葛根素注射液联合胰岛素泵短期强化治疗对妊娠期糖尿病患者血糖控制及妊娠结局的影响

Effect of puerarin injection combined with short-term intensive treatment of insulin pump on blood glucose control and pregnancy outcome in patients with gestational diabetes mellitus

目的探讨葛根素注射液联合胰岛素泵短期强化治疗对妊娠期糖尿病(GDM)患者血糖控制及妊娠结局的影响。方法选取朔州市中心医院2014年2月至2017年1月诊治的GDM患者78例,按随机数字表法分为两组,每组39例。对照组给予常规多次皮下注射胰岛素治疗,观察组给予葛根素注射液联合胰岛素泵短期强化治疗。治疗前后检查对比两组血糖[空腹血糖(FBG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)]、氧化应激反应指标[丙二醛(MDA)、活性氧(ROS)、超氧化物歧化酶(SOD)]、血脂[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]水平,并对比两组的妊娠结局。结果①血糖血脂水平:治疗后与对照组比较,观察组血糖、血脂水平优于对照组,差异有统计学意义(P<0.05);②氧化应激反应指标水平:治疗后观察组MDA(40.21±3.22)nmol/ml、ROS(202.97±19.24)U/ml水平低于对照组[MDA(52.36±3.67)nmol/ml、ROS(278.21±22.75)U/ml],SOD水平(223.08±24.02)U/ml高于对照组(168.50±20.89)U/ml,差异有统计学意义(P<0.05);③妊娠结局:观察组低血糖(5.13%)、子痫前期(2.56%)、剖宫产(28.21%)、羊水过多(5.13%)、早产(7.69%)、巨大儿(2.56%)低于对照组[低血糖(25.64%)、子痫前期(20.51%)、剖宫产(58.97%)、羊水过多(25.64%)、早产(30.77%)、巨大儿(23.08%)],差异有统计学意义(P<0.05);观察组妊娠期高血压(2.56%)、产后出血(2.56%)、胎儿窘迫(5.13%)与对照组[妊娠期高血压(7.69%)、产后出血(5.13%)、胎儿窘迫(12.82%)]比较,差异未见统计学意义(P>0.05)。结论葛根素注射液联合胰岛素泵短期强化治疗GDM,可减轻患者氧化应激反应,降低患者血糖、血脂水平,改善妊娠结局。

Objective To investigate the effect of puerarin injection combined with short-term intensive treatment of insulin pump on blood glucose control and pregnancy outcome in patients with gestational diabetes mellitus(GDM). Methods Seventy-eight cases of GDM patients in Shuozhou Central Hospital from February 2014 to January 2017 were selected and grouped by the random digital table, with 39 cases in each group. The control group received routine multiple subcutaneous insulin injection, while the observation group was given puerarin injection combined with short-term intensive treatment of insulin pump. The levels of blood glucose[fasting blood glucose (FBG), 2 h postprandial plasma glucose (2hPG), glycosylated hemoglobin (HbA1c)], oxidative stress indicators[malondialdehyde (MDA), reactive oxygen species (ROS), superoxide dismutase (SOD)], blood lipids[triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C)] were compared. Results ①The level of blood glucose and blood lipid: after treatment, the levels of blood glucose and blood lipid in the observation group were better than those in the control group, and the differences were significant(P<0.05).②The level of oxidative stress response index: the levels of MDA (40.21± 3.22) nmol/ml and ROS (202.97± 19.24) U/ml in the observation group were lower than those in the control group[MDA (52.36±3.67) nmol/ml, ROS (278.21± 22.75) U/ml], and the level of SOD (223.08± 24.02) U/ml higher than that of the control group (168.50± 20.89) U/ml, and the differences were significant(P<0.05).③Pregnancy outcome: hypoglycemia (5.13%), preeclampsia (2.56%), caesarean section (28.21%), amniotic fluid (5.13%), preterm birth (7.69%), and macrosomia (2.56%) in the observation group were lower than those in the control group[hypoglycemia (25.64%), preeclampsia (20.51%), cesarean section (58.97%), amniotic fluid (25.64%), premature delivery (30.77%), macrosomia (23.08%)], and the differences were significant(P<0.05). The pregnancy induced hypertension (2.56%), postpartum hemorrhage (2.56%), and fetal distress (5.13%) in the observation group was not significantly different from the control group[pregnancy induced hypertension (7.69%), postpartum hemorrhage (5.13%), fetal distress (12.82%)] in the control group(P>0.05). Conclusions Puerarin injection combined with short-term intensive treatment of insulin pump in treating GDM patients can reduce the reaction of oxidative stress, reduce the level of blood sugar and blood lipid of the patients, and improve the outcome of pregnancy.