益气养阴组方对妊娠期糖尿病的疗效观察及母婴围产结局的影响

Study on clinical effect of Yiqi Yangyin prescription imposed on gestational diabetes mellitus and perinatal outcome

目的:探讨益气养阴组方对妊娠期糖尿病的治疗效果及母婴围产结局的影响。方法:选择186例妊娠期糖尿病患者,随机分为观察组(益气养阴组方配合个体化营养治疗)和对照组(个体化营养治疗)。比较治疗前后生化指标(空腹及餐后血糖、糖化血红蛋白、空腹胰岛素),并计算胰岛素抵抗指数。随访跟踪至产后,比较母婴围生结局。结果:治疗前两组各项指标均无统计学差异(P>0.05)。治疗后两组餐后2h血糖、空腹胰岛素、糖化血红蛋白、胰岛素抵抗指数与对照组比较差异有统计学意义(P<0.05)。观察组剖宫产率、胎膜早破、子痫前期、产后出血率、新生儿窒息、胎窘、巨大儿发生率同样低于对照组,差异均有统计学意义(P<0.05)。结论:益气养阴组方能有效控制血糖,改善妊娠期糖尿病患者胰岛素抵抗程度,降低母婴不良围生结局发生率。

AIM： To observe the effect of Yiqi Yangyin prescription imposed on gestational dia- betes mellitus （GDM） and perinatal outcome. METHODS. 186 GDM patients were divided into experimental and control groups randomly. The patients of experimental group were given the Chinese medicine of Yiqi Yangyin prescription and medical nutrition therapy. The patients of control group were given medical nutrition ther-apy only. Biochemical tests including fasting blood glucose, postprandial blood glucose, gly- cosylated hemoglobin and fasting insulin as well as indices of insulin resistance （HOMA-IR） were carried out for all patients before and after the treatment. Maternal and fetal outcomes were analyzed in two groups after delibery. RE- SULTS. There was no significant difference be- tween the two groups before treatment （P〉0.05）. The 2-hour postprandial blood glucose, fasting insulin, glycosylated hemoglobin and HOMA-IR of two groups were all improved to different degrees （P 〈 0.05）, and those of the experimental group improved more significantly （P〈0.05）. The rate of cesarean section, prema- ture rupture of membrane, preeclampsia, post- partum hemorrhage, neonatal sphyxia, fetal dis- tress, fetal macrosomia in experimental group were significantly lower than those in controlgroup （P 〈 0.05）. CONCLUSION. The Yiqi Yangyin prescription has a favourable curative effect on glucose control and insulin resistance as well as maternal and fetal outcomes.