Clinical Observation On Postpartum Intervention Of Jianpi Huatan Method In Pregnancy Diabetes Mellitus

Objective:To explore the clinical effect of Jianpi Huatan Granule on postpartum glucose metabolism in gestational diabetes mellitus(GDM),and to provide TCM treatment for preventing and postponing type 2 diabetes mellitus(T2DM)in GDM patients.Methods: A total of 72 patients with GDM who delivered in Henan Hospital of Traditional Chinese Medicine from April to August 2018 were included in the clinical observation.They were reexamined six weeks after delivery.For example,BMI met the overweight criteria(BMI > 24kg/m2)and were not diagnosed as diabetes mellitus(DM)and met the criteria of syndrome differentiation of traditional Chinese medicine.Seventy-two postpartum patients with GDM were randomly divided into two groups:behavior intervention group(control group)36 cases and behavior intervention + oral Chinese medicine group(observation group)36 cases.Behavior intervention group(control group): simple behavior intervention;behavior intervention + oral Chinese medicine group(observation group): on the basis of behavior intervention,oral Jianpi Huatan Granule for three courses of treatment.BMI,FPG,OGTT2 h PG,Hb Alc and FINS were recorded before and after the intervention,and HOMA-IR(HOMA-IR=FPG*FINS/22.5)was calculated.The differences of each index between the two groups before and after the intervention and after the treatment were analyzed.Results:1.A total of 72 cases of postpartum GDM patients were collected in this study,including 6 cases of shedding in the study process,33 cases remaining in the observation group and 33 cases remaining in the control group.A total of 66 cases could be statistically analyzed.The results of OGTT examination in 66 patients with GDM at 42 days postpartum were as follows: 26 patients with normal glucose tolerance(NGT),accounting for 39.4%.There were 24 patients with impaired fasting glucose(IFG)or impaired glucose tolerance(IGT),accounting for 36.4%.There were16 patients with both IFG and IGT,accounting for 24.2%.2.Comparison between the behavioral intervention group(control group)before and after intervention: BMI,FPG,OGTT2 h PG,Hb Alc and homa-ir were all decreased compared with those before treatment,but there were no statistically significant differences in BMI,FPG,Hb Alc and homa-ir(P>0.05),while there were statistically significant differences in OGTT2 h PG(P<0.05).3.Comparison of behavioral intervention + oral Chinese medicine group(observation group)before and after intervention: BMI,FPG,OGTT2 h PG,Hb Alc and homa-ir were significantly reduced compared with those before intervention.BMI,FPG,Hb Alc and homa-ir showed significant differences(P<0.01),while OGTT2 h PG showed significant differences(P<0.05).4.Comparison between the two groups after intervention: compared with the control group,BMI,FPG,OGTT2 h PG,Hb Alc and homa-ir of the observation group were significantly decreased after intervention,with statistically significant differences(P<0.05).Among them,BMI,FPG,Hb Alc and homa-ir in the observation group were significantly lower than those in the control group after intervention,with significant differences(P<0.01).Observation group after intervention OGTT2 h PG and control group after intervention,the difference was statistically significant(P<0.05)5.Normal and abnormal occurrence of glucose metabolism before and after intervention in observation group and control group:Control group: 36 included cases,3 exfoliated cases and the remaining 33 cases.Before intervention: 11 cases of NGT patients,Accounted for 33.3%;There were 16 patients with IFG or IGT,accounting for 48.5%.There were 6 patients with IFG+ IGT,accounting for 18.2%.After intervention: 16 cases of NGT patients,accounting for48.5%;There were 17 patients with IFG or IGT,accounting for 51.5%.There were 0patients with IFG+ IGT,accounting for 0.0%.Observation group: 36 included cases,3 exfoliated cases,and the remaining 33 cases.Before intervention: 15 patients with NGT,accounting for 45.5%;There were 8patients with IFG or IGT,accounting for 24.2%.There were 10 patients with IFG+IGT,accounting for 30.3%.After intervention,24 cases(72.7%)were treated with NGT.There were 9 patients with IFG or IGT,accounting for 27.3%.There were 0patients with IFG+ IGT,accounting for 0.0%.6.During the treatment period,the patient’s vital signs,routine hematuria and liver and kidney functions were all within the normal range.No allergic reactions.Conclusion:1.Some patients with gestational diabetes have abnormal glucose metabolism after delivery.2.Jianpihuatan granule combined with behavioral intervention can effectively improve the abnormal glucose metabolism of postpartum patients with gestational diabetes and reduce the level of glycosylated hemoglobin.3.The combined behavioral intervention of jianpi huatan granule can effectively reduce the prevalence of impaired fasting glucose and impaired glucose tolerance after GDM.4.Combined behavioral intervention of jianpi huatan granules can reduce BMI and insulin resistance of patients.5.Attention should be paid to postpartum follow-up of patients with gestational diabetes.