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目的:探讨二甲双胍联合黄芪四君子汤对妊娠期糖尿病孕妇妊娠结局的影响。方法:选取2014年5月—2015年5月于本院产科就诊以妊娠期糖尿病为诊断的患者80例,根据随机数字表法随机分为两组:对照组40例,予常规治疗;实验组40例,予二甲双胍联合黄芪四君子汤治疗,直至患者有分娩先兆后停止服用。观察两组患者治疗前后血糖控制情况、血清CRP、Mg~(2+)及脂联素水平、妊娠结局及新生儿情况,探索二甲双胍联合黄芪四君子汤对妊娠期糖尿病孕妇的疗效及安全性,其数据结果应用统计学软件SPSS 19.0加以处理。结果:与对照组相比,实验组患者血清FBG、2h PG、Hb A1c及血清CRP均较低(P<0.05),血清Mg~(2+)及脂联素水平均明显高于同期对照组(P<0.05)。实验组的早产率、剖腹产率、蛋白尿率、子痫前期发病率等妊娠不良结局明显低于对照组(P<0.05),实验组的新生儿窘迫、巨大儿及新生儿低血糖发生率明显低于对照组(P<0.05)。结论:二甲双胍联合黄芪四君子汤能够明显降低妊娠期糖尿病患者的血清CRP,升高Mg~(2+)及脂联素水平,改善血糖水平,降低妊娠不良结局,改善新生儿情况。
Objective: To investigate the effect of metformin combined with Astragalus Sijunzi Decoction on pregnant women with gestational diabetes mellitus. Methods: From May 2014 to May 2015, 80 patients diagnosed with gestational diabetes mellitus in obstetrics department of our hospital were randomly divided into two groups according to the random number table method: control group of 40 cases, routine treatment; experimental group 40 cases, metformin combined with Astragalus Sijunzi Tang treatment, until the patient has given birth after the cessation of taking. To observe the control of blood glucose, serum levels of CRP, Mg 2+ and adiponectin, pregnancy outcome and neonates before and after treatment in both groups, and to explore the efficacy and safety of metformin combined with Huangqi Sijunzi Decoction in pregnant women with gestational diabetes. Data results were processed using statistical software SPSS 19.0. Results: Compared with the control group, the levels of serum FBG, 2h PG, Hb A1c and serum CRP in the experimental group were lower (P <0.05), and the levels of serum Mg2 + and adiponectin in the experimental group were significantly higher than those in the control group (P <0.05). The adverse pregnancy outcomes such as preterm birth rate, caesarean section rate, proteinuria rate and preeclampsia incidence in the experimental group were significantly lower than those in the control group (P <0.05). The incidence of neonatal distress, macrosomia and neonatal hypoglycemia was significantly higher in the experimental group Lower than the control group (P <0.05). Conclusion: Metformin combined with Astragalus Sijunzi Decoction can significantly reduce serum CRP, increase the levels of Mg2 + and adiponectin, improve blood glucose level, reduce the adverse pregnancy outcome and improve the neonatal status in gestational diabetes mellitus patients.