二甲双胍联合运动疗法干预妊娠期糖尿病患者的临床研究

Clinical Study of Metformin Combined with Exercise Therapy in Intervention of Patients with Gestational Diabetes Mellitus

目的:探讨二甲双胍联合运动疗法对妊娠期糖尿病(GDM)患者临床效果的影响。方法:将2020年3月到2022年3月北京航天总医院收治的89例GDM患者,按照抛掷硬币法随机分为组分为观察组(n=45)和对照组(n=44)。对照组口服盐酸二甲双胍片,观察组在对照组基础上加用运动疗法。对比两组患者的临床疗效、血糖指标、氧化应激指标、炎症因子水平、妊娠结局及不良反应。结果:治疗后观察组临床疗效总有效率93.33(42/45)高于对照组75.00%(33/44)(P<0.05)。治疗后两组患者空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbAlc)均降低,且观察组显著低于对照组(均P<0.05)。治疗后两组超氧化物歧化酶(SOD)水平均升高且观察组显著高于对照组,丙二醛(MDA)、活性氧(ROS)水平均降低且观察组显著低于对照组(均P<0.05)。治疗后两组超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)水平均降低且观察组水平显著低于对照组(均P<0.05)。观察组剖宫产、早产发生率低于对照组(均P<0.05)。治疗期间两组患者不良反应事件总发生率无差异(P>0.05)。结论:二甲双胍联合运动疗法能有效控制GDM患者血糖水平,优化氧化应激指标,降低炎症因子水平,改善妊娠结局,且具有一定的安全性。

Objective:To explore the influence of metformin combined with exercise therapy on the clinical effect of patients with gestational diabetes mellitus(GDM).Methods:89 patients with gestational diabetes admitted to Beijing Aerospace General Hospital from March 2020 to March 2022 were were randomly divided into observation group(n=45)and control group(n=44)according to the coin toss method.The control group was given metformin hydrochloride tablets orally,while the observation group was given exercise therapy on the basis of the control group.The clinical efficacy,blood glucose indicators,oxidative stress indicators,inflammatory factor levels,pregnancy outcomes,and adverse reactions of the two groups of patients were compared.Results:After treatment,After treatment,the total effective rate of clinical efficacy in the observation group was 93.33%(42/45),which was higher than 75.00%(33/44)in the control group(P<0.05).After treatment,fasting blood glucose(FPG),2 h plasma glucose(2hPG),and glycosylated hemoglobin(HbAlc)in both groups decreased,and the observation group was significantly lower than the control group(all P<0.05).After treatment,the levels of superoxide dismutase(SOD)in both groups increased and the observation group was significantly higher than the control group,while the levels of malondialdehyde(MDA)and reactive oxygen species(ROS)decreased and the observation group was significantly lower than the control group(all P<0.05).After treatment,the level of hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor(TNF-α),interleukin-6(IL-6)in both groups decreased and the observation group was significantly lower than that in the control group(all P<0.05).The incidence of cesarean section and premature delivery in the observation group was lower than that in the control group(all P<0.05).There was no difference in the total incidence of adverse events between the two groups during treatment(P>0.05).Conclusion:Metformin combined with exercise therapy can effectively control blood glucose levels in GDM patients,optimize oxidative stress indicators,reduce inflammatory factor levels,and improve pregnancy outcomes,and has certain safety.