| ObjectiveThis study aims to investigate patients with gestational diabetes mellitus of Chinese medical syndrome, summarize the gestational diabetes of TCM syndrome type distribution, and the gestational diabetes of TCM syndrome is associated with glucose metabolism index which were analyzed, In order to provide theoretical basis for the syndrome diagnosis of gestational diabetes of traditional Chinese medicine, and lay a foundation for further gestational diabetes treatment of traditional Chinese medicine.MethodThis study choose 220 cases who were diagnosed GDM in obstetric outpatient and regular prenatal patients at high risk of gestational diabetes outpatient servicing in March 2013 to December 2014 the first affiliated hospital of guangzhou university of TCM, according to Diagnosis standards for common syndromes in traditional Chinese medicine, we develope gestational diabetes syndromes questionnaire which is about common syndromes of gestational diabetes, and used the questionnaire to investigate the TCM syndrome, summarize the gestational diabetes wether it related TCM syndrome types. GDM pregnant women are collected indicators of glucose metabolism, including fasting and postprandial blood glucose, fasting and postprandial 2 hour insulin, fasting and postprandial 2 hour C peptide and glycosylated hemoglobin, combine with the corresponding index to calculate insulin resistance index; Choose five types of common TCM syndrome, compare the differences between various syndromes in the levels of glucose metabolism index mean, analysis integral changes of five kinds of common syndromes with the level of glucose metabolism index. All materials are adopted into SPSS19.0 statistical software for statistical analysis.Results1 The distribution of TCM syndrome in GDM:mind Yin deficiency syndrome in 65 cases (29.5%).Qi and Yin deficiency syndrome in 52 cases (23.6%);Wet pixu (spleen deficient) trapped the 21 cases (9.5%);Liver depression and qi stagnation syndrome 19 cases (8.6%); Spleen and kidney Yang deficiency syndrome, 17 cases (7.7%); Kidney Yin deficiency syndrome,8 cases (3.6%);The kidney Yang deficiency syndrome in 5 cases (2.3%);Heart qi deficiency syndrome in 5 cases (2.3%);Liver stomach Yin deficiency syndrome in 4 cases (1.8%);Anaemia pixu (spleen deficient) card in 2 cases (0.9%);Syndrome does not exceed 14 points is defined as undetermined card type,22 cases (10.0%).2 The average age of gestational diabetes patients in this servey is 30.20 ±4.39 years old, the older pregnant women account for 16.8% of the total. Wet trapped pixu (spleen deficient) syndrome in patients with an average age of 33.14±4.21 years, significantly higher than the rest of the four type often witness and the average age of the undetermined card type, P<0.05, the difference was statistically significant.Diagnosis in patients with gestational age at 25.71±2.81 weeks on average. The average pregnancy body mass index was 21.57±3.12 squared (Kg/m2), in which pregnancy body mass index more than 23 squared (Kg/m2) ratio of 30.9%. Gestational diabetes five common TCM type of syndrome type and undecided between patients confirmed gestational age and body mass index before childbirth mean differences had no statistical significance; History of 17 cases who diagnosed with polycystic ovary syndrome, five kinds of common between TCM type of syndrome type and pending no difference between the distribution of the patients with polycystic ovary syndrome.3 The comparison of glucose metabolism index of mean between five kinds of common syndrome and the undeterminedComparison of fasting blood sugar between five kinds of common syndrome and the undetermined,1 hour after the meal, blood sugar, blood sugar 2 hours after meal, mean glycated hemoglobin, difference between each group had no statistical significance (P>0.05). Mind Yin deficiency, qi and Yin deficiency syndrome, wet trapped pixu (spleen deficient) and liver depression and qi stagnation syndrome compared with undetermined card type, fasting C peptide increased significantly, the difference was statistically significant (P< 0.05);Wet trapped pixu (spleen deficient) with mind Yin deficiency syndrome, liver depression and qi stagnation syndrome, spleen and kidney Yang deficiency syndrome and undetermined type,2 hours after meal C peptide increases, the difference was statistically significant (P<0.05). Spleen and kidney Yang deficiency syndrome and mind Yin deficiency syndrome, qi and Yin deficiency and liver depression and qi stagnation syndrome, HOMA-IR is reduced, the difference was statistically significant (P<0.05).4 The research of correlating between glucose metabolism index and integral changes of common syndrome in TCM(1) Gestational diabetes mind card of Yin deficiency syndromes integral size is positively correlated with 1 hour after meal the blood sugar level (r=0.279, P=0.279).(2) Gestational diabetes qi and Yin deficiency syndromes integral size and postprandial 2 hours blood glucose levels exist positive correlation (r=0.314, P=0.314).(3) Gestational diabetes wet trapped the syndromes of integral size pixu (spleen deficient) and C peptide and HOMA on an empty stomach-there was.a positive correlation IR level (rC peptide=0.465, P=0.034; rHOM-IR=0.558, P =0.009).(4) Gestational diabetes liver depression and qi stagnation syndrome syndromes integral size was inersely associated with homa-ir level there is positive correlation (r=0.474, P=0.474).(5) Gestational diabetes spleen kidney Yang deficiency syndrome; syndromes integral size and glycated hemoglobin levels and HOMA IR exist positive correlation (r HbAlc=0.623, P=0.008; rHOMA=0.646, P=0.005).Conclusion1 Gestational diabetes mellitus of TCM is deficiency syndrome, give priority with Yin deficiency, both the origin and smooth, the minority of Yang deficiency. A heart, spleen, liver and kidney. The five kinds of common syndrome types respectively mind Yin deficiency syndrome, qi and Yin deficiency syndrome, wet trapped pixu (spleen deficient) certificate, liver depression and qi stagnation syndrome, spleen and kidney Yang deficiency.2 All gestational diabetes fasting and postprandial blood glucose levels between TCM syndrome types were no obvious difference, the difference lies only on the level of insulin resistance, which is a pathophysiological changes of pre-diabetes. Gestational diabetes3 In the type of insulin resistance is the most light, and insulin resistance in patients with wet trapped pixu (spleen deficient) licenses is most obvious, consider and wet trapped pixu (spleen deficient) syndrome patients’ average age is on the high side. Therefore, patients with wet trapped pixu (spleen deficient) card can through diet mission, using the spleen of TCM intervention of moisture penetration to try to improve the state of insulin resistance, prevent progression. In addition, considering the gestational diabetes treatment based on syndrome differentiation who make function of the spleen and the main operation in the process of the cause of damage is likely to be associated with insulin resistance increase, so the key to the spleen can be used as traditional Chinese medicine gestational diabetes control.4 Gestational diabetes symptoms are not obvious, so we can consider to adopt the method of detecting glucose metabolism index level and indirect to judge wether the gestational diabetes each common TCM syndrome types of severity or not, to provide objective reference. |
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