参苓白术散对脾虚湿困型妊娠期糖尿病产后代谢影响的临床分析

Clinical Analysis of the Effect of Shenlingbaizhu Powder on Postpartum Metabolism of Gestational Diabetes Mellitus with Spleen Deficiency and Dampness

目的 评价参苓白术散改善脾虚湿困型妊娠期糖尿病(gestational diabetes mellitus,GDM)产后代谢的有效性和安全性。方法 选取2020年7—12月在广东省妇幼保健院产科住院分娩的172例脾虚湿困型单胎GDM孕产妇为研究对象,随机分为治疗组和对照组,各86例。所有孕产妇均进行健康教育控制饮食,两组均给与常规降糖治疗,治疗组还口服加减参苓白术散,比较相关代谢指标的变化。结果 治疗4周,产后42 d随访的代谢指标中,治疗组空腹血糖(FPG)水平较对照组低,差异有统计学意义(P<0.05);治疗组体质指数(BMI)、血尿素氮(BUN)、尿酸(UA)均低于对照组,差异有统计学意义(P<0.05)。结论 运用参苓白术散加减可以改善脾虚湿困型GDM孕产妇的产后代谢,降低产后体质量、保护肾功能、降低尿酸水平。

Objective To evaluate the efficacy and safety of Shenlingbaizhu Powder in improving postpartum metabolism of gestational diabetes mellitus(GDM)with spleen deficiency and dampness.Methods A total of one hundred and seventy-two cases of GDM singlet pregnant women with spleen deficiency and dampness who were hospitalized in the Department of Obstetrics of Guangdong Maternal and Child Health Care Hospital from July 2020 to December 2020 were selected as the research objects,and randomly divided into the treatment group and the control group,with 86 cases in each group.All pregnantwomen received health education and diet control,and both groups received routine hypoglycemic treatment.In the treatment group,Shenlingbaizhu Powder was also taken orally to compare the changes of related metabolic indexes.Results After 4 weeks of treatment and 42 days postpartum follow-up,the level of fasting plasma glucose(FPG)in the treatment group was lower than that in the control group,the difference was statistically significant(P<0.05);the body mass index(BMI),blood urea nitrogen(BUN)and uric acid(UA)in the treatment group were lower than those in the control group,the difference was statistically significant(P<0.05).Conclusion The addition and reduction of Shenlingbaizhu Powder can improve postpartum metabolism,reduce postpartum weight,protect renal function and reduce uric acid level of GDM pregnant women with spleen deficiency and dampness.