目的 探讨参芪降糖胶囊联合地特胰岛素注射液治疗妊娠糖尿病的临床疗效。方法 选取2022年2月—2024年1月在天津北大医疗海洋石油医院就诊的83例妊娠糖尿病患者，按随机数字表法将所有患者分为对照组（41例）和治疗组（42例）。对照组每日晚间皮下注射地特胰岛素注射液，1次/d，初始剂量10 UI/次，根据个体需要调整剂量。治疗组在对照组基础上口服参芪降糖胶囊，3粒/次，3次/d。两组患者持续治疗3个月。比较总有效率、血糖指标达标时间、血清炎症因子。结果 治疗后，治疗组的总有效率为95.24%，对照组的总有效率为80.49%，组间比较差异显著（P＜0.05）。治疗后，治疗组空腹血糖（FBG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbA1c）达标时间均短于对照组，差异有统计学意义（P＜0.05）。治疗后，治疗组的空腹胰岛素（FINS）、胰岛β细胞功能指数（HOMA-β）明显升高，胰岛素抵抗指数（HOMA-IR）明显降低（P＜0.05），且治疗组的FINS、HOMA-β明显高于对照组，HOMA-IR明显低于对照组（P＜0.05）。治疗后，治疗组的血清亮氨酸丰富α2-糖蛋白1（LRG1）、含pyrin结构域NOD样受体家族3（NLRP3）、生长停滞特异性蛋白6（GAS6）水平显著降低（P＜0.05），且治疗组的血清LRG1、NLRP3、GAS6水平均显著低于对照组（P＜0.05）。结论 参芪降糖胶囊联合地特胰岛素注射液可提高妊娠糖尿病的临床疗效，改善血糖和胰岛素功能，降低炎症反应。

Objective To investigate the therapeutic effect of Shenqi Jiangtang Capsules combined with Insulin Detemir Injection in treatment of gestational diabetes mellitus. Methods A total of 83 patients with gestational diabetes mellitus treated in Tianjin Peking University Medical Offshore Oil Hospital from February 2022 to January 2024 were selected and divided into control group (41 cases) and treatment group (42 cases) according to random number table method. Patients in the control group were sc Insulin Detemir Injection at night once daily, with an initial dose of 10 UI per injection, adjusted according to individual needs. Patients in the treatment group po administered with Shenqi Jiangtang Capsules on the basis of the control group, 3 grains/time, 3 times daily. Patients in two groups received continuous treatment for three months. The total effective rate, time to reach blood glucose target, and serum inflammatory factors were compared. Results After treatment, the total effective rate was 95.24% in the treatment group and 80.49% in the control group, and the difference was significant (P < 0.05). After treatment, the standard times of FBG, 2 h PG, and HbA1c in the treatment group was shorter than that in the control group, and the difference was statistically significant (P < 0.05). After treatment, FINS and HOMA-β in the treatment group were significantly increased, but HOMA-IR in the treatment group was significantly decreased (P < 0.05), and FINS and HOMA-β in the treatment group were significantly higher than those in the control group, but HOMA-IR in the treatment group was significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of LRG1, NLRP3, and GAS6 in the treatment group were significantly decreased (P < 0.05), and the serum levels of LRG1, NLRP3, and GAS6 in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Shenqi Jiangtang Capsules combined with Insulin Detemir Injection can improve the clinical effect of gestational diabetes mellitus, improve blood sugar and insulin function, and reduce inflammation.

R983