孕早期中医体质及糖化血红蛋白水平与妊娠期糖尿病发病的相关性

发布时间：2018-07-11 11:48

本文选题：妊娠期糖尿病 + 中医体质　；参考：《河南中医药大学》2016年硕士论文

【摘要】：目的:探讨孕早期中医体质及糖化血红蛋白水平与妊娠期糖尿病(gestational diabetes mellitus,GDM)发病的相关性,从“治未病”的角度出发,对高危人群进行中医体质调理,为临床预防GDM的发生提供思路和方法,构建具有中医特色的孕期保健模式。方法:本课题采用横断面调查的研究方法,对2015年3月~2016年2月在河南中医药大学第一附属医院定期产前检查的孕妇进行抽样调查,选取符合GDM诊断标准的105例孕妇作为病例组,采用单纯随机抽样法从243例同期健康孕妇中选取105例作为对照组。对调查对象采用自拟的郑州市地区妊娠早期孕妇中医体质调查表(见附录1)进行调查,将调查结果录入SPSS,建立数据库。全部数据采用SPSS21.0统计学软件进行处理,计量资料如年龄、体质指数等采用两独立样本的t检验进行统计分析,用均数±标准差进行统计描述,计数资料职业、教育程度等采用χ~2检验进行分析,对病例组及对照组体质类型构成差异的比较采用Fisher精确概率法分析,对GDM相关因素的研究采用logistic回归分析。结果:(1)中医体质辨识中GDM孕妇组主要的偏颇体质类型为痰湿质,占24.8%,其次为阴虚质,正常孕妇组主要偏颇体质为阳虚质、阴虚质,GDM孕妇组与正常孕妇组体质构成存在明显差异,P=0.020.05提示差异具有统计学意义;(2)GDM孕妇组与健康孕妇组糖化血红蛋白水平存在明显差异,P=0.0020.05,其差异有显著统计学意义;(3)GDM孕妇组与健康孕妇组孕前体重指数、糖尿病家族史、PCOS史、饮食偏嗜的比较,差异具有统计学意义(P0.05);(4)通过GDM相关因素Logistic回归分析提示:痰湿体质、糖尿病家族史、糖化血红蛋白水平均与GDM发病呈正相关,相关系数分别为1.247、1.209、2.261,OR值分别为3.351、3.479、9.596。结论:(1)痰湿体质为GDM的易感偏颇体质;(2)糖化血红蛋白水平与GDM呈正相关,有望成为早期预测GDM的指标;(3)多因素Logistic回归分析提示:糖尿病家族史、痰湿质、糖化血红蛋白水平是GDM的独立危险因素。
[Abstract]:Objective: to investigate the correlation between the level of TCM constitution and glycosylated hemoglobin in early pregnancy and the incidence of (gestational diabetes mellitusus in gestational diabetes mellitus (GDM). To provide ideas and methods for clinical prevention of GDM, and to construct pregnant health care model with TCM characteristics. Methods: a cross-sectional survey was conducted on pregnant women in the first affiliated Hospital of Henan University of traditional Chinese Medicine from March 2015 to February 2016. 105 pregnant women who met the criteria of GDM diagnosis were selected as the case group, and 105 pregnant women were selected as control group from 243 healthy pregnant women in the same period by simple random sampling. The questionnaire of TCM physique of pregnant women in early pregnancy in Zhengzhou area (see Appendix 1) was used to investigate the subjects. The results were recorded in SPSS and the database was established. All the data were processed by SPSS21.0 statistical software, the measured data such as age and body mass index were analyzed by the t test of two independent samples, the mean 卤standard deviation was used to describe the statistics, and the occupation of the data was counted. The educational level was analyzed by 蠂 ~ 2 test, the difference of constitution between the case group and the control group was analyzed by Fisher exact probability method, and the relevant factors were analyzed by logistic regression analysis. Results: (1) in TCM physique identification, the main biased physique type of GDM pregnant women was phlegm and dampness, accounting for 24.8%, followed by yin deficiency, while normal pregnant women mainly biased Yang deficiency. There is a significant difference in constitution between GDM group and normal pregnant group. (2) there is a significant difference in glycosylated hemoglobin level between GDM pregnant group and healthy pregnant woman group (P0. 0020.05), and the difference is statistically significant. (2) there is a significant difference in glycosylated hemoglobin level between GDM pregnant women group and healthy pregnant women group (P < 0. 0020.05). (3) body mass index (BMI) before pregnancy in GDM pregnant women and healthy pregnant women, The difference was statistically significant (P0.05); (4). Logistic regression analysis showed that phlegm dampness constitution, diabetic family history and glycosylated hemoglobin level were positively correlated with the onset of); (. The correlation coefficients were 1.247 / 1.209 / 2.261 and the OR values were 3.351 / 3.479 / 9.596, respectively. Conclusion: (1) phlegm dampness constitution is susceptible to GDM, (2) the level of glycosylated hemoglobin is positively correlated with GDM, which is expected to be an early predictor of GDM, (3) multivariate logistic regression analysis shows that: family history of diabetes, phlegm wet substance, Glycosylated hemoglobin level is an independent risk factor for GDM.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.9

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