目的 探討參芪降糖顆粒聯(lián)合精蛋白生物合成人胰島素注射液治療妊娠期糖尿病的臨床療效。方法 選取2019年9月—2022年9月保定市第四中心醫(yī)院收治的98例妊娠期糖尿病患者，根據(jù)計(jì)算機(jī)隨機(jī)排列法分為對(duì)照組和治療組，每組49例。對(duì)照組每晚睡前皮下注射精蛋白生物合成人胰島素注射液，0.5～1.0 IU/kg，1次/d。治療組在對(duì)照組基礎(chǔ)上溫水沖服參芪降糖顆粒，1袋/次，3次/d。兩組連續(xù)治療1個(gè)月后統(tǒng)計(jì)療效。觀察兩組的臨床療效，比較兩組的動(dòng)態(tài)血糖指標(biāo)、胰島素功能指標(biāo)和血清指標(biāo)水平。結(jié)果 治療后，治療組的總有效率為95.92%，明顯高于對(duì)照組的總有效率81.63%（P＜0.05）。治療后，兩組的平均血糖值、血糖波動(dòng)系數(shù)、持續(xù)高血糖時(shí)間比均低于治療前（P＜0.05），且治療組平均血糖值、血糖波動(dòng)系數(shù)、持續(xù)高血糖時(shí)間比較對(duì)照組更低（P＜0.05）。治療后，兩組胰島素分泌指數(shù)（HOMA-β）顯著升高，胰島素抵抗（HOMA-IR）顯著降低（P＜0.05）；治療組的HOMA-β高于對(duì)照組，HOMA-IR低于對(duì)照組（P＜0.05）。治療后，兩組的血清半乳糖凝集素13（Gal-13）、葡萄糖轉(zhuǎn)運(yùn)蛋白4（GLUT4）、脂肪組織中網(wǎng)膜素1（omentin-1）水平明顯高于治療前（P＜0.05）；治療組的血清Gal-13、GLUT4、omentin-1水平高于對(duì)照組（P＜0.05）。結(jié)論 參芪降糖顆粒聯(lián)合精蛋白生物合成人胰島素注射液可顯著提高妊娠期糖尿病的療效，提高降糖效果，改善胰島細(xì)胞功能。

Objective To investigate the clinical effect of Shenqi Jiangtang Granules combined with Isophane Protamine Biosynthetic Human Insulin Injection in treatment of gestational diabetes mellitus. Methods Patients (98 cases) with gestational diabetes mellitus in the Fourth Central Hospital of Baoding from September 2019 to September 2022 were divided into control and treatment groups according to the computer random arrangement method, and each group had 49 cases. Patients in the control group were sc administered with Isophane Protamine Biosynthetic Human Insulin Injection every night before sleep, 0.5 — 1.0 IU/kg, once daily. Patients in the treatment group were po administered with Shenqi Jiangtang Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 1 month. After treatment, the clinical efficacies were evaluated, and the levels of dynamic blood glucose indicators, insulin function indicators, and serum indicators in two groups were compared. Results After treatment, the total effective rate in the treatment group was 95.92%, significantly higher than 81.63% in the control group (P < 0.05). After treatment, the average blood glucose value, blood glucose fluctuation coefficient, and duration ratio of sustained hyperglycemia in two groups were lower than before treatment (P < 0.05), and the average blood glucose value, blood glucose fluctuation coefficient and duration ratio of sustained hyperglycemia in the treatment group were lower than those in the control group (P < 0.05). After treatment, HOMA-β in two groups were significantly increased, but HOMA-IR in two groups were significantly decreased (P < 0.05). HOMA-β of the treatment group was higher than that of the control group, but HOMA-IR of the treatment group was lower than that of the control group (P < 0.05). After treatment, serum levels of Gal-13, GLUT4, and omentin-1 in two groups were significantly higher than before treatment (P< 0.05). The serum levels of Gal-13, GLUT4, and omentin-1 in the treatment group were higher than those in the control group (P < 0.05). Conclusion Shenqi Jiangtang Granules combined with Isophane Protamine Biosynthetic Human Insulin Injection can significantly improve efficacy of gestational diabetes mellitus, hypoglycemic effect, and function of pancreatic islet cells.

R977；R984

保定市科技計(jì)劃項(xiàng)目(2041ZF234)