参芪麦味地黄汤联合胰岛素治疗妊娠期糖尿病临床研究  

Clinical Study on Shenqi Maiwei Dihuang Decoction Combined with Insulin for Gestational Diabetes Mellitus

作　　者：徐泽霞 刘会玲 丁晓兰 XU Zexia;LIU Huiling;DING Xiaolan(Xinzheng Huaxin Minsheng Hospital,Xinzheng He'nan 451100,China;Binzhou Hospital of Traditional Chinese Medicine,Binzhou Shandong 256600,China)

机构地区：[1]新郑华信民生医院,河南新郑451100 [2]滨州市中医医院,山东滨州256600

出　　处：《新中医》2023年第14期71-76,共6页New Chinese Medicine

摘　　要：目的:观察参芪麦味地黄汤联合胰岛素治疗妊娠期糖尿病(GDM)气阴两虚证的临床疗效。方法:选取98例GDM气阴两虚证患者,以随机数字表法分为观察组和对照组各49例。对照组予以胰岛素治疗,观察组予以参芪麦味地黄汤联合胰岛素治疗,2组均治疗4周,随访至胎儿娩出后1周。比较2组中医证候疗效,观察2组治疗前后糖代谢指标、脂肪因子、炎症指标的变化,记录2组妊娠结局。结果:治疗后,观察组中医证候疗效总有效率83.67%,高于对照组63.27%(P<0.05)。2组空腹血糖(FBG)、餐后2 h血糖(P2hBG)、糖化血红蛋白(HbA1c)水平均较治疗前降低(P<0.05),观察组FBG、P2hBG、HbA1c水平均低于对照组(P<0.05)。2组血清瘦素(LP)、视黄醇结合蛋白4 (RBP4)水平均较治疗前降低(P<0.05),观察组血清LP、RBP4水平均低于对照组(P<0.05);2组血清脂联素(ADPN)、网膜素-1 (Omentin-1)水平均较治疗前升高(P<0.05),观察组血清ADPN、Omentin-1水平均高于对照组(P<0.05)。2组血清肿瘤坏死因子-α (TNF-α)、超敏C-反应蛋白(hs-CRP)、白细胞介素-6 (IL-6)水平均较治疗前降低(P<0.05),观察组血清TNF-α、hs-CRP、IL-6水平均低于对照组(P<0.05)。观察组产妇不良结局发生率8.16%,与对照组14.29%比较,差异无统计学意义(P>0.05)。观察组新生儿不良结局发生率6.12%,低于对照组26.53%(P<0.05)。结论:参芪麦味地黄汤联合胰岛素治疗GDM气阴两虚证疗效显著,可有效改善患者的糖脂代谢状况,控制机体炎症反应,对新生儿不良结局有一定的预防作用。Objective:To observe the clinical effect of Shenqi Maiwei Dihuang Decoction combined with insulin on gestational diabetes mellitus(GDM)with syndrome of dual deficiency of qi and yin.Methods:A total of 98 patients with GDM with syndrome of dual deficiency of qi and yin were selected and divided into the observation group and the control group according to the random number table method,with 49 cases in each group.The control group was treated with insulin,and the observation group was given Shenqi Maiwei Dihuang Decoction combined with insulin for treatment.Both groups were treated for 4 weeks and followed up until 1 week after delivery.The curative effects of traditional Chinese medicine(TCM)syndrome were compared between the two groups.Before and after treatment,the changes of glucose metabolism indexes,adipokines and inflammation indexes in the two groups were observed;the pregnancy outcome in both groups were recorded.Results:After treatment,the total effective rate of TCM syndrome was 83.67%in the observation group,higher than that of 63.27%in the control group(P<0.05).The levels of fast blood glucose(FBG),2-hour postprandial blood glucose(P2hBG)and(HbA1c)in both groups were decreased when compared with those before treatment(P<0.05),and the above 3 levels in the observation group were lower than those in the control group(P<0.05).The levels of serum leptin(LP)and retinol-binding protein 4(RBP4)in both groups were decreased when compared with those before treatment(P<0.05),and the above 2 levels in the observation group were lower than those in the control group(P<0.05);the levels of serum adiponectin(ADPN)and Omentin-1 in both groups were increased when compared with those before treatment(P<0.05),and the above 2 levels in the observation group were higher than those in the control group(P<0.05).The levels of serum tumor necrosis factor-α(TNF-α),high sensitive C-reactive protein(hs-CRP)and interleukin-6(IL-6)in both groups were decreased when compared with those before treatment(P<0.05),and the above 3 lev

关 键 词：妊娠期糖尿病 气阴两虚证 参芪麦味地黄汤 胰岛素 糖代谢 脂肪因子 炎症指标 妊娠结局 

分 类 号：R714.25[医药卫生—妇产科学]