摘要
[目的]系统评价基于血糖负荷的饮食教育对妊娠期糖尿病病人的干预效果,为妊娠期糖尿病病人的饮食选择提供依据。[方法]计算机检索Cochrane Library、PubMed、EBSCO、MedLine、CBMdisc、CNKI、万方、维普数据库,搜集基于血糖负荷的饮食教育在妊娠期糖尿病病人中应用的随机对照试验,由两名研究者对纳入文献进行严格质量评价和资料提取,对符合质量标准的文献采用RevMan 5.3软件进行分析。[结果]共纳入9篇文献,涉及835例病人。Meta分析结果显示:基于血糖负荷的饮食教育较常规饮食教育相比,所引起的糖化血红蛋白差异无统计学意义[WMD=-1.08,95%CI(-2.18,0.02),P=0.06],但能明显降低空腹血糖[WMD=-0.92,95%CI(-1.60,-0.25),P=0.007]与餐后2h血糖[WMD=-1.68,95%CI(-2.50,-0.87),P<0.000 1],降低不良妊娠结局发生率[RR=0.57,95%CI(0.36,0.90),P=0.02]。[结论]基于血糖负荷的饮食教育更有助于改善妊娠期糖尿病病人的血糖水平,降低母婴并发症,改善围生期结局。
Objective:To evaluate the effect of diet education based on blood glucose load on gestational diabetes mellitus patients,and to provide a basis for the dietary choice of gestational diabetes mellitus patients.Methods:The randomized controlled trials(RCTs)of blood glucose-based dietary education applied in gestational diabetes mellitus patients were searched and collected from Cochrane Library,PubMed,EBSCO,Medline,CBMdisc,CNKI,Wanfang database,and VIP database.Literatures were evaluated and extracted strictly by 2reviewers according to quality evaluation standard,and the RevMan 5.3software was used to analyze.Results:A total of 9articles involving 835 patients were included.Meta-analysis showed that compared with the routine diet education,the diet education based on blood glucose load did not cause statistically significant difference in glycated hemoglobin(WMD=-1.08,95% CI(-2.18,0.02),P=0.06),however,it could significantly reduce the fasting blood glucose[WMD=-0.92,95%CI(-1.60,-0.25),P=0.007],postprandial 2hblood glucose[WMD=-1.68,95% CI(-2.50,-0.87),P=0.000 1],and the incidence of adverse pregnancy outcomes[RR=-0.57,95%CI(0.36,0.90),P=0.02].Conclusions:Dietary education based on blood glucose load was more helpful to improve the blood glucose level of gestational diabetes mellitus patients,reduce maternal and infant complications and improve perinatal outcome.
出处
《护理研究（上旬版）》
2017年第9期3144-3148,共5页
Chinese Nursing Researsh
关键词
妊娠期糖尿病
血糖负荷
饮食教育
META分析
血糖
不良妊娠结局
gestational diabetes mellitus
blood glucose load
dietary education
meta-analysis
blood glucose
adverse pregnancy outcome
