[1]袁建娜,张华俊,张瑞杰,等.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[J].陕西中医,2024,(8):1078-1082.[doi:DOI:10.3969/j.issn.1000-7369.2024.08.015]
　YUAN Jianna,ZHANG Huajun,ZHANG Ruijie,et al.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[J].,2024,(8):1078-1082.[doi:DOI:10.3969/j.issn.1000-7369.2024.08.015]
点击复制

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
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年8期
页码:
1078-1082
栏目:
临床研究
出版日期:
2024-08-05

文章信息/Info

Title:
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
作者:
袁建娜; 张华俊; 张瑞杰; 冯玉军
(秦皇岛市妇幼保健院,河北 秦皇岛 066000)
Author(s):
YUAN Jianna; ZHANG Huajun; ZHANG Ruijie; FENG Yujun
(Qinhuangdao Maternal and Child Health Hospital,Qinhuangdao 066000,China)
关键词:
妊娠期糖尿病;  杞菊地黄汤;  胰岛素;  胰岛功能;  脂肪因子;  母婴结局
Keywords:
Gestational diabetes mellitus;  Qiju Dihuang decoction;  Insulin;  Islet function;  Adipokine;  Maternal and infant outcomes
分类号:
R 714.25
DOI:
DOI:10.3969/j.issn.1000-7369.2024.08.015
文献标志码:
A
摘要:
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。
Abstract:
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-β in 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.

参考文献/References:

