中医药治疗妊娠期糖尿病173例

Chinese Medicine in Treatment of Gestational Diabetes Mellitus: 173 Cases

目的:观察补肾健脾汤治疗脾肾阳虚型妊娠期糖尿病患者的临床疗效。方法:将278例脾肾阳虚型妊娠期糖尿病患者分为观察组(173例)及对照组(105例),2组均采用规范的糖尿病医学营养治疗方法,并由专人指导运动方式方法。观察组同时服用补肾健脾汤。观察2组血糖达标时间、治疗前后空腹血糖、餐后2小时血糖水平及中医证候积分、羊水指数的变化情况,分娩结局。结果:空腹血糖值、餐后1小时血糖、餐后2小时血糖、中医证候评分、羊水指数评分、血糖达标时间治疗前后2组组内比较,差异有统计学意义(P<0.05);治疗后组间比较差异也有统计学意义(P<0.05)。剖宫产率、妊娠期高血压发生率观察组均低于对照组,2组比较差异有统计学意义(P<0.05);胎膜早破及产后出血发生率2组比较,差异无统计学意义(P>0.05)。低体质量儿发生率、新生儿低血糖发生率观察组低于对照组,2组比较差异有统计学意义(P<0.05);早产及巨大儿发生率2组比较,差异无统计学意义(P>0.05)。结论:补肾健脾汤有助于降低脾肾阳虚型妊娠期糖尿病的血糖,缩短血糖达标时间,降低中医证候评分及羊水指数,有助于降低剖宫产率、妊娠期高血压发生率,改善新生儿结局。

Objective： To observe the effects of Bushen Jianpi decoction in treatment of spleen-kidney yang deficiency of GDM and to explore the application of Chinese Medicine in the field of obstetrics. Methods： 278 patients with spleen-kidney yang deficiency of GDM were divided into the observation group （173 cases） and the control group （105 cases）. Both groups were given standard diabetic medical nutrition therapies and exercise method guided by specialist. The observation group was further given Bushen Jianpi decoction at the same time. Then the blood glucose therapeutic time, fasting blood glucose （FBS） in pretherapy and post-treatment, blood glucose after two hours of meal, TCM symptoms score, the change condition of anmiotic fluid index（AFI） and delivery outcome were observed in both groups. Results： After treatment, there were statistical differences within both groups （P〈0.05） in FBS, blood glucose after one and two hours of meal, TCM symptoms score, AFI scores and blood glucose therapeutic time. Also there were statistical differences between two groups （P〈0.05）. Rate of cesarean delivery, rate of gestational hypertension, rate of low Body Mass （BM） and neonatal hypoglycemia in the observation group lower than the control group, there were statistical differences between two groups （P〈0.05）. Compared rate of PROM, rate of postpartum hemorrhage, rate of premature delivery and macrosomia between two groups, there were no statistical differences （P〉0.05）. Conclusion： Bushen Jianpi decoction is conducive to reducing glucose of patient with spleen-kidney yang deficiency of GDM, shortening blood glucose therapeutic time, lowering TCM symptoms score and AFI, lowering the rate of cesarean delivery and gestational hypertension and improving neonatal outcome.