本文選題：妊娠期糖尿病 + 中醫(yī)體質(zhì)　； 參考：《河南中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:探討孕早期中醫(yī)體質(zhì)及糖化血紅蛋白水平與妊娠期糖尿病(gestational diabetes mellitus,GDM)發(fā)病的相關(guān)性,從“治未病”的角度出發(fā),對(duì)高危人群進(jìn)行中醫(yī)體質(zhì)調(diào)理,為臨床預(yù)防GDM的發(fā)生提供思路和方法,構(gòu)建具有中醫(yī)特色的孕期保健模式。方法:本課題采用橫斷面調(diào)查的研究方法,對(duì)2015年3月~2016年2月在河南中醫(yī)藥大學(xué)第一附屬醫(yī)院定期產(chǎn)前檢查的孕婦進(jìn)行抽樣調(diào)查,選取符合GDM診斷標(biāo)準(zhǔn)的105例孕婦作為病例組,采用單純隨機(jī)抽樣法從243例同期健康孕婦中選取105例作為對(duì)照組。對(duì)調(diào)查對(duì)象采用自擬的鄭州市地區(qū)妊娠早期孕婦中醫(yī)體質(zhì)調(diào)查表(見(jiàn)附錄1)進(jìn)行調(diào)查,將調(diào)查結(jié)果錄入SPSS,建立數(shù)據(jù)庫(kù)。全部數(shù)據(jù)采用SPSS21.0統(tǒng)計(jì)學(xué)軟件進(jìn)行處理,計(jì)量資料如年齡、體質(zhì)指數(shù)等采用兩獨(dú)立樣本的t檢驗(yàn)進(jìn)行統(tǒng)計(jì)分析,用均數(shù)±標(biāo)準(zhǔn)差進(jìn)行統(tǒng)計(jì)描述,計(jì)數(shù)資料職業(yè)、教育程度等采用χ~2檢驗(yàn)進(jìn)行分析,對(duì)病例組及對(duì)照組體質(zhì)類(lèi)型構(gòu)成差異的比較采用Fisher精確概率法分析,對(duì)GDM相關(guān)因素的研究采用logistic回歸分析。結(jié)果:(1)中醫(yī)體質(zhì)辨識(shí)中GDM孕婦組主要的偏頗體質(zhì)類(lèi)型為痰濕質(zhì),占24.8%,其次為陰虛質(zhì),正常孕婦組主要偏頗體質(zhì)為陽(yáng)虛質(zhì)、陰虛質(zhì),GDM孕婦組與正常孕婦組體質(zhì)構(gòu)成存在明顯差異,P=0.020.05提示差異具有統(tǒng)計(jì)學(xué)意義;(2)GDM孕婦組與健康孕婦組糖化血紅蛋白水平存在明顯差異,P=0.0020.05,其差異有顯著統(tǒng)計(jì)學(xué)意義;(3)GDM孕婦組與健康孕婦組孕前體重指數(shù)、糖尿病家族史、PCOS史、飲食偏嗜的比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);(4)通過(guò)GDM相關(guān)因素Logistic回歸分析提示:痰濕體質(zhì)、糖尿病家族史、糖化血紅蛋白水平均與GDM發(fā)病呈正相關(guān),相關(guān)系數(shù)分別為1.247、1.209、2.261,OR值分別為3.351、3.479、9.596。結(jié)論:(1)痰濕體質(zhì)為GDM的易感偏頗體質(zhì);(2)糖化血紅蛋白水平與GDM呈正相關(guān),有望成為早期預(yù)測(cè)GDM的指標(biāo);(3)多因素Logistic回歸分析提示:糖尿病家族史、痰濕質(zhì)、糖化血紅蛋白水平是GDM的獨(dú)立危險(xiǎn)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 鹵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.
【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R271.9

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