饮食和运动干预对妊娠期糖尿病病人血糖控制和妊娠结局影响的Meta分析

A meta-analysis of influence of diet and exercise interventions on blood glucose control and pregnancy outcomes in patients with gestational diabetes mellitus

[目的]评价饮食、运动干预对妊娠期糖尿病病人血糖控制和妊娠结局的影响。[方法]计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普(VIP)、万方、PubMed、EBSCO、Springer Link数据库关于饮食和运动干预对妊娠期糖尿病病人血糖控制和妊娠结局影响的随机对照试验(RCT),对相关文献进行筛选和资料提取,并按照Cochrane偏倚风险评估评判标准进行文献质量评价,对符合质量标准的RCT进行Meta分析。[结果]共纳入6篇RCT。干预组(饮食和运动干预)病人空腹血糖和餐后2h血糖值及妊娠不良结局(妊娠期高血压、羊水过多、巨大儿、早产、胎儿窘迫)发生情况均低于对照组(常规护理),两组比较差异有统计学意义(P<0.05)。[结论]妊娠期糖尿病病人进行饮食和运动干预,能够有效控制血糖,减少妊娠不良结局的发生。

Objective：To evaluate the influence of diet and exercise interventions on blood glucose control and pregnancy outcome in patients with gestational diabetes mellitus.Methods：Computer retrieved China hownet（CNKI）,Chinese biomedical literature database（CBM）,VIP,Wangfang,PubMed,EBSCO,Springer Link database about diet and exercise intervention in patients with gestational diabetes glycemic control and pregnancy outcomes of randomized controlled trial（RCT）,the data of related literature were extracted.And according to Cochrane Bias Risk Assessment Criteria,literature quality was evaluated,and RCT conforming to quality criteria was analyzed by Meta-analysis.Results：A total of 6 RCT articles were included.Fasting blood glucose,2-h postprandial blood glucose and adverse pregnancy outcomes（gestational hypertension,excessive amniotic fluid,macrosomia,premature birth,fetal distress）were all lower in intervention group（diet and exercise intervention）than that in control group（routine care）,and the differences between the two groups were statistically significant（P〈0.05）.Conclusions：Diet and exercise interventions for gestational diabetes patients could effectively control blood glucose and reduce the occurrence of adverse pregnancy outcomes.