黄芪四君子汤联合个性化营养干预对妊娠糖尿病患者炎症指标和妊娠结局的影响

Effect of Huangqi Sijunzi Decoction and Individualized Nutrition Intervention on Inflammatory Indicators and Pregnancy Outcome for Patients with Gestational Diabetes Mellitus

目的:探讨黄芪四君子汤联合个性化营养干预对妊娠糖尿病(GDM)患者炎症指标和妊娠结局的影响。方法:将90例GDM患者按照随机数字表法分为2组,每组45例,对照组给予二甲双胍口服和个性化营养干预治疗,治疗组在此基础上给予中药黄芪四君子汤口服。比较两组治疗前后血糖指标、胰岛素抵抗指标和炎症指标,并比较两组妊娠结局。结果:治疗后治疗组FGB、2hPG、HbA1c、FINS、HOMA-IR低于对照组(P<0.01),HOMA-β高于对照组(P<0.01),血清IL-6、hs-CRP、TNF-α水平均低于对照组(P<0.01);治疗组早产、胎膜早破、羊水过多发生率、巨大儿、新生儿低血糖发生率低于对照组(P<0.05),差异均有统计学意义。结论:黄芪四君子汤联合个性化营养干预可有效控制血糖,改善胰岛素抵抗,降低不良妊娠结局的发生,治疗GDM效果显著,其机制可能与该疗法可有效降低血清炎症因子含量有关。

Objective:To explore the effect of Huangqi Sijunzi Decoction and individualized nutrition intervention on inflammatory indicators and pregnancy outcome for patients with gestational diabetes mellitus(GDM).Methods:90 patients with GDM were divided into two groups according to the random number table method,with 45 cases in each group.The controlled group were given Metformin orally and individualized nutrition intervention treatment,while the treatment group were given Huangqi Sijunzi Decoction orally based on the controlled group.The blood sugar index,insulin resistance index and inflammation index of the two groups were compared before and after treatment,and the pregnancy outcome of the two groups was compared.Results:After treatment,FGB,2 hPG,HbA1 c,FINS,HOMA-IR of the treatment group were lower than those of the controlled group(P<0.01),HOMA-βwas higher than that of the controlled group(P<0.01),and serum levels of IL-6,hs-CRP and TNF-alpha were lower than those of the controlled group(P<0.01).The incidence of preterm birth,premature rupture of membranes,polyhydramnios,macrosomia and neonatal hypoglycemia of the treatment group were lower than those of the controlled group(P<0.05).The difference was statistically significant.Conclusion:Huangqi Sijunzi Decoction combined with individualized nutrition intervention can effectively control blood sugar,improve insulin resistance,reduce the occurrence of adverse pregnancy outcomes,and it has distinct effect on GDM.Its mechanism may be related to the serum inflammatory factors.