二甲双胍联合黄芪四君子汤对妊娠期糖尿病孕妇妊娠结局的影响研究

Effect of Metformin Combined with Astragalus Four Gentlemen Decoction in Treatment of Pregnant Women with Gestational Diabetes Mellitus

目的:探讨二甲双胍联合黄芪四君子汤对妊娠期糖尿病孕妇妊娠结局的影响。方法:选取2014年5月—2015年5月于本院产科就诊以妊娠期糖尿病为诊断的患者80例,根据随机数字表法随机分为两组:对照组40例,予常规治疗;实验组40例,予二甲双胍联合黄芪四君子汤治疗,直至患者有分娩先兆后停止服用。观察两组患者治疗前后血糖控制情况、血清CRP、Mg^(2+)及脂联素水平、妊娠结局及新生儿情况,探索二甲双胍联合黄芪四君子汤对妊娠期糖尿病孕妇的疗效及安全性,其数据结果应用统计学软件SPSS 19.0加以处理。结果:与对照组相比,实验组患者血清FBG、2h PG、Hb A1c及血清CRP均较低(P<0.05),血清Mg^(2+)及脂联素水平均明显高于同期对照组(P<0.05)。实验组的早产率、剖腹产率、蛋白尿率、子痫前期发病率等妊娠不良结局明显低于对照组(P<0.05),实验组的新生儿窘迫、巨大儿及新生儿低血糖发生率明显低于对照组(P<0.05)。结论:二甲双胍联合黄芪四君子汤能够明显降低妊娠期糖尿病患者的血清CRP,升高Mg^(2+)及脂联素水平,改善血糖水平,降低妊娠不良结局,改善新生儿情况。

Objective： To investigate the effect of metformin combined with Astragalus Four Gentlemen Decoction in the treatment of pregnant women with gestational diabetes mellitus. Methods： A total of 80 pregnant women with gestational diabetes mellitus from 2014. 5 to 2015. 5 in out courtyard department of gynaecology and obstetrics in pregnancy were selected and randomly divided into 2 groups. Forty cases in the control group were treated with routine treatment and forty cases in the experiment group were treated on the base of the control group with metformin and Astragalus Four Gentlemen Decoction and patients were treated until the warning before delivery. Blood glucose control,serum CRP,Mg2＋and adiponectin levels,pregnancy outcome and neonatal status were compared before and after the treatment in 2 groups and to explore the efficacy and safety of metformin combined with Astragalus Four Gentlemen Decoction in pregnant women with gestational diabetes mellitus and the data was processed by statistical software SPSS 19. 0. Results： Compared with the control group,FBG,2 h PG,Hb A1 c and serum CRP in serum were lower（ P 〈 0. 05）. Mg2＋in serum and serum adiponectin levels were significantly higher（ P 〈 0. 05）. The premature delivery rate,cesarean section rate,the rate of urinary protein and preeclampsia incidence pregnancy adverse outcome of the experiment group were significantly lower than those of the control group（ P 〈 0. 05）. The neonatal respiratory distress,macrosomia and neonatal hypoglycemia occurrence rate of the experiment group were significantly lower（ P 〈 0. 05）. Conclusion： Metformin combined with Huangqi Sijunzi Decoction can significantly decrease pregnancy gestational diabetes patients serum CRP,Mg2＋and can elevate adiponectin level to improve blood sugar levels,reduce the adverse pregnancy outcomes and improve neonatal.