个体化营养治疗和运动疗法对妊娠期糖尿病的联合治疗价值分析

Analysis of the Combined Treatment Value of Individualized Nutrition Therapy and Exercise Therapy for Gestational Diabetes

目的研究经筛查不需要胰岛素治疗的妊娠期糖尿病患者采取个体化营养治疗联合运动疗法的临床效果。方法选取该院2014年8月—2016年4月期间所收治的经筛查不需要胰岛素治疗的妊娠期糖尿病患者68例作为该次研究对象,按照随机数字表法将其分为研究组(n=34)与对照组(n=34),对照组应用常规饮食与运动指导,研究组行个体化营养治疗与孕妇运动疗法(体操治疗),对比分析两组孕妇的空腹血糖、餐后2 h血糖以及糖化血红蛋白的变化,并比较两组新生儿出生体重与围产期结局。结果两组在早产、胎儿窘迫、新生儿高胆红素血症、子痫前期方面差异无统计学意义(P>0.05),研究组巨大儿发生率显著低于对照组,组间差异有统计学意义(χ~2=5.100 0,P<0.05)。治疗后,研究组FBG(4.41±0.42)mmol/L、2 hPBG(5.71±0.54)mmol/L以及HbAlc(5.54±0.45)%水平显著低于对照组(4.68±0.52)mmol/L、(7.24±0.53)mmol/L、(5.95±0.43)%,组间差异有统计学意义(t=2.355 3、11.790 7、3.840 9,P<0.05)。结论个体化营养治疗与运动疗法联合应用在妊娠期糖尿病中的效果显著能够有效控制孕妇的血糖,且新生儿的出生体重较为理想,能够有效促进母婴健康。

Objective To study the clinical effects of individualized nutritional therapy combined with exercise therapy in gestational diabetes patients who did not require insulin therapy. Methods 68 patients with gestational diabetes mellitus who were screened for no treatment with insulin in the hospital from August 2014 to April 2016 were enrolled as the study subjects. They were divided into study group （n=34） and control group（n=34） according to the random number table method. The control group used routine diet and exercise guidance, the study group performed individualized nutrition therapy and pregnant women exercise therapy （gymnastics treatment）, and compared the fasting blood glucose and postprandial 2 hours of the two groups of pregnant women of blood glucose and glycosylated hemoglobin changes, and compared the birth weight and perinatal outcomes of the two groups. Results There was no significant difference between the two groups in premature delivery, fetal distress, neonatal hyperbilirubinemia, and preeclampsia（P〉0.05）. The incidence of macrosomia in the study group was significantly lower than that in the control group, and the difference between the groups was statistically significant （χ2=5.100 0, P〈0.05）. After treatment, the FBG （4.41±0.42） mmol/L, 2 hPBG（5.71±0.54） mmol/L and HbAlc （5.54±0.45）% levels in the study group were significantly lower than those in the control group （4.68±0.52） mmol/L, （7.24±0.53）mmol/L, （5.95±0.43）%, the difference between the groups was significant, and there was statistically significant （t=2.355 3, 11.790 7, 3.840 9, P〈0.05）. Conclusion The combination of individualized nutrition therapy and exercise therapy in gestational diabetes can significantly control the blood glucose of pregnant women, and the birth weight of newborns is ideal, which can effectively promote maternal and child health.