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[摘要]
目的 研究参芪降糖颗粒联合盐酸二甲双胍片对妊娠期糖尿病患者妊娠结局和胰岛β细胞功能的影响。方法 选择2015年1月-2017年12月西安市中医医院的95例妊娠期糖尿病患者,随机将患者分为对照组(48例)和观察组(47例)。对照组于餐后口服盐酸二甲双胍片,0.25 g/次,3次/d;观察组在对照组基础上冲服参芪降糖颗粒,3 g/次,3次/d。比较两组患者的妊娠结局,治疗前后的餐后2 h血糖、空腹血糖、胰岛β细胞功能以及血脂水平。结果 观察组的剖宫产率以及胎盘早剥、产后出血、HPLLP综合征等并发症的发生率均明显低于对照组(P<0.05)。观察组的新生儿窒息、胎儿窘迫、巨大儿、胎儿早产和围产儿死亡发生率均明显低于对照组(P<0.05)。治疗后,两组的餐后2 h血糖以及空腹血糖值均明显降低,HOMA-β明显升高(P<0.05),且观察组餐后2 h血糖以及空腹血糖值均明显低于对照组,HOMA-β明显高于对照组(P<0.05)。治疗后,两组三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)水平均显著降低,低密度脂蛋白胆固醇(LDL-C)显著升高,同组治疗前后比较差异具有统计学意义(P<0.05),且观察组血脂水平明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论 参芪降糖颗粒联合盐酸二甲双胍片可以有效改善妊娠期糖尿病患者的妊娠结局以及胰岛β细胞功能,降低血糖和血脂水平,具有较高的临床参考应用价值。
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[Abstract]
Objective To investigate the clinical effect of Shenqi Jiangtang Granules combined with Metformin Hydrochloride Tablets on pregnancy outcome and islet beta cell function in patients with gestational diabetes. Methods A total of 95 cases of patients with gestational diabetes in Xi'an Traditional Chinese Medicine Hospital from January 2015 to December 2017 were randomly divided into control group (48 cases) and observation group (47 cases). Patients in the control group were po administered with Metformin Hydrochloride Tablets after meals, 0.25 g/time, three times daily. Patients in the observation group were po administered with Shenqi Jiangtang Granules on the basis of control group, 3 g/time, three times daily. The pregnancy outcomes, postprandial 2 h blood glucose, fasting blood glucose, islet beta cell function, and blood lipid levels of two groups before and after treatment were compared. Results The rate of cesarean section rate and the incidence of complications such as placental abruption, postpartum hemorrhage and HPLLP syndrome were significantly lower than those of the control group (P<0.05). The incidence of neonatal asphyxia, fetal distress, fetal distress, fetal macrosomia, fetal preterm birth, and perinatal mortality in the observation group were significantly lower than those of the control group (P<0.05). After treatment, 2 h blood glucose and fasting blood glucose were significantly decreased, HOMA-β was significantly increased (P<0.05). And 2 h blood glucose and fasting blood glucose in the observation group were significantly lower than those in the control group, HOMA-β was significantly higher than those in the control group (P<0.05). After treatment, the levels of TG, TC, and LDL-C in two groups were significantly decreased, but the HDLC was increased (P<0.05). And the levels of blood lipid in the observation group were significantly better than those in the control group (P<0.05). Conclusion Shenqi Jiangtang Granules combined with Metformin Hydrochloride Tablets can effectively improve pregnancy outcome and pancreatic beta cell function, reduce blood sugar and blood lipid level in patients with gestational diabetes mellitus, and has a high clinical reference value.
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