目的 探讨参芪降糖颗粒联合精蛋白生物合成人胰岛素注射液治疗妊娠期糖尿病的临床疗效。方法 选取2019年9月—2022年9月保定市第四中心医院收治的98例妊娠期糖尿病患者，根据计算机随机排列法分为对照组和治疗组，每组49例。对照组每晚睡前皮下注射精蛋白生物合成人胰岛素注射液，0.5～1.0 IU/kg，1次/d。治疗组在对照组基础上温水冲服参芪降糖颗粒，1袋/次，3次/d。两组连续治疗1个月后统计疗效。观察两组的临床疗效，比较两组的动态血糖指标、胰岛素功能指标和血清指标水平。结果 治疗后，治疗组的总有效率为95.92%，明显高于对照组的总有效率81.63%（P＜0.05）。治疗后，两组的平均血糖值、血糖波动系数、持续高血糖时间比均低于治疗前（P＜0.05），且治疗组平均血糖值、血糖波动系数、持续高血糖时间比较对照组更低（P＜0.05）。治疗后，两组胰岛素分泌指数（HOMA-β）显著升高，胰岛素抵抗（HOMA-IR）显著降低（P＜0.05）；治疗组的HOMA-β高于对照组，HOMA-IR低于对照组（P＜0.05）。治疗后，两组的血清半乳糖凝集素13（Gal-13）、葡萄糖转运蛋白4（GLUT4）、脂肪组织中网膜素1（omentin-1）水平明显高于治疗前（P＜0.05）；治疗组的血清Gal-13、GLUT4、omentin-1水平高于对照组（P＜0.05）。结论 参芪降糖颗粒联合精蛋白生物合成人胰岛素注射液可显著提高妊娠期糖尿病的疗效，提高降糖效果，改善胰岛细胞功能。

Objective To investigate the clinical effect of Shenqi Jiangtang Granules combined with Isophane Protamine Biosynthetic Human Insulin Injection in treatment of gestational diabetes mellitus. Methods Patients (98 cases) with gestational diabetes mellitus in the Fourth Central Hospital of Baoding from September 2019 to September 2022 were divided into control and treatment groups according to the computer random arrangement method, and each group had 49 cases. Patients in the control group were sc administered with Isophane Protamine Biosynthetic Human Insulin Injection every night before sleep, 0.5 — 1.0 IU/kg, once daily. Patients in the treatment group were po administered with Shenqi Jiangtang Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 1 month. After treatment, the clinical efficacies were evaluated, and the levels of dynamic blood glucose indicators, insulin function indicators, and serum indicators in two groups were compared. Results After treatment, the total effective rate in the treatment group was 95.92%, significantly higher than 81.63% in the control group (P < 0.05). After treatment, the average blood glucose value, blood glucose fluctuation coefficient, and duration ratio of sustained hyperglycemia in two groups were lower than before treatment (P < 0.05), and the average blood glucose value, blood glucose fluctuation coefficient and duration ratio of sustained hyperglycemia in the treatment group were lower than those in the control group (P < 0.05). After treatment, HOMA-β in two groups were significantly increased, but HOMA-IR in two groups were significantly decreased (P < 0.05). HOMA-β of the treatment group was higher than that of the control group, but HOMA-IR of the treatment group was lower than that of the control group (P < 0.05). After treatment, serum levels of Gal-13, GLUT4, and omentin-1 in two groups were significantly higher than before treatment (P< 0.05). The serum levels of Gal-13, GLUT4, and omentin-1 in the treatment group were higher than those in the control group (P < 0.05). Conclusion Shenqi Jiangtang Granules combined with Isophane Protamine Biosynthetic Human Insulin Injection can significantly improve efficacy of gestational diabetes mellitus, hypoglycemic effect, and function of pancreatic islet cells.

R977；R984

保定市科技计划项目(2041ZF234)