妊娠期糖尿病孕妇的常见中医体质分布及糖脂代谢研究

目的:探讨妊娠期糖尿病(Gestational Diabetes Mellitus,GDM)孕妇的常见中医体质分布及糖脂代谢情况,为防治GDM提供理论依据。方法:随机选取265例GDM孕妇作为研究对象,采用体质调查问卷,判定GDM患者的中医体质类别。检测受试者的糖脂代谢指标空腹血糖(Glucose,GLU)、餐后2 h血糖(2 hours Postprandial Blood Glucose,2 h PG)和糖化血红蛋白(Glycated Hemoglobin A1c,HbA1c)、总胆固醇(Total Cholesterol,TC)、三酰甘油(Triglycerides,TG)和低密度脂蛋白(Low Density Lipoprotein Cholesterol,LDL-C)]。选取前五种常见的体质类型,比较各组间糖脂代谢指标差异。结果:GDM常见中医体质为痰湿质(30.6%,81/265)、湿热质(23.8%,63/265)、气虚质(16.2%,43/265)、平和质(10.2%,27/265)、阳虚质(8.3%,22/265)。糖脂代谢方面,痰湿质组TC和LDL-C水平均分别高于气虚质、平和质和阳虚质组(P<0.05);但GDM常见五种中医体质组间GLU、2 h PG、HbA1c和TG水平差异均无统计学意义(P>0.05)。结论:GDM孕妇中医体质以偏颇质为主,以痰湿质所占比例最高,糖脂代谢差异主要体现在血脂代谢方面。治疗应注重祛湿化痰健脾,并注意调控血脂代谢。

A study on common TCM constitution types and glycolipid metabolism of pregnant women with gestational diabetes mellitus

Objective:Common TCM constitution types and glycolipid metabolism of pregnant women with GDM were evaluated.Methods:265 cases were randomly enrolled in this study.The TCM constitution types of patients were determined according to questionnaires.The glucolipid metabolism indexes(including GLU,2 h PG,HbA1c,TC,TG and LDL-C)were detected.The five common TCM constitution types were selected to compare the differences in glycolipid metabolism among all groups.Results:Five TCM constitution types were the Phlegm-dampness constitution(30.6%,81/265),dampness-heat constitution(23.8%,63/265),Qi deficiency constitution(16.2%,43/265),balanced constitution(10.2%,27/265)and Yang(阳)deficiency constitution(8.3%,22/265).In terms of glucolipid metabolism,TC and LDL-C levels in the Tanshi constitution group were higher than the Qixu constitution group and banlanced constitution group and Yangxu constitution group(P<0.05).There were no significant difference in GLU,2 h PG,HbA1c and TG levels among groups(P>0.05).Conclusion:The TCM constitution type of pregnant women with GDM is mainly biased constitution type,with Tanshi constitution accounting for the highest proportion.The difference in glucolipid metabolism is mainly reflected in lipid metabolism.Treatment should focus on eliminating dampness,removing phlegm and strengthening spleen,and pay attention to the regulation of lipid metabolism.