门冬胰岛素联合六味地黄丸对妊娠期糖尿病患者胰岛素抵抗及新生儿免疫功能的影响

目的探讨门冬胰岛素联合六味地黄丸对妊娠期糖尿病患者胰岛素抵抗及新生儿免疫功能的影响.方法将60例妊娠期糖尿病患者按随机数字表法分为两组,各30例.两组均予以门冬胰岛素治疗,研究组在此基础上联合六味地黄丸治疗,观察1个月,随访至分娩结束.于治疗前后检测血糖指标(糖化血红蛋白、空腹血糖、餐后2h血糖)水平、胰岛素功能指标(空腹胰岛素、胰岛β细胞功能指数、胰岛素抵抗指数)水平,统计不良反应发生率、不良母婴结局,并检测新生儿免疫功能指标水平.结果(1)治疗后两组糖化血红蛋白、空腹血糖及餐后2 h血糖水平均较治疗前显著降低(P<0.01),研究组显著低于对照组(P<0.01).(2)治疗后两组空腹胰岛素水平及胰岛素抵抗指数较治疗前显著降低(P<0.01),研究组显著低于对照组(P<0.01);胰岛β细胞功能指数较治疗前显著升高(P<0.01),研究组显著高于对照组(P<0.01).(3)两组不良反应发生率比较差异无统计学意义(P>0.05).(4)研究组新生儿窒息、早产发生率显著低于对照组(P<0.05),新生儿CD3^+、CD4^+、CD4^+/CD8^+水平均显著高于对照组(P<0.05或0.01).结论门冬胰岛素联合六味地黄丸可提升妊娠期糖尿病患者血糖控制水平,改善胰岛素功能,降低不良妊娠结局发生率,提高新生儿免疫功能,安全可靠.

Effects of insulin aspart combined with Liuwei Dihuang Pill on insulin resistance and neonatal immune function in patients with gestational diabetes

Objective To investigate the effects of insulin aspart combined with Liuwei Dihuang Pill on insulin resistance and neonatal immune function in patients with gestational diabetes.Methods 60 patients with GDM were divided into two groups according to the random number table method,30 cases each.Both groups were treated with insulin aspart,and the research group was treated with Liuwei Dihuang Pill on this basis,observed for 1 month,and followed up to the end of delivery.Before and after treatment,the blood glucose index(glycated hemoglobin,fasting blood glucose,2 h postprandial blood glucose)and insulin function index(fasting insulin,HOMA-β,HOMA-IR)were measured.The incidence of adverse reactions,adverse maternal and infant outcomes were counted,and the levels of neonatal immune function indicators were measured.Results(1)After 1 month of treatment,the levels of HbA1c,FPG and 2 hPG were lower than those before treatment(P<0.01),and the study group was lower than the control group(P<0.01).(2)After 1 month of treatment,the FINS and HOMA-IR of the two groups were lower than that before the treatment(P<0.01),and the study group was lower than the control group(P<0.01).The HOMA-βwas higher than that before the treatment(P<0.01),and the study group was higher than the control group(P<0.01).(3)There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).(4)The incidence of neonatal asphyxia and preterm birth in the study group was significantly lower than that in the control group(P<0.05).The levels of CD3^+,CD4^+,CD4^+/CD8^+in newborns were significantly higher than those in the control group(P<0.05 or 0.01).Conclusions The combination of insulin aspart and Liuwei Dihuang Pill in the treatment of gestational diabetes can improve blood sugar control,improve insulin function,reduce the incidence of adverse pregnancy outcomes,improve neonatal immune function,and have safety.