六味地黄汤加减结合胰岛素治疗妊娠期糖尿病的临床观察

Clinical Observation of Liuwei Didhuang Decoction combined with Insulin in the Treatment of Gestational Diabetes

目的:探讨六味地黄汤加减结合胰岛素治疗妊娠期糖尿病的临床疗效,及其对血糖、分娩方式、母婴结局的影响。方法:选择本院妇产科2013年1月至2015年1月诊治的120例确诊为肝肾亏虚妊娠期糖尿病的孕妇为研究对象,采用随机数字表随机分为观察组与对照组,每组60例。对照组给予饮食联合胰岛素治疗,根据血糖控制情况适当调整胰岛素用量。观察组在对照组的基础上加用六味地黄汤治疗,入院确诊后即给予六味地黄汤口服治疗,2次/d,早晚各1次,7 d/疗程,2组均给予治疗至分娩结束后。观察2组的临床疗效。结果:经治疗后,观察组的有效率高于对照组,差异具有统计学意义(P<0.05);观察组及对照的空腹血糖、餐后2 h血糖的控制情况均较治疗前有所改善,差异均具有统计学意义(P<0.05);而观察组的控制情况优于对照组,差异均具有统计学意义(P<0.05);观察组孕妇的妊娠期高血压疾病的发病率和剖宫产率高于对照组,差异均具有统计学意义(P<0.05);观察组新生儿的早产儿、巨大儿、胎儿窘迫和新生儿窒息的发病率高于对照组,差异均具有统计学意义(P<0.05)。结论:六味地黄汤结合胰岛素能有效的控制肝肾亏虚型妊娠糖尿病孕妇的血糖,并能降低妊娠期糖尿病的发病率及剖宫产率,同时能降低早产儿、巨大儿、胎儿窘迫和新生儿窒息的发病率,值得临床推广应用。

Objective： To observe the effect of Liuwei Dihuang decoction combined with insulin in treating gestational diabetes,and their impact on blood sugar,mode of delivery,maternal outcome. Methods： A total of 120 cases of pregnant patients diagnosed of gestational diabetes with liver and kidney deficiency syndrome and admitted into obstetrics and gynecology hospital in January2014-June 2015 were randomly divided into 2 groups with 60 cases in each. The control group received diet therapy combined with insulin therapy,and the dosage of insulin was adjusted based on blood glucose control. On the basis of the control group,the observation group also received Liuwei Dihuang decoction,2 times / day,7 days / a session of treatment. Both groups received the treatment until childbirth. The clinical efficacy of the two groups were observed. Results： After treatment,the observation group has higher efficiency,and the difference was statistically significant（ P〈 0. 05）. Compared before treatment,both the observation group and the control group improved in fasting blood glucose,postprandial 2 h blood sugar control and the differences were statistically significant（ P〈 0. 05）,besides,the improvement of the observation group is better than the control group,and the differences were statistically significant（ P 〈0. 05）. In the control group,the incidence of hypertensive disorders in pregnancy and cesarean section yields higher than those of the observation group,and the difference was statistically significant（ P〈 0. 05）. Also,in control group,the incidence of preterm newborn infant,huge infant,fetal distress and neonatal asphyxia were higher than those of the control group and the differences were statistically significant（ P 〈0. 05）. Conclusion： Liuwei Dihuang decoction combined with insulin can effectively control blood sugar and treat kidney deficiency syndrome of gestational diabetes in pregnant women. Also,it can reduce the incidence of gestational hypertension and cesarean section rate,at the same time,reduce the incidence of preterm infant,huge infant,fetal distress and neonatal asphyxia,which is worthy of clinical application.