参麦地黄汤联合胰岛素治疗气阴两虚型妊娠期糖尿病的效果及对代谢指标和炎症因子水平的影响

Effect of Shenmai Dihuang Decoction combined with insulin in the treatment of gestational diabetes mellitus with deficiency of qi and yin and its effect on metabolic indexes and inflammatory factor levels

关键词:  参麦地黄汤  胰岛素治疗  妊娠期糖尿病  代谢指标  炎症因子

Key words:  Shenmai Dihuang Decoction  insulin therapy  gestational diabetes mellitus  metabolic indicators  inflammatory factor

摘要:

[目的] 探索参麦地黄汤联合胰岛素治疗气阴两虚型妊娠期糖尿病（GDM）的临床效果及对代谢指标和炎症因子水平的影响。[方法] 选取120例承德市中心医院GDM患者（2022年5月—2023年5月）随机分为观察组和对照组，每组各60例。两组患者疗程均为3个月，比较两组GDM患者治疗后的疗效及不良妊娠结局，比较治疗前后两组GDM患者的代谢指标，包括糖化血红蛋白（HbA1c）、空腹血糖（FBG）、餐后2 h血糖（2 hPG）、胰岛素抵抗指数（HOMA-IR）、空腹胰岛素（FINS）。使用全自动酶免分析仪检测治疗前后两组GDM患者炎症因子的水平，包括白细胞介素（IL）-1β、IL-6、超敏C反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）。[结果] 观察组临床总有效率比对照组高，不良妊娠结局发生率低于对照组（P＜0.05）。治疗后，两组患者血糖降低，观察组患者低于对照组（P＜0.05），观察组患者HOMA-IR、FINS水平较低（P＜0.05），IL-1β、IL-6、TNF-α及hs-CRP下降，观察组下降幅度较高（P＜0.05）。[结论] 参麦地黄汤联合胰岛素治疗能够降低GDM患者不良妊娠结局发生率、血糖水平、HOMA-IR、FINS水平及血清IL-1β、IL-6、TNF-α及hs-CRP水平。

Abstract:

[Objective] Exploring the effect of Shenmai Dihuang Decoction combined with insulin in the treatment of gestational diabetes mellitus（GDM） with deficiency of qi and yin and its influence on metabolic indexes，inflammatory factor levels. [Methods] The 120 GDM patients（May 2022-May 2023） admitted to Chengde Central Hospital were selected and randomly divided into 60 cases of observation group and 60 cases of control group. The course of treatment was 3 months for both groups. Compare the efficacy and adverse pregnancy outcomes of GDM patients in the two groups after treatment. The metabolic indexes of GDM patients in the two groups before and after treatment were compared，including HbA1c，FBG，2 hPG，HOMA-IR，and FINS. The levels of inflammatory factors in GDM patients in the two groups before and after treatment were detected by using a fully automated enzyme immunoassay analyzer，including IL-1β，IL-6，hs-CRP，and TNF-α. [Results] The observation group had a higher overall clinical effectiveness rate than the control group，and the rate of adverse pregnancy outcomes was lower than that of the control group（P＜0.05）；after the treatment，blood glucose decreased in both groups，and the observation group was lower than that of the control group（P＜0.05），and the levels of HOMA-IR and FINS were lower in the observation group（P＜0.05） after the treatments. After treatment，IL-1β，IL-6，TNF-α and hs-CRP decreased in both groups，with a higher decrease in the observation group（P＜0.05）. [Conclusion] Shenmai Dihuang Decoction combined with insulin can reduce the incidence of adverse pregnancy outcomes，blood glucose levels，HOMA-IR，FINS levels and serum levels of IL-1β，IL-6，TNF-α and hs-CRP in GDM patients.