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目的探讨小麦纤维素颗粒添加疗法对妊娠期糖尿病(gestational diabetes mellitus,GDM)患者血糖和血脂的影响,以及对GDM患者的最佳营养治疗方案。方法采取多中心随机对照临床研究,选取在孕24~28周诊断为GDM的患者180例,随机分为观察组和对照组,每组各90例,分别接受医学营养治疗+小麦纤维素颗粒和医学营养治疗4周。分别在治疗前、饮食干预4周后检测空腹血糖(fasting plasma glucose,FPG)和餐后1 h、餐后2 h血糖、糖化血红蛋白(glycosylated hemoglobin,Hb A1c)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白(high density lipid cholesterol,HDL)、低密度脂蛋白(low density lipid cholesterol,LDL)水平,比较两组妊娠结局情况。结果干预4周后两组FPG、HDL比较差异无统计学意义(P>0.05);观察组餐后1 h、2 h小时血糖、Hb A1c、LDL、TC和TG[(9.60±1.71)mmol/L、(7.90±1.48)mmol/L、(4.40±0.7)%、(3.19±0.49)mmol/L、(5.62±1.21)mmol/L、(2.09±0.48)mmol/L]均低于对照组[(10.30±1.68)mmol/L、(8.90±1.65)mmol/L、(4.80±0.8)%、(3.56±0.58)mmol/L、(6.13±1.17)mmol/L、(2.57±0.52)mmol/L],(P<0.05);两组妊娠结局比较差异无统计学意义(P>0.05)。结论在GDM患者饮食中添加小麦纤维素颗粒4周可以显著改善GDM患者的血糖和血脂水平。
Objective To investigate the effects of wheat granule addition therapy on blood glucose and blood lipids in patients with gestational diabetes mellitus (GDM) and the optimal nutritional therapy for GDM patients. Methods A multicenter randomized clinical trial was conducted. One hundred and eighty patients diagnosed with GDM between 24 and 28 weeks’ gestation were randomly divided into observation group and control group, with 90 patients in each group receiving medical nutrition treatment and wheat cellulose granules Medical nutrition treatment for 4 weeks. Blood glucose, glycosylated hemoglobin (Hb A1c), total cholesterol (TC) were measured before treatment and after 4 weeks of diet intervention respectively. The fasting plasma glucose (FPG) , Triglyceride (TG), high density lipid cholesterol (HDL) and low density lipoprotein (LDL) levels were compared between the two groups. Results There was no significant difference in FPG and HDL between the two groups after intervention for 4 weeks (P> 0.05). The levels of Hb A1c, LDL, TC and TG [(9.60 ± 1.71) mmol / L, (7.90 ± 1.48) mmol / L, (4.40 ± 0.7)%, (3.19 ± 0.49) mmol / L, (5.62 ± 1.21) mmol / L and (2.09 ± 0.48) mmol / L] The levels of [(10.30 ± 1.68) mmol / L, (8.90 ± 1.65) mmol / L, (4.80 ± 0.8)%, (3.56 ± 0.58) mmol / L, /L], (P <0.05). There was no significant difference in pregnancy outcome between the two groups (P> 0.05). Conclusion The addition of wheat-cellulose granules to the diet of GDM patients for 4 weeks significantly improved blood glucose and lipid levels in GDM patients.