中医辨证治疗妊娠期糖尿病的临床效果  

Effect of the Traditional Chinese Medicine Constitution Differentiation and Treatment on Gestational Diabetes Mellitus

作　　者：侯峰[1] 梁海英[1] 肖英[2] 郑瑛[1] 饶美兰[1] 

机构地区：[1]广东省妇幼保健院产科,广州510010 [2]广东省妇幼保健院中医妇科

出　　处：《中国计划生育学杂志》2015年第10期688-691,共4页Chinese Journal of Family Planning

基　　金：广东省中医药局课题(20131123)

摘　　要：目的:探讨中医辨证治疗妊娠期糖尿病(GDM)的临床效果。方法:采用前瞻性研究方法,对在本院门诊正规产检的GDM孕妇进行体质评估,分别从平和体质与偏颇体质孕妇中随机选择60例为平和体质组与偏颇体质组。检测两组孕妇血清中的糖脂代谢水平,分别对两组孕妇进行饮食调节或中医辨证治疗,分析干预前后指标的变化,判断中医治疗效果。结果:偏颇体质组孕妇空腹血糖(FPG)、空腹胰岛素(FINS)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白水平(LDL-C)明显高于平和体质组,而内脂素、高密度脂蛋白(HDL-C)、载脂蛋白A(ApoA)及载脂蛋白A与载脂蛋白B的比值(ApoA/ApoB)明显低于平和体质组(P<0.05)。经过中医辨证治疗后,发现偏颇体质组中有42例(70%)转为平和体质,18例(30%)仍为偏颇体质。中医辨证治疗后偏颇体质组FPG、FINS、糖化血红蛋白(HbA1c)、TG、TC、LDL-C和ApoB水平明显低于治疗前(P<0.05),而内脂素、HDL-C、ApoA和ApoA/ApoB值则高于治疗前(P<0.05)。结论:GDM孕妇多为中医偏颇体质,辨证治疗GDM,能有效改善糖脂代谢紊乱。Objective： To explore the clinical effect of the traditional chinese medicine treatment Based upon Differentia- tion of Syndromes in patients with gestational diabetes mellitus（GDM）. Methods： 120 cases of gestational women with GDM who received antenatal care in Guangdong Women and Children Hospital were recruited. According to outcomes of physical assessment of these women by Chinese medicine, all the women were divided into balance type group（n=60） or imbalance type group（n= 60）. Serum levels of glucose and lipid metabolism indexes were determined for all women. All women were given dietary guidance and chinese medicine treatment based on syndrome differentiation. Glucose and lipid metabolism indexes were analyzed before and after intervention, and the effects of traditional chinese medical were evaluated. Results： Levels of fasting plasma glucose（FPG）, fasting insulin（FINS）, triglyceride（TG）, low density lipoprotein eholesterol（LDL-C） and total cholesterol（TC） in patients with imbalance type was higher than that of patients with balance type, but the levels of Visfatin, high density lipoprotein cholesterol（HDL-C）, apolipopro- tein A（ApoA） and ApoA/ApoB was lower than that of patients in the balance type group, the differences was statisti- cally significant（P^0.05）. After the traditional chinese medicine intervention, 42 cases of gestational women with im- balance type were changed into balance type. The levels of FPG, FINS, glyeosylated hemoglobin Ale （HbAlc）, TG, TC, LDL-C and apolipoprotein B（ApoB） in the pregnant women with imbalance type were significantly lower than that of pretherapy（P〈0.05）. However, the levels of Visfatin, HDL-C, ApoA and ApoA/ApoB were higher than that of pretherapy（P〈0.05）. Conclusion： Most of pregnant women with GDM are imbalance types. The traditional chinese medicine treatment based on syndrome differentiation is effective in treating GDM, which can improve the metabolism of glucose and lipid disorders.

关 键 词：妊娠期糖尿病 糖代谢 脂代谢 中医体质 

分 类 号：R271.9[医药卫生—中西医结合]