观察芪麦益气汤联合门冬胰岛素对妊娠期糖尿病患者胰岛β细胞功能及血清PAPP-A、Kisspeptin水平的影响

Effects of Qimai Yiqi Decoction Assisted Insulin Aspart on Islet β-cell Function and L evels of Serum PAPP-A and Kisspeptin in Patients with Gestational Diabetes Mellitus

目的观察芪麦益气汤联合门冬胰岛素对妊娠期糖尿病(GDM)患者胰岛β细胞功能及血清妊娠相关蛋白(PAPP-A)、人吻素-1(Kisspeptin)水平的影响。方法选取我院收治的106例气虚GDM孕妇作为研究对象,随机数字表法分为对照组与实验组各53例,对照组采用门冬胰岛素治疗,实验组在对照组治疗基础上加用芪麦益气汤,均治疗4周,比较两组治疗有效率,治疗前后血糖情况,胰岛素抵抗指数(HOMAIR)、胰岛β细胞功能指数(HOMA-β)、血清PAPP-A、Kisspeptin水平以及分娩结局。结果治疗后,实验组治疗有效率显著高于对照组(P<0.05);实验组空腹血糖(FPG)、餐后1h血糖(1h PPG)、餐后2h血糖(2h PPG)水平明显低于对照组(P<0.05);两组HOMA-IR、Kisspeptin均低于治疗前(P<0.05),HOMA-β、PAPP-A均高于治疗前(P<0.05),实验组HOMA-IR、Kisspeptin均低于对照组(P<0.05),HOMA-β、PAPP-A均高于对照组(P<0.05);实验组发生妊娠并发症的总发生率低于对照组(P<0.05)。结论芪麦益气汤、门冬胰岛素联合治疗可降低GDM孕妇血糖,提高HOMA-β和血清PAPP-A水平,降低Kisspeptin水平,改善分娩结局。

Objective To observe the effects of Qimai Yiqi decoction assisted insulin aspart on isletβ-cell function and levels of serum pregnancy-associated plasma protein A(PAPP-A)and kisspeptin in women with gestational diabetes mellitus(GDM).Methods A total of 106 GDM pregnant women of qi-deficiency were randomly divided into experimental group and control group,53 cases in each group.Control group was treated with insulin aspart,while experimental group was treated with Qimai Yiqi decoction on the basis of control group.Both groups were treated for 4 weeks.The response rate of treatment,blood glucose before and after treatment,homeostasis model assessmentβ(HOMA-β),levels of serum PAPP-A and kisspeptin,and delivery outcomes were compared between the two groups.Results At the end of treatment course,response rate of treatment in experimental group was higher than that in control group(P<0.05);levels of FPG,1 h PPG and 2 h PPG in experimental group were significantly lower than those in control group(P<0.05);HOMA-IR and kisspeptin in both groups were decreased,while HOMA-βand PAPP-A were increased(P<0.05);HOMA-IR and kisspeptin in experimental group were lower than those in control group,while HOMA-βand PAPP-A were higher than those in control group(P<0.05);the total incidence of pregnancy complications in experimental group was lower than that in control group(P<0.05).Conclusion Qimai Yiqi decoction assistedinsulin aspart can decrease blood glucose of GDM pregnant women,increase levels of HOMA-βand serum PAPP-A,decrease kisspeptin level and improve delivery outcomes.