加味四君子汤联合穴位按摩在妊娠期糖尿病的应用效果

Effect of modified Sijunzi Decoction combined with acupoint massage in gestational diabetes mellitus

摘要:

目的 探究加味四君子汤联合穴位按摩对妊娠期糖尿病（GDM）患者的影响。方法 选取2021年3月—2024年3月江西省妇幼保健院接收的100例GDM患者，按信封抽签法随机分为单一组和联合组，各50例。单一组给予穴位按摩治疗，联合组给予加味四君子汤联合穴位按摩治疗。比较两组治疗疗效，治疗前后血糖水平、胰岛功能、中医证候积分及不良妊娠结局。结果 联合组治疗总有效率高于单一组（P <0.05）。联合组治疗后空腹血糖（FPG）、餐后2 h血糖（2hPG）、糖化血红蛋白（HbA1c）均低于单一组（P <0.05）。联合组治疗前后FPG、2hPG和HbA1c的差值均大于单一组（P <0.05）。联合组治疗后胰岛β细胞功能指数（HOMA-β）高于单一组（P <0.05），胰岛素抵抗指数（HOMA-IR）、空腹胰岛素（FINS）均低于单一组（P <0.05）。联合组治疗前后HOMA-β、HOMA-IR和FINS的差值均大于单一组（P <0.05）。联合组治疗后中医证候积分中的主症积分、次症及舌脉积分、总分均低于单一组（P <0.05）。联合组治疗前后主症积分、次症及舌脉积分、总分的差值均大于单一组（P <0.05）。联合组的不良妊娠结局总发生率低于单一组（P <0.05）。结论 加味四君子汤联合穴位按摩在GDM患者中的应用效果较为显著。

Abstract:

Objective To explore the effects of modified Sijunzi Decoction combined with acupoint massage on patients with gestational diabetes mellitus (GDM).Methods A total of 100 GDM patients admitted to Jiangxi Maternal and Child Health Hospital from March 2021 to March 2024 were selected and randomly divided into a monotherapy group (n = 50) and a combination group (n = 50) using the envelope method. The monotherapy group received acupoint massage alone, while the combination group received both modified Sijunzi Decoction and acupoint massage. The treatment efficacy, changes in blood glucose levels, pancreatic function, and traditional Chinese medicine (TCM) syndrome scores, and adverse pregnancy outcomes were compared between the two groups.Results The combination group showed a higher overall effective rate than the monotherapy group (P < 0.05). After treatment, the combination group had lower levels of fasting plasma glucose (FPG), 2-hour postprandial glucose (2hPG), and glycated hemoglobin (HbA1c) compared to the monotherapy group (P < 0.05). The differences in FPG, 2hPG, and HbA1c before and after treatment were greater in the combination group than in the monotherapy group (P < 0.05). After treatment, the combination group exhibited higher homeostasis model assessment of β-cell function (HOMA-β) (P < 0.05), and lower homeostasis model assessment of insulin resistance (HOMA-IR) and fasting insulin (FINS) levels than the monotherapy group (P < 0.05). The pre-to-post-treatment differences in HOMA-β, HOMA-IR, and FINS levels were greater in the combination group (P < 0.05). After treatment, the primary symptom scores, secondary symptom scores, tongue and pulse scores, and total TCM syndrome scores in the combination group were all lower than those in the monotherapy group (P < 0.05). The differences in these scores before and after treatment were greater in the combination group (P < 0.05). The incidence of adverse pregnancy outcomes was lower in the combination group than in the monotherapy group (P < 0.05).Conclusion The combined application of modified Sijunzi Decoction and acupoint massage demonstrates significant efficacy in GDM patients.