Abstract: Objective　To explore the correlation between traditional Chinese Medicine (TCM) constitutions and risk of gestational diabetes mellitus (GDM) based on theory of preventing diseases in TCM, and to provide references for preventing and treating GDM. Methods　A total of 270 pregnant women admitted to Liwan Hospital of Traditional Chinese Medicine from September 2020 to October 2021 were randomly selected as the research subjects. According to the results of oral glucose tolerance test, the pregnant women were divided into a GDM group and a control group. A hospital-made questionnaire was used to investigate the general information (age, pregnancy times, diet habits, etc.) and TCM constitution types (designed based on the standard of Classification and Judgment of TCM Constitution) of the two groups. t test and χ² test were used. Univariate and multivariate logistic regression analyses were used to screen out the TCM constitution types related to the pathogenesis of GDM. Results　The age, body mass index in the second trimester, rate of diet preference for sweets, and rates of family history of diabetes and GDM were (30.05±3.75), (24.65±3.60) kg/m², 25.40% (16/63), 36.51% (23/63), and 4.76% (3/63) in the GDM group, and were (28.40±4.10), (23.45±3.40) kg/m², 6.76% (14/207), 13.53% (28/207), and 0.97% (2/207) in the control group, with statistical differences (t=2.851 and 2.419; χ²=23.936, 16.650, and 6.441; all P<0.05). The pre-pregnancy TCM constitution types in both groups were dominated by peaceful constitution; the rates of peaceful constitution, yin deficiency constitution, and phlegm damp constitution were 41.27% (26/63), 12.70% (8/63), and 23.81% (15/63) in the GDM group, and were 69.57% (144/207), 4.35% (9/207), and 5.31% (11/207) in the control group, with statistical differences (χ²=16.583, 5.709, and 18.987; all P<0.05). Multivariate logistic regression analysis showed that age, family history of diabetes, diet preference for sweets, and phlegm-dampness constitution were independent factors for GDM (all P<0.05). Conclusions　Old age, family history of diabetes, preference for sweets, and phlegm-dampness constitution are independent risk factors for GDM. From the aspect of TCM constitution, phlegm-dampness constitution is susceptible to biased constitution of GDM, yin-deficiency constitution is a potential susceptible constitution type of GDM, and peaceful constitution may prevent the onset of GDM.

Key words: Theory of preventing diseases, TCM constitution of pregnant women, Gestational diabetes mellitus

摘要： 目的　基于中医“治未病”理论探讨孕妇中医体质与妊娠期糖尿病（gestational diabetes mellitus，GDM）发病风险的相关性，为GDM防治提供依据。方法　采用简单随机抽样法，选择2020年9月至2021年10月广州市荔湾区中医医院收治的270例孕妇作为研究对象，根据口服葡萄糖耐量试验结果将孕妇分为GDM组和对照组。采用医院自制的调查问卷对两组孕妇的一般资料（年龄、妊娠次数、饮食习惯等）和中医体质类型（基于《中医体质分类与判断》标准设计）进行调查，采用t检验、χ²检验，并运用单因素及多因素logistics回归分析筛选出与GDM发病相关的中医体质类型。结果　GDM组年龄为（30.05±3.75）岁，孕中期体质量指数为（24.65±3.60）kg/m²，饮食偏嗜甜食率为25.40%（16/63）、糖尿病家族史率为36.51%（23/63）、GDM史率为4.76%（3/63），对照组分别为（28.40±4.10）岁、（23.45±3.40）kg/m²、6.76%（14/207）、13.53%（28/207）、0.97%（2/207），两组比较，差异均有统计学意义（t=2.851、2.419，χ²=23.936、16.650、6.441，均P<0.05）。两组孕前中医体质类型均以平和质为主，但GDM组平和质率为41.27%（26/63），低于对照组的69.57%（144/207），阴虚质率为12.70%（8/63）、痰湿质率为23.81%（15/63），均高于对照组［分别为4.35%（9/207）、5.31%（11/207）］，两组比较差异均有统计学意义（χ²=16.583、5.709、18.987，均P<0.05）。多因素logistic回归分析结果显示：年龄、糖尿病家族史、饮食偏嗜甜食、痰湿体质是引发GDM的独立因素（均P<0.05）。结论　大龄、有糖尿病家族史、饮食偏嗜甜食、、痰湿体质是引发GDM的独立危险因素。从中医体质方面来看痰湿质是GDM易感偏颇体质，阴虚质是GDM潜在的易感体质类型，平和质或可预防GDM发病。

关键词: “治未病”, 孕妇中医体质, 妊娠期糖尿病