摘要
目的:系统评价及探讨中药汤剂联合门冬胰岛素对妊娠期糖尿病患者疗效、血糖指标以及母婴结局的影响。方法:计算机检索医学相关数据库。检索年限为建库至2021年7月20日,收集符合纳入标准的随机对照或者半随机对照试验,以Cochrane评价手册为标准,评价文章偏倚风险及质量,并采用RevMan5.4软件进行Meta分析。结果:分析结果提示与对照组单独使用门冬胰岛素治疗GDM相比,试验组联合中药汤剂治疗临床总疗效强于对照组[OR=4.05,95%CI(2.24,7.31),P<0.00001];血糖指标控制水平包括空腹血糖[MD=-1.08,95%CI(-1.48,-0.67),P<0.00001]、餐后2h血糖[MD=-1.41,95%CI(-2.00,-0.82),P<0.00001]、糖化血红蛋白[MD=-1.53,95%CI(-2.15,-0.91),P<0.00001]均优于对照组;试验组不良母婴结局包括早产[OR=0.36,95%CI(0.20,0.66),P=0.001]、新生儿低血糖[OR=0.44,95%CI(0.25,0.76),P=0.003]、巨大儿[OR=0.31,95%CI(0.16,0.62),P=0.0008]、产后出血[OR=0.36,95%CI(0.19,0.67),P=0.001]、羊水过多[OR=0.44,95%CI(0.26,0.75),P=0.003]、胎膜早破[OR=0.41,95%CI(0.23,0.73),P=0.002]的发生率均低于对照组。结论:在治疗GDM时,中药联合门冬胰岛素是有效的选择方案,能够显著改善患者病情,减少不良妊娠的发生率。
Objective:To systematically review and explore the effect of traditional Chinese medicine decoction combined with insulin aspart on the curative effect,blood glucose index and maternal and infant outcomes of patients with gestational diabetes mellitus.Methods:Computer retrieval of medical-related databases.The search period was from the establishment of the database to July 20,2021.Randomized controlled or quasi-randomized controlled trials that met the inclusion criteria were collected.The Cochrane Evaluation Manual was used as the standard to evaluate the risk of bias and quality of the articles,and RevMan5.4 software was used for meta-analysis.Results:The analysis results showed that compared with the control group using insulin aspart alone in the treatment of GDM,the total clinical efficacy of the experimental group combined with traditional Chinese medicine decoction in the treatment of GDM was stronger than that of the control group[OR=4.05,95%CI(2.24,7.31),P<0.00001];blood glucose control levels include fasting blood glucose[MD=-1.08,95%CI(-1.48,-0.67),P<0.00001],2h postprandial blood glucose[MD=-1.41,95%CI(-2.00,-0.82),P<0.00001],glycosylated hemoglobin[MD=-1.53,95%CI(-2.15,-0.91),P<0.00001]were better than those in the control group;adverse maternal and infant outcomes in the experimental group included preterm birth[OR=0.36,95%]CI(0.20,0.66),P=0.001],neonatal hypoglycemia[OR=0.44,95%CI(0.25,0.76),P=0.003],macrosomia[OR=0.31,95%CI(0.16,0.62),P=0.0008],postpartum hemorrhage[OR=0.36,95%CI(0.19,0.67),P=0.001],polyhydramnios[OR=0.44,95%CI(0.26,0.75),P=0.003],fetal The incidence of premature membrane rupture[OR=0.41,95%CI(0.23,0.73),P=0.002]was lower than that of the control group.Conclusion:In the treatment of GDM,traditional Chinese medicine combined with insulin aspart is an effective option,which can significantly improve the patient’s condition and reduce the incidence of adverse pregnancy.
作者
任美莲
徐健众
REN Meilian;XU Jianzhong(Guizhou University of Traditional Chinese Medicine,Guizhou Guiyang 550025,China;Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China)
出处
《中医药临床杂志》
2022年第2期299-304,共6页
Clinical Journal of Traditional Chinese Medicine
基金
国家重点研发计划资助(NO.2018YFC1704104)。
关键词
妊娠期糖尿病
门冬胰岛素
中药汤剂
META分析
Gestational diabetes mellitus
Insulin aspart
Chinese herbal decoction
Meta-analysis
