摘要
目的:观察黄芪四君子汤辅助治疗对肥胖伴妊娠期糖尿病(GDM)患者胰岛素抵抗及妊娠结局的影响。方法:将2020年3月~2021年3月于我院治疗的102例气阴两虚型肥胖伴GDM患者随机分为观察组与对照组各51例。对照组给予常规治疗,观察组在对照组基础上给予黄芪四君子汤辅助治疗。比较两组临床疗效,比较治疗前、治疗后两组中医证候积分、血糖指标[空腹血糖(FPG)、餐后2h血糖(2h PG)、糖化血红蛋白(HbA1c)]、胰岛功能指标[胰岛素抵抗指数(HOMA-IR)、空腹胰岛素(FINS)、胰岛β细胞功能(HOMA-β)]及血清相关因子[促代谢因子(Betatrophin)、细胞黏附分子(sICAM-1)、肿瘤坏死因子(TNF-α)、白介素6(IL-6)]水平,统计两组不良妊娠结局发生率。结果:观察组临床总有效高于对照组(P<0.05)。治疗后,两组中医证候积分(咽干口燥,倦怠乏力、气短懒言、五心烦热)、血糖指标(FPG、2h PG、HbA1c)、胰岛功能(HOMA-IR、FINS)、血清相关指标(Betatrophin、sICAM-1、TNF-α、IL-6)均低于治疗前,观察组低于对照组(P<0.05);两组HOMA-β水平高于治疗前,观察组高于对照组(P<0.05)。观察组妊娠高血压、羊水过多、剖宫产、早产、巨大儿、新生儿低血糖发生率均低于对照组(P<0.05)。结论:黄芪四君子汤辅助治疗肥胖伴GDM效果显著,能改善患者中医证候,提高血糖控制效果,恢复胰岛功能,调节血清相关因子水平,减少不良妊娠结局的发生。
Objective:To observe the effect of Huangqi Sijunzi Decoction adjuvant therapy on insulin resistance and pregnancy outcomes for patients with obesity complicated with gestational diabetes mellitus(GDM).Methods:102 patients with obesity and GDM of Qi-Yin deficiency who were treated in the hospital between March 2020 and March 2021 were randomly divided into an observation group and a controlled group with 51 cases in each group.The controlled group was given routine treatment while the observation group was given Huangqi Sijunzi Decoction adjuvant therapy on the basis of the controlled group.The clinical efficacy as well as scores of TCM syndromes,blood glucose indicators[fasting plasma glucose(FPG),2 h postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA1 c)],pancreatic islet function indicators[homeostasis model assessment of insulin resistance(HOMA-IR),fasting insulin(FINS),pancreatic isletβ-cell function(HOMA-β)]and serum-related factors[Betatrophin,soluble inter-cellular adhesion molecule-1(sICAM-1),tumor necrosis factor(TNF-α),interleukin-6(IL-6)]before and after treatment were compared between the two groups.The incidence rates of adverse maternal-infant outcomes in the two groups were statistically analyzed.Results:The total clinical effective rate in the observation group was higher than that in the controlled group(P<0.05).After treatment,the scores of TCM syndromes(dry throat and mouth,fatigue,shortness of breath and lazy speech,dysphoria in chestpalms-soles)and levels of blood glucose indicators(FPG,2 hPG,HbA1 c),pancreatic islet function(HOMA-IR,FINS)and serum-related indicators(Betatrophin,sICAM-1,TNF-α,IL-6)in the two groups were lower than those before treatment,and the scores and levels in the observation group were lower than those in the controlled group(P<0.05).The level of HOMA-βin the two groups was higher than that before treatment,and the level was higher in the observation group than that in the controlled group(P<0.05).The incidence rates of gestational hypertension,polyhydramnios,cesarean section,premature birth,macrosomia and neonatal hypoglycemia in the observation group were lower compared with those in the controlled group(P<0.05).Conclusion:Huangqi Sijunzi Decoction adjuvant therapy has significant effect on obesity with GDM,and it can improve the TCM syndromes,enhance the blood glucose control effect,restore the pancreatic islet function,regulate the levels of serum-related factors,and reduce the occurrence of adverse pregnancy outcomes.
作者
丁静
何学素
肖琳
王文珍
李英
李昭慧
Ding Jing;he xuesu;Xiao Lin(Department of Obstetrics and Gynecology,Dazhou Municipal Hospital of Integrated Traditional Chinese and Western Medicine,Dazhou Sichuan 635000,China)
出处
《四川中医》
2022年第12期150-153,共4页
Journal of Sichuan of Traditional Chinese Medicine
关键词
黄芪四君子汤
糖尿病
妊娠
肥胖
胰岛素抵抗
妊娠结局
Huangqi Sijunzi Decoction
Diabetes mellitus
Gestational
Obesity
Insulin resistance
Pregnancy outcomes
