六味地黄汤结合胰岛素治疗妊娠期糖尿病临床观察

Clinical Observation on Liuwei Dihuang Decoction Combined with Insulin in the Treatment of Gestational Diabetes Mellitus

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效果。方法将2020年1月—2020年12月在阜新市卫生健康服务中心妇产科治疗的92例妊娠期糖尿病患者,随机分为2组,对照组使用胰岛素治疗,在此基础上,观察组使用六味地黄汤加减治疗,对比2组的血糖指标、中医证候积分变化、分娩方式及妊娠并发症、围产儿结局。结果观察组治疗后空腹血糖(FPG)、餐后2 h血糖(2 h PG)明显低于对照组(P<0.05);观察组治疗后中医证候积分明显低于对照组(P<0.05);观察组剖宫产率以及妊娠期高血压、羊水过多、产后出血、产褥期感染等妊娠并发症发生率明显低于对照组(P<0.05);观察组早产儿、巨大儿、新生儿窒息、新生儿低血糖等围产儿不良结局发生率明显低于对照组(P<0.05)。结论六味地黄汤加减结合胰岛素治疗妊娠期糖尿病的临床效果显著,能有效控制血糖,减轻中医证候,降低剖宫产率以及母婴不良妊娠结局发生率,提高母婴的健康水平,具有积极的临床意义。

Objective To investigate the clinical observation of Liuwei Dihuang decoction combined with insulin in the treatment of gestational diabetes.Methods 92 pregnant diabetic patients treated in Fuxin Health Service Center from January 2020 to December 2020 were randomly divided into two groups.The control group was treated with insulin.On this basis,the observation group was treated with Liuwei Dihuang decoction.The blood glucose indexes,traditional Chinese medicine(TCM)syndrome score,delivery mode,complications of pregnancy and perinatal outcome were compared.Results After treatment,Fasting plasma glucose(FPG)and 2-hour postprandial blood glucose(2 h PG)in observation group were significantly lower than those in control group(P<0.05).The TCM syndrome score of the observation group was significantly lower than that of the control group after treatment(P<0.05).The cesarean section rate and the incidence of pregnancy complications such as pregnancy hypertension,excessive amniotic fluid,postpartum hemorrhage and puerperium infection in the observation group were significantly lower than those in the control group(P<0.05).The incidence of perinatal adverse outcomes of preterm infants,macrosomia,neonatal asphyxia and neonatal hypoglycemia in observation group was significantly lower than that in control group(P<0.05).Conclusion Liuwei Dihuang decoction combined with insulin has a significant clinical effect on gestational diabetes mellitus,which can effectively control blood sugar,reduce TCM syndromes,reduce cesarean section rate and the incidence of adverse pregnancy outcomes,and improve the health level of mother and baby,and it has positive clinical significance.