chronic
disease epidemic, particularly of type II diabetes[2].
Social relationships can enhance or hamper quality of life, coherence, sense of personal worth, health, educational
and economic opportunities[3]. Social network members (eg, from health and community services, ethno-specific
groups, families, friends, sporting clubs, faith-based) influence lifestyle behaviors and self-management of
diabetes [4]. Little study has explored these networks and their features which influence migrant people to adopt
approaches beneficial/detrimental to their lifestyles, diabetes risk and self-management.
As the unique methods of TCM diagnostic procedures and treatment strategies of type II diabetes are in
current-day practice, many researchers have investigated the efficacy and safety of using herbs medicine and have
demonstrated positive results and fewer side effects than western biomedical interventions involving the use of
medications[5].The ensuing treatment strategy thus not only addresses the disease itself, but also the pattern of
disharmony underlying the disease, meaning that diabetes can be addressed using several possible treatment
strategies. However, in our clinical practice, the patients’ condition may fluctuate during the treatment due to their
diet habits and beliefs.
Case study
Description of the patient: Male, 50 yrs old. Australian (English origin, last generation migrated from England).
Main symptoms present: The patient feels abdominal pain andstress which relates to the blood sugar test result
showing type II diabetes for over half year.
第九届世界中医药大会
The 9th World Congress of Chinese Medicine
•43 0•
临 证 体 会
Clinical experience
The present condition and history: The patient feels abdominal pain and bloating at the middle and left side of his
abdomen.He had a blood test half a year ago which indicated type II diabetes, the blood sugar level was 6.5. Five
years ago diagnosed chronic gastritis and chronic cholecystitis.His appetite is ok, but sometimes has a sticky
bowel movement.
Accompanying symptoms: Occasionally feels palpitationand has an elevatedcholesterol level; Commonly
feelinghot
The examination of general condition: 1) Tongue: Red-purple tongue body, with a deep crack covering 80% (more
in mid and rear) of the tongue, yellow greasy coating.2) Pulse: Slippery and wiry pulse. 3) Face and skin: slightly
red and dry. 4) Dietary checks indicate that the patient isconsuming a large amount of food, meat diet, dietary
products,spicy food and alcohol.
Chinese medicine diagnosis: Damp heat in the Middle and Lower Jiao, Liver Spleen disharmony, Stomach and
Kidney Yin deficiency.
Treatment strategies: Clearing damp heat, harmonizingLiver and Spleen, regulating diet
Chinese herbal formula: Jia Wei Xiao Yao San and Wen Dan Tang modification for two weeks.
Treatment outcomes: The patient’s abdominal pain reduced significantly, abdominal bloating reduced about 50%,
bowel movement improved. Tongue coating reduced and the color changed from yellow to white. Pulse was
slightly slippery and wiry.
The same treatment with dosage modificationswas continued for four weeks: The patient had another blood test
two months after the above treatment and the results indicated a normal sugar level. There were no noticeable
symptoms.
Advise: using dietary therapy to follow up, eg. To increase vegetables and fruits, reduce meat diet and spicy food.
Follow up treatments and outcomes: In 3 months, the patient came back with the previous presented symptoms
and signs but not as severe as before. After being questioned about his diet, the patient indicated that spicy food,
wine and meat have been consumed. After a discussion on the importance of managing diet, the patient indicated
that the diet habit had been established from the last generation, when they were in England. This includes three
meals, one morning tea and one afternoon tea. He believed that he had been taking a balanced and healthy diet for
years. Chinese medicine dietary therapy education sessions have been conducted at three different times with the
whole familyin order to convince the patient to change his diet. Together with the collaboration of his family, the
patient’s blood sugar level and abdominal pain have not re-occurredsince.
Discussion
The patient’s family dietary habit brought from England was composed by a large amount of meat, some diary
food(eg. Cheese and milk), bread, vegetables and cake, coffee, wine and black tea.The climate in England is cold
andthe geographic location of England belongs to Metal in the five elements. Warm natured foods are needed to
balance the Yin and Yang. Most of the foods mentioned are warm natured, which can increase heat and consume
Yin. The patient has a weak digestivefunction andmetabolicsyndromes, these foods could not be digested easily by
him, resulting in damp heat or food stagnation, causing abdominal symptoms. However, the climate in Australia is
warm andthe geographic location of Australia belongs to Fire in the five elements, all the warm natured foods
caused more imbalance of Yin and Yang, increased the heat. This patient has heat and stomach Yin deficiency, if
the diet is not changed, the patterns of disharmony could re-occur easily.
Conclusion
The habit of choosing and cooking of meat diets, the different views of rich and sweet food are common issues in
type II diabetes occurrence and development. It is important that people change their living environmentsto adopt
new approaches to benefittheir lifestyles and reduce diabetes risk. Chinese herbal medicine could provide
effective treatment on type II diabetes. Chinese medicine yin yang, five element theory and dietary therapy
practice are valuable and beneficial to the prevention and management of chronic diseases.The harmonization
between human beings and their living environments directly impact on peoples’ health and well-being.
References
1.WHO 2009, Diabetes, Fact sheet No 312 November.
2.(1) Wilson, P. W., Kannel, W. B., Silbershatz, H., D’Agostino, R. B. (1999). Clustering of metabolic factors and
coronary heart disease. Archives of Internal Medicine. 159:1104–1109. (2) Isomaa, B., Almgren, P., Tuomi, T.,
Forsen, B., Lahti, K., Nissen, M., Taskinen, M. R. and Groop L. (2001). Cardiovascular morbidity and mortality
associated with the metabolic syndrome. Diabetes Care. 24:683–689. (3) Trevisan, M., Liu, J., Bahsas, F. B.,
Menotti, A. (1998). Syndrome X and mortality: a population-based study: Risk Factor and Life Expectancy
Research Group. American Journal of Epidemiology. 148:958–966. (4) Haffner, S. M., Valdez, R. A., Hazuda, H.
P., Mitchell, B. D., Morales, P. A. and Stern, M. P. (1992). Prospective analysis of the insulin-resistance syndrome
第九届世界中医药大会
The 9th World Congress of Chinese Medicine
•431•
临 证 体 会
Clinical experience
(syndrome X). Diabetes. 41:715–722.
3.World Health Organisation. (1991). Sundsvall Statement on Supportive Environments for Health. Third
International Conference on Health Promotion, Sundsvall, Sweden, 9–15 June. Geneva.
4.Gallant, M. P. (2003). The influence of social support on chronic illness self-management: a review and
directions for research. Health Education and Behavior, 30(2):170-195.
5.Liu, J; Zhang, M; Wang, W; Grimsgaard, S 2004, Chinese Herbal Medicines for Type 2 6.Diabetes Mellitus,
Cochrane Database of Systematic Reviews 2002, Issue 3. Art. No.: CD003642. DOI:
10.1002/14651858.CD003642.pub2.

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