目的 探讨个体化指导在门诊高龄妊娠期糖尿病(GDM)中的临床效果。方法 采用前瞻性随机对照试验方法,90例GDM患者随机分为干预组和对照组各45例,干预组通过药师+营养师联合门诊,进行药学联合营养个体化指导,对照组无药学和营养个体化指导。比较两组患者空腹血糖(FPG)、餐后2 h血糖(2hPG)、用药依从性及药品不良反应等指标变化。结果 干预组FPG、2hPG、糖化血红蛋白(HbA1C)、血糖达标率和用药依从性指标均优于对照组,差异均有统计学意义(P<0.05)。干预组药品不良反应发生1例(低血糖1例),对照组药品不良反应发生5例(低血糖3例,注射部位皮肤硬结1例,皮疹1例),差异有统计学意义(P<0.05)。干预组羊水过多、剖宫产、早产、巨大儿发生率低于对照组,差异有统计学意义(P<0.05)。结论 个体化指导能够改善GDM患者的FFG、2hPG、HbA1C,提高患者用药依从性,降低药品不良反应及母婴并发症的发生。
Abstract
OBJECTIVE To explore the clinical effect of individualized guidance on the outpatient service of elderly patients with gestational diabetes mellitus (GDM). METHODS A prospective randomized controlled tria was carried out,totally 90 cases of elderly patients with GDM were divided into the intervention group(45 cases) and the control group (45 cases). In the intervention group, pharmacists and nutritionists were combined for individualized guidance of pharmacy and nutrition, while the control group had no individualized guidance of pharmacy and nutrition. The fasting blood glucose(FPG), 2 h postprandial blood glucose(2hPG),medication compliance and adverse drug reactions were compared between the two groups. RESULTS The FPG, 2hPG, HbA1C, blood glucose compliance index,medication compliance of the intervention group were better than the control group(P＜0.05). The adverse drug reactions in the intervention group had 1 case of hypoglycemia. The control group had 5 cases of adverse drug reactions,including 3 cases of hypoglycemia,1 case of induration at injection site and 1 case of skin rash(P＜0.05). The incidence of polyhydramnios, cesarean section, premature delivery and macrosomia of the intervention group were better than the control group(P＜0.05). CONCLUSION Individualized guidance can improve the FFG,PFG,HbA1C and medication compliance of GDM patients, reduce the occurrence of adverse drug reactions and maternal and infant complications.
关键词
妊娠期糖尿病 /
个体化指导 /
药学服务 /
妊娠结局 /
高龄
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Key words
gestational diabetes mellitus /
individualized guidance /
pharmaceutical care /
pregnancy outcome /
advanced age
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中图分类号：
R969.4
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参考文献
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脚注
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基金
中国药学会全国医药经济信息网科普研究重点项目资助(CMEI2020KPYJ00509)
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