目的 研究黄芪颗粒联合门冬胰岛素治疗妊娠糖尿病的临床疗效。方法 选取成都市天府新区人民医院2013年2月—2015年2月收治的妊娠糖尿病产妇100例,随机分为对照组和治疗组,每组各50例。对照组在一般治疗的基础上皮下注射门冬胰岛素注射液,0.5～1.0 U/kg,其中2/3用量用餐时给药,剩余1/3用量是基础胰岛素。治疗组在对照组的基础上,服用黄芪颗粒15 g/d,2次/d。以连续服用4周为一个疗程。比较两组治疗前后的临床疗效,尿蛋白、尿素氮、血肌酐和糖化血红蛋白(HbA1c),血糖、血脂指标总胆固醇(TC)和三酰甘油(TG),血糖达标时间、胰岛素用量和低血糖发生率,以及产后母婴的生理状况。结果 治疗组总有效率(90.00%)明显高于对照组的总有效率(82.00%),两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者的尿蛋白、尿素氮、血肌酐及HbA1c均显著减少,同组治疗前后差异均具有统计学意义(P<0.05);且治疗组的改善程度优于对照组,两组比较差异具有统计学意义(P<0.05)。两组的空腹和饭后2 h血糖以及TC、TG均较治疗前有所降低,同组治疗前后差异具有统计学意义(P<0.05);治疗组治疗后的空腹和饭后2 h血糖以及TC、TG较对照组治疗后均有所降低,且差异具有统计学意义(P<0.05)。治疗后,治疗组的血糖达标时间、胰岛素用量和低血糖发生率均低于对照组,且两组比较差异具有统计学意义(P<0.05)。治疗组母婴的妊娠结局指标明显优于对照组(P<0.05)。结论 黄芪颗粒联合门冬胰岛素治疗妊娠糖尿病的具有较好的疗效,具有一定的临床推广应用价值。

Objective To investigate the clinical effects of Huangqi Granules combined with insulin aspart in treatment of gestational diabetes. Methods Puerperae (100 cases) with gestational diabetes in Chengdu Tianfu New District People's Hospital from February 2013 to February 2015 were randomly divided into control and treatment groups, and each group had 50 cases. The patients in the control group were sc administered with Insulin Aspart Injection on the basis of general treatment, 0.5—1.0 U/kg, 2/3 dosage when having dinner, and the remaining 1/3 was basal insulin. The patients in the treatment group were po administered with Huangqi Granules on the basis of the control group, 15 g/d, twice daily. The patients in two groups were treated for 4 weeks as a course. After treatment, the efficacy, urinary protein, urea nitrogen, serum creatinine and haemoglobin (HbA1c), blood glucose and blood lipid indicators total cholesterol (TC) and triacylglycerol (TG), recovering time of blood glucose, insulin dose, and blood sugar occurrence rate, and physiological status of puerperae and infants after delivery. Results The clinical efficacy in treatment group (90.00%) was higher than that in control group (82.00%) with significant difference (P < 0.05). After treatment, urinary protein, urea nitrogen, serum creatinine, and HbA1c of two groups were lower than those before treatment, and the difference was significant (P < 0.05). These observed indexes in treatment group were better than those in control group, with significant difference between two groups (P < 0.05). Fasting blood glucose and blood glucose after dinner for 2 h, and TC and TG in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). These observational indexes in treatment group were better than those in control group, with significant difference between two groups (P < 0.05). After treatment, recovering time of blood glucose, insulin dose, and blood sugar occurrence rate in treatment group were lower than those in control group, with significant difference between two groups (P < 0.05). Pregnant outcome indicators of puerperae and infants in treatment group were better than those in control group with significant difference (P < 0.05). Conclusion Huangqi Granules combined with insulin aspart has good effect in treatment of gestational diabetes, which has a certain clinical application value.