妊娠期糖尿病患者中医体质类型分析及其与孕产期并发症的相关性研究  

TCM constitution types of gestational diabetes mellitus and their correlation to complications during pregnancy and childbirth

作　　者：王景尚[1] 吴英 刘晓巍[2] 李源[2] 郭翠梅[2] 武颖[1] 尹晓丹[1] 李宪锐 何军琴[1] Wang Jingshang;Wu Ying;Liu Xiaowei;Li Yuan;Guo Cuimei;Wu Ying;Yin Xiaodan;Li Xianrui;He Junqin(Department of Traditional Chinese Medicine,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China;Department of Obstetrics,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院中医科,北京100026 [2]首都医科大学附属北京妇产医院围产医学部

出　　处：《北京中医药大学学报》2020年第8期696-701,共6页Journal of Beijing University of Traditional Chinese Medicine

基　　金：北京中医药科技发展资金项目(No.JJ2016-22);北京市优秀人才培养项目(No.2015000021469G216);北京市医院管理局临床医学发展专项经费资助项目(No.ZYLX201510);北京市医院管理局登峰人才培养计划(No.DFL20151301)。

摘　　要：目的明确妊娠期糖尿病(GDM)患者的中医体质类型及其与孕产期并发症的相关性。方法纳入144例在首都医科大学附属北京妇产医院建立孕产妇围产保健手册、定期进行相关检查的孕产妇,其中GDM组72例、对照组(无妊娠合并症)72例。测定孕妇入组时空腹血糖(FBG)、糖化血红蛋白(HBA1c)和糖化血清蛋白(GSP)水平,在入组时和分娩前分别进行中医体质辨识、记录孕产期并发症的发生情况。结果GDM组FBG、HBA1c和GSP水平均高于对照组;入组时及分娩前GDM组的偏颇体质比例高于对照组(P<0.01)。入组时,GDM组孕妇最常见的体质类型为阴虚质(27.8%)和痰湿质(20.8%);分娩前,GDM组以阴虚质(26.4%)、痰湿质(18.1%)为常见;GDM组妊娠高血压、剖宫产、胎膜早破、巨大儿、早产儿等孕产期并发症发生次数均高于对照组(P<0.05);阴虚质、气虚质、湿热质及痰湿质是GDM组孕产期并发症发生次数最高的4种体质类型;GDM组内阴虚质并发症发生次数高于平和质(P<0.05)。结论GDM患者易出现偏颇体质,以阴虚质和痰湿质最为常见,且阴虚质GDM患者孕产期并发症的比例高于平和质,为临床及早干预提供了思路。Objective To observe the TCM constitution types of gestational diabetes mellitus(GDM),and their correlation to complications during pregnancy and childbirth.Methods 144 cases who took routine pregnancy check-up in Beijing Obstetrics and Gynecology Hospital,Capital Medical University,were enrolled,including GDM group and control group(no pregnancy complications)(n=72).The levels of fasting blood glucose(FBG),glycosylated hemoglobin(HBA1 c)and glycosylated serum protein(GSP)were measured on enrollment.The TCM constitution identification was done on enrollment and before delivery.The occurrence of complications during pregnancy and childbirth were recorded.Results The levels of FBG,HBA1 c and GSP in the GDM group were significantly higher than those in the control group(P<0.01).The proportion of biased constitutions in the GDM group was significantly higher than that in the control group(P<0.01).On enrollment,the most common TCM constitution types in the GDM group were Yin Deficiency Constitution and Phlegm-Dampness constitution,accounting for 27.78%and 20.83%respectively.Before delivery,the proportion of Yin Deficiency Constitution and Phlegm-Dampness Constitution in the GDM group were 26.4%and 18.1%respectively.The incidence of complications during pregnancy and delivery in the GDM group was significantly higher than that in control group(P<0.05).Yin Deficiency,Qi Deficiency,Dampness-Heat and Phlegm-Dampness were the four constitution types with the highest incidence of complications during pregnancy and childbirth in the GDM group,which were significantly higher than those in the control group.In the GDM group,the complications rates of the Yin Deficiency Constitution were all higher than that of Balanced Constitution(P<0.05).Conclusion Patients with GDM seem to be more likely to have biased constitution types,especially Yin Deficiency and Phlegm-Dampness Constitutions.Meanwhile the incidence of complications during pregnancy and perinatal period in GDM patients with Yin dificiency Constitution seems to be higher

关 键 词：妊娠期糖尿病 中医体质 孕产期并发症 

分 类 号：R271.9[医药卫生—中西医结合]