杞菊地黄汤加减联合胰岛素治疗妊娠期糖尿病效果及对患者胰岛功能、脂肪因子和母婴结局的影响

Effect of Qiju Dihuang decoction combined with insulin in treatment of gestational diabetes mellitus and its influence on islet function,adipokine and maternal and infant outcomes

目的:探讨杞菊地黄汤加减联合胰岛素治疗妊娠期糖尿病效果及对患者胰岛功能、脂肪因子和母婴结局的影响。方法:110例妊娠期糖尿病患者作为研究对象,根据治疗方法分为观察组(n=55)与对照组(n=55)。两组均给予常规治疗干预,对照组采用胰岛素治疗,观察组在对照组基础上加用杞菊地黄汤加减治疗,均持续治疗4周。比较两组临床效果及母婴结局,观察治疗前后中医证候积分、血糖控制指标[空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)]、胰岛功能[胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)]及脂肪因子[血清瘦素(LP)、脂联素(ADPN)及脂肪组织中网膜素1(Omentin-1)]水平变化。结果:观察组治疗后总有效率高于对照组(P<0.05)。治疗后,观察组主症积分、次症积分低于对照组(均P<0.05)。观察组FBG、2 hPG、HbA1c低于对照组(均P<0.05)。治疗后,观察组HOMA-IR、HOMA-β优于对照组(均P<0.05)。治疗后,观察组ADPN、Omentin-1水平高于对照组,LP水平低于对照组(均P<0.05)。观察组不良母婴结局发生率低于对照组(P<0.05)。结论:杞菊地黄汤加减联合胰岛素治疗妊娠期糖尿病可有效减轻患者临床症状,提高治疗效果,控制血糖水平,改善胰岛功能,且可有效调节脂肪因子水平,降低不良母婴结局发生率。

Objective:To investigate the effect of Qiju Dihuang decoction combined with insulin in the treatment of gestational diabetes mellitus and its influence on islet function,adipokine and maternal and infant outcomes.Methods:110 patients with gestational diabetes mellitus were divided into observation group(n=55)and control group(n=55)according to different treatment methods.Both groups were given conventional treatment.The control group was treated with insulin,and the observation group was treated with Qiju Dihuang decoction on the basis of the control group.The clinical effects and maternal and infant outcomes of the two groups were compared.The TCM syndrome scores,blood glucose control indexes[fasting blood glucose(FBG),2-hour postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA1c)],islet function[insulin resistance index(HOMA-IR),insulin secretion index(HOMA-β)]and adipokine[serum leptin(LP),adiponectin(ADPN),Omentin-1]were observed before and after treatment.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the main syndrome score and secondary syndrome score in the observation group were lower than those in the control group(all P<0.05).The blood glucose control indexes of FBG,2 hPG and HbA1c in the observation group were lower than those in the control group(all P<0.05).After treatment,HOMA-IR and HOMA-βin the observation group were better than those in the control group(all P<0.05).After treatment,the levels of ADPN and Omentin-1 in the observation group were higher than those in the control group,and the LP level was lower than that in the control group(all P<0.05).The incidence of adverse maternal and infant outcomes in the observation group was lower than that in the control group(P<0.05).Conclusion:Qiju Dihuang decoction combined with insulin in the treatment of gestational diabetes mellitus can effectively reduce the clinical symptoms of patients,improve the therapeutic effect,control blood glucose levels,improve islet function,and can effectively regulate the level of adipokine,reduce the incidence of adverse maternal and infant outcomes.