[1] 金日男,蒋秋林,吴聪海,等.精准营养治疗妊娠期糖尿病孕妇的分娩结局及其子代预后的研究[J].中国现代医药杂志,2023,25(7):6-11.
[2] VOUNZOULAKI E,KHUNTI K,ABNER S C,et al.Progression to type 2 diabetes in women with a known history of gestational diabetes:Systematic review and meta-analysis[J].British Medical Journal,2020,369:1361.
[3] 刘军敏,薛艳平,白红,等.疏肝健脾方联合胰岛素泵对肝郁脾虚型妊娠期糖尿病患者血脂、妊娠及外周血单核细胞TLR4基因影响[J].中国计划生育学杂志,2020,28(5):685-689.
[4] 刘秋杨,朱慧芳,王迎春,等.黄芪四君子汤联合门冬胰岛素治疗妊娠期糖尿病临床研究[J].陕西中医,2021,42(10):1408-1411.
[5] 漆海宁.黄芪四君子汤加减方对妊娠期糖尿病(气阴两虚型)血清炎症指标和妊娠结局的影响[J].中国计划生育和妇产科,2018,10(8):41-45.
[6] 翟凤霞,郭明月,谷云鹏.妊娠期糖尿病中医研究现状[J].中医临床研究,2015,7(12):107-108,110.
[7] 邢祝乔.杞菊地黄汤加减联合常规西药用于妊娠期高血压治疗的临床效果[J].黑龙江医学,2022,46(24):2980-2982.
[8] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中国实用内科杂志,2018,38(4):292-344.
[9] AMERICAN DIABETES ASSOCIATION.Classification and diagnosis of diabetes[J].Diabetes Care,2015,38(S1):8-16.
[10] 中华中医药学会.糖尿病中医防治指南[J].中国中医药现代远程教育,2011,9(4):148-151.
[11] 魏小辉,王育璠.2015年国际妇产科联盟(FIGO)妊娠期糖尿病诊疗指南解读[J].中华内分泌代谢杂志,2016,32(11):895-899.
[12] 都燕,任娟,罗苗苗.肌醇和维生素B、D对妊娠糖尿病小鼠炎症及脂代谢的影响及机制探讨[J].陕西医学杂志,2022,51(2):159-163.
[13] 郝玉洁,张军.妊娠期糖尿病发病机制的研究现状及进展[J].中国医药,2023,18(10):1587-1591.
[14] 陈学奇,葛蓓芬.妊娠期糖尿病的中医治疗体会[J].浙江中医杂志,2021,56(12):877-878.
[15] 苑程鲲,王萌影,彭丽敏,等.中医治疗妊娠期糖尿病的探究[J].中医药学报,2022,50(8):13-16.
[16] 王巍,赵平.参芪麦味地黄汤联合运动疗法对妊娠期糖尿病气阴两虚型患者糖脂代谢及妊娠结局的影响[J].陕西中医,2018,39(10):1339-1341.
[17] 苏保洲.枸杞子活性成分药理作用研究进展[J].江苏中医药,2022,54(3):78-81.
[18] 杨根岭,胡荣静,李金艳.葛根素对妊娠期糖尿病大鼠的治疗效果及作用机制的研究[J].中国中医急症,2022,31(1):67-70.
[19] 高龙龙,尹丽君,孟祎凡,等.麦冬及其有效成分抗心脑血管疾病的药理研究进展[J].中国中医药现代远程教育,2021,19(13):182-185.
[20] 唐淑艳.妊娠期糖尿病中医体质类型与胰岛素抵抗、胰岛β细胞功能的相关性研究[D].南宁:广西中医药大学,2018.
[21] 韩慧慧,马娜,张云清,等.杞菊地黄汤联合诺和锐特充治疗妊娠期糖尿病41例[J].西部中医药,2020,33(4):106-108.
[22] 李亚妮,肖景华,计静,等.妊娠期糖尿病患者孕晚期阴道微生态状况、血清网膜素、促代谢因子水平变化及临床意义[J].陕西医学杂志,2022,51(11):1372-1375,1380.
[23] 韦汝凤,刘冬艳,兰桂珍,等.妊娠期糖尿病患者血清半胱氨酸、脂肪因子与糖脂代谢及炎症反应的相关性分析[J].中南医学科学杂志,2022,50(3):405-408.
[24] 贺思思,孙鸿妍,张晓天,等.脂联素检测在2型糖尿病诊治中的研究进展[J].中国实验诊断学,2023,27(11):1374-1377.
[25] 丁雪华,朱玉花.妊娠期糖尿病患者血清Ficolin-3、Omentin-1、FGF19水平检测及其对发生GDM的预测价值[J].检验医学与临床,2024,21(2):242-246.
[26] 冯丽,宋微.孕早期母体血清瘦素、脂连蛋白水平对妊娠糖尿病的预测价值[J].天津科技,2024,51(3):80-82.
[27] 喻艳.妊娠期糖尿病患者血清瘦素、Chemerin水平表达及其临床意义[J].药品评价,2020,17(10):5-6.
[28] 王珊,高坚蓉,李霞.妊娠期糖尿病并发胎儿生长受限106例临床研究[J].陕西医学杂志,2023,52(1):67-70.

相似文献/References:

[1]董巍巍,段雪涛,王红红,等.六味地黄汤加味联合穴位按摩治疗妊娠期糖尿病疗效及对患者妊娠结局的影响*[J].陕西中医,2020,(4):447.
[2]刘秋杨,朱慧芳,王迎春,等.黄芪四君子汤联合门冬胰岛素治疗妊娠期糖尿病临床研究[J].陕西中医,2021,(10):1408.[doi:DOI:10.3969/j.issn.1000-7369.2020.10.021]
[3]贾燚鑫,宋志慧,高春燕,等.麦冬多糖调控胰高血糖素样肽-1对妊娠期糖尿病大鼠肠道菌群及糖代谢的影响[J].陕西中医,2023,(4):427.[doi:DOI:10.3969/j.issn.1000-7369.2023.04.004]
　JIA Yixin,SONG Zhihui,GAO Chunyan,et al.Effects of ophiopogon polysaccharides on intestinal flora and glucose metabolism in gestational diabetic rats by regulating GLP-1[J].,2023,(8):427.[doi:DOI:10.3969/j.issn.1000-7369.2023.04.004]

备注/Memo

备注/Memo:
基金项目:河北省医学科学研究课题(20221621); 河北省秦皇岛市重点研发计划科技支撑项目(202004A025)
更新日期/Last Update: 2024-08-08