目的 研究黃芪顆粒聯(lián)合門冬胰島素治療妊娠糖尿病的臨床療效。方法 選取成都市天府新區(qū)人民醫(yī)院2013年2月—2015年2月收治的妊娠糖尿病產(chǎn)婦100例,隨機(jī)分為對(duì)照組和治療組,每組各50例。對(duì)照組在一般治療的基礎(chǔ)上皮下注射門冬胰島素注射液,0.5～1.0 U/kg,其中2/3用量用餐時(shí)給藥,剩余1/3用量是基礎(chǔ)胰島素。治療組在對(duì)照組的基礎(chǔ)上,服用黃芪顆粒15 g/d,2次/d。以連續(xù)服用4周為一個(gè)療程。比較兩組治療前后的臨床療效,尿蛋白、尿素氮、血肌酐和糖化血紅蛋白(HbA1c),血糖、血脂指標(biāo)總膽固醇(TC)和三酰甘油(TG),血糖達(dá)標(biāo)時(shí)間、胰島素用量和低血糖發(fā)生率,以及產(chǎn)后母嬰的生理狀況。結(jié)果 治療組總有效率(90.00%)明顯高于對(duì)照組的總有效率(82.00%),兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者的尿蛋白、尿素氮、血肌酐及HbA1c均顯著減少,同組治療前后差異均具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組的改善程度優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。兩組的空腹和飯后2 h血糖以及TC、TG均較治療前有所降低,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);治療組治療后的空腹和飯后2 h血糖以及TC、TG較對(duì)照組治療后均有所降低,且差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,治療組的血糖達(dá)標(biāo)時(shí)間、胰島素用量和低血糖發(fā)生率均低于對(duì)照組,且兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療組母嬰的妊娠結(jié)局指標(biāo)明顯優(yōu)于對(duì)照組(P<0.05)。結(jié)論 黃芪顆粒聯(lián)合門冬胰島素治療妊娠糖尿病的具有較好的療效,具有一定的臨床推廣應(yīng)用價(jià)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.