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中醫淺談妊娠糖尿病

| 09-04-2017

《中醫淺談妊娠糖尿病》


下葵涌中醫中心  林浩雯註冊中醫師

           「妊娠糖尿病」是指在懷孕前未患糖尿病,反在懷孕時才出現高血糖現象,這樣的孕婦就是罹患「妊娠糖尿病」,其發生率約百分之一至三。由於「妊娠糖尿病」是因懷孕造成,所以篩檢方法必須在懷孕24週後做「口服葡萄糖耐量測試」(OGTT),即可驗出血糖是否過高,並須注意高血糖長期存在易致孕婦出現腎臟、血管損傷,還有機會導致胎兒早產或巨嬰症等問題。


           那「妊娠糖尿病」的高危一族是哪些?在多項研究表明,印度、東南亞、非洲地區及印第安人均屬於高危種族人群;其二是有不良孕產史的孕婦如有死產史、不孕史、羊水過多史或曾有相關不良孕產史者,再次妊娠時發生妊娠糖尿病的機率高於正常妊娠。其三是家族有糖尿病病史的孕婦,如果父母同時患病,孕婦發生妊娠糖尿病的可能性會增加九倍多;還有妊娠中期胰島素分泌受限、孕前體重過重或懷孕後體重增加太快、高齡妊娠(34歲以上)等都會容易引起妊娠糖尿病。


           雖然「妊娠糖尿病」的孕婦致命率已減少,但是對血糖還未可控制的孕婦併發症也較高,容易造成自然流產或早產達一成半至三成;並易併發妊娠高血壓,多於正常孕婦三至五倍;而且「妊娠糖尿病」的孕婦血糖控制較差,易發生糖尿病酮酸中毒,對孕婦危害較大。至於「妊娠糖尿病」對胎兒影響也不淺,易致胎兒巨大或出現畸形及胎兒出現糖尿病、血管病變等的發病率較高。


           中醫認為糖尿病是屬於消渴症範圍,病因病機主要以飲食不節、情志失調、勞欲過度、稟賦不足等,導致人體陰津虧損、燥熱偏勝。主要臟腑病變是肺、胃、腎,並分為三消症,口渴多飲為上消,上消屬肺;多食善飢為中消,中消屬胃,多飲多尿為下消,下消屬腎。妊娠糖尿病患者和一般糖尿病患者一樣會有「三多」的症狀:吃多、喝多、尿多;患者一般是陰虛燥熱體質,在治療上採用益氣養陰治療原則為主,而孕婦就應避免清熱活血。

以下介紹三款湯水適合妊娠糖尿病的孕婦:

沙參玉竹粥

適宜於肺熱津傷,口渴多飲,口舌乾燥的妊娠糖尿病者。功效清熱潤肺,生津止渴。

材料:
北沙參15克、玉竹15克、大米50-100克、瘦肉50克、鹽、生薑、植物油各適量

養陰安神人參湯

適用於氣陰虧虛,症見懷孕期間出現心悸無神,口渴引飲,能食與便溏並見,尿頻量多,神疲乏力,自汗或盜汗的妊娠糖尿病患者。服此湯有益氣養陰,健脾補肺,生津潤燥之功。

材料:
人參15克、麥冬15克、瘦肉50克、鹽、生薑、植物油各適量。
但要注意由於人參的「抗凝」作用,臨產及分娩時不提倡服人參,以避免增加產後出血。

雪耳紅棗乳鴿湯

此湯具有補血養顏、滋陰生津的作用。常用此湯有補益血氣、滋潤肌膚及防止衰老等功效,適合一家大小日常飲用。

材料:
乳鴿1隻、雪耳15克、紅棗5粒、豬瘦肉20克


         大致上來說,妊娠糖尿病的孕婦只要在飲食上注意以下事項,就較易將血糖控制在正常範圍:第一:少量多餐、定時定量;第二是飯後輕度運動;第三是忌甜食、多吃高纖食物(例如:糙米、五穀米、蔬菜),即可有助延緩餐後血糖上升。


         孕婦確診妊娠糖尿病也不要擔心,因為只要在飲食上格外注意糖分的攝取和適當運動,大部份患者都能將血糖控制在正常值內,以免血糖過高而危害母體及胎兒的健康;對於不能控制血糖在正常值的孕婦,應該及早求診或給予胰島素治療,並尋求醫生建議,或可配合運用中藥可改善症狀,且治療併發症方面有明顯優勢。

文章內容僅供參考,不能作為診斷及治療的醫據。
如需獲得健康方面的幫助,請諮詢中醫師及醫護人員的專業意見。

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