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妊娠期糖尿病孕妇行为改变理论下等长抗阻力运动的临床观察

Clinical observation of isometric resistance exercise using the theory of behavior change among pregnant women with gestational diabetes mellitus

    摘要
  • 摘要:
    目的 观察妊娠期糖尿病孕妇应用行为改变理论下等长抗阻力运动的临床效果，为改善其血糖水平提供理论参考。
    方法 选取2022年3 — 7月于北京市通州区妇幼保健院产科建档产检且确诊妊娠期糖尿病的患者94例为研究对象，采用随机数表法将患者分为干预组和对照组，每组各47例。对照组给予常规医学营养及运动干预，干预组在对照组基础上联合行为改变理论下等长抗阻力运动进行干预，两组患者均持续干预4周。比较两组患者干预前后血糖水平空腹血糖、餐后2 h血糖、糖化血红蛋白（glycosylated hemoglobin，HbA1c）、妊娠期糖尿病相关知识了解情况（妊娠期糖尿病知识问卷）、遵从医嘱行为、自我护理能力自我护理能力测量表（Exercise of Self-care Agency Scale，ESCA）的差异，并随访两组患者的妊娠结局。
    结果 干预后，两组患者的空腹血糖、餐后2 h血糖、HbA1c水平均低于干预前，且干预组空腹血糖、餐后2 h血糖、HbA1c水平均低于对照组（5.11 ± 0.37）mmol/L vs.（5.32 ± 0.42）mmol/L；（6.83 ± 0.34）mmol/L vs.（7.04 ± 0.46）mmol/L；（5.43 ± 0.61）% vs.（5.72 ± 0.56）%，且差异均有统计学意义（均P < 0.05）；干预后，两组患者的妊娠期糖尿病相关知识了解情况、遵从医嘱行为、ESCA评分均高于干预前，且干预组高于对照组（均P < 0.05）；干预组患者的不良妊娠结局总发生率低于对照组（P < 0.05）。
    结论 行为改变理论下等长抗阻力运动能明显控制妊娠期糖尿病孕妇的血糖水平，提高患者对于疾病相关知识的了解程度和遵医行为，对促进妊娠结局改善具有重要意义。

     

    Abstract:
    Objective  To observe clinical effect of isometric resistance exercise on gestational diabetes mellitus(GDM) using the theory of behavior change, so as to provide evidence for decreasing blood glucose level.
    Methods  A total of 94 patients with GDM who received perinatal care in Tongzhou Maternal and Child Health Hospital were recruited as study subjects from March to July, 2022. They were randomly divided into intervention and control group by random number table method, with 47 cases in each group. Control group was given routine medical nutrition and exercise intervention, while the intervention group was given isometric resistance exercise using the theory of behavior change plus routine care. The intervention lasted for 4 weeks in both groups. The differences in blood glucose levels fasting blood glucose, 2 h postprandial blood glucose, glycosylated hemoglobin (HbA1c), awareness of GDM (GDM knowledge questionnaire), medical compliance behavior, and self-care ability Exercise of Self-care Agency Scale (ESCA) before and after intervention between the two groups were compared, and pregnancy outcomes of the two groups were followed up.
    Results  After intervention, the levels of fasting blood glucose, 2 h postprandial blood glucose and HbA1c in 2 groups were lower than those before intervention. And these indicators in the intervention group were lower than those in the control group (5.11 ± 0.37) mmol/L vs. (5.32 ± 0.42) mmol/L; (6.83 ± 0.34) mmol/L vs. (7.04 ± 0.46) mmol/L; (5.43 ± 0.61)% vs. (5.72 ± 0.56)%, all P < 0.05. After intervention, awareness of GDM, medical compliance behavior and ESCA score in 2 groups were higher than those before intervention, and the indicators in the intervention group were higher than those in the control group (P < 0.05). The incidence of adverse pregnancy outcome in the intervention group was lower than that in the control group (P < 0.05).
    Conclusion Isometric resistance exercise using the theory of behavior change can significantly control the blood glucose level among pregnant women with GDM, improve patients’ awareness of the disease and medical compliance behavior, which are of great importance for the improvement of pregnancy outcome.

     

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