Objective To observe the clinical effect of Zuogui Pill combined with western medicine in treatment of gestational diabetes mellitus (GDM) with qi and yin deficiency syndrome.
Methods A total of 92 GDM patients with qi and yin deficiency syndrome from the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine between January 2022 and October 2023 were enrolled and randomly divided into study group and control group, with 46 patients in each group. The control group received western medicine treatment, while the study group received Zuogui Pill combined with western medicine treatment. Both groups were treated for 4 weeks. The treatment effects, as well as the levels of glycolipid indicatorstotal cholesterol (TC), triglyceride (TG), fasting plasma glucose (FPG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and glycated hemoglobin (HbA1c), insulin resistance indicators fasting insulin (FINS), homeostasis model assessment of β-cell function (HOMA-β), and homeostasis model assessment of insulin resistance (HOMA-IR), inflammatory and stress factorsserum amyloid A (SAA), interleukin-6 (IL-6), malondialdehyde (MDA), and reactive oxygen species (ROS), serum microRNA (miR)-21 and miR-149 levels, and occurrence of adverse pregnancy outcomes were compared between the two groups before and after treatment.
Results After 4 weeks of treatment, the total effective rate was higher in the study group than that in the control group (P < 0.05). After treatment, the levels of FPG, HbA1c, TC, LDL-C, and TG were lower, and the levels of HDL-C were higher in both groups than before treatment, and the levels of FPG, HbA1c, TC, LDL-C in the study group were lower than those in the control group, and the level of HDL-C was higher in the study group than that in the control group(P < 0.05). After treatment, the levels of FINS and HOMA-IR were lower in both groups than before treatment, and their levels in the study group were lower than those in the control group; the levels of HOMA-β were higher in both groups than before treatment, and its level in the study group was higher than that in the control group (P < 0.05). After treatment, the levels of SAA, IL-6, MDA, and ROS were lower in both groups than before treatment, and their levels in the study group were lower than those in the control group (P < 0.05). Before treatment, there were no statistically significant differences in the levels of serum miR-21 and miR-149 between the two groups (P>0.05); after treatment, the levels of serum miR-21 and miR-149 were lower in both groups than before treatment, and their levels in the study group were lower than those in the control group (P < 0.05). Before treatment, the traditional Chinese medicine syndrome score was (8.12±1.31) in the study group and (7.86±1.28) in the control group, with no statistically significant difference between the two groups (P>0.05); after treatment, the traditional Chinese medicine syndrome score was (3.31±0.46) in the study group, which was lower than (4.57±0.59) in the control group (t=11.423, P < 0.05). Compared with the control group, the incidence of adverse pregnancy outcomes was lower in the study group(P < 0.05).
Conclusions Zuogui Pill combined with western medicine can effectively improve glycolipid metabolism and insulin resistance in GDM patients and reduce the incidence of adverse pregnancy outcomes.
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