中药内服治疗妊娠期糖尿病的现代文献研究

闫文双 杜雅斌 赵翠萍 崔轶凡

【摘 要】 目的：探討中药内服治疗妊娠期糖尿病的辨证分型与用药规律。方法：检索近二十年发表的中药内服治疗妊娠期糖尿病的文献，提取有关证型、方剂、中药等内容，在数据管理的基础上进行统计分析。结果：检索获取符合标准的文献107篇，总结得出妊娠期糖尿病常见证型有：气阴两虚证、肝肾阴虚证、脾肾两虚证、脾气虚证;常用方剂：黄芪四君子汤、六味地黄丸、四君子汤、七味白术散、泰山磐石散、玉液汤;妊娠期糖尿病前4位证型常用中药：气阴两虚证（黄芪、地黄、白术、茯苓）、肝肾阴虚证（地黄、山药、丹皮、山茱萸）、脾肾两虚证（黄芪、党参、山药、当归）、脾气虚证（茯苓、甘草、山药、白术）。结论：妊娠期糖尿病的发生与阴虚、肝脾肾功能失调关系密切，以气阴两虚为主，治疗上依据方证关系，多采用辨证选方的方法，依据药证关系，归纳总结出前4位证型常用中药，以辨临床参考。

【关键词】 妊娠期糖尿病;中药内服;用药规律;文献研究

【中图分类号】R714.25   【文献标志码】 A    【文章编号】1007-8517（2021）10-0069-04

Modern Iiterature Research on the Treatment of Gestational Diabetes Mellitus with Traditional Chinese Medicine

YAN Wenshuang1 DU Yabin1 ZHAO Cuiping2 Cui Yifan1*

1.Shanxi University of Chinese Medicine，Jinzhong 030600，China;

2.Department of Obstetrics and Gynecology， Affiliated Hospital of Shanxi University of Traditional Chinese

Medicine，Taiyuan 030000，China

Abstract：Objective To explore the differentiation of symptoms and signs of gestational diabetes mellitus  treated by traditional Chinese medicine. Methods Retrieval of the published literature on the treatment of gestational diabetes mellitus with traditional Chinese medicine in the past 20 years， extraction of related syndromes， prescriptions， traditional Chinese medicine and other contents， statistical analysis on the basis of data management. Results After retrieving 107 literatures that meet the standard， it is concluded that gestational diabetes mellitus is usually characterized by deficiency of qi and Yin， deficiency of liver and kidney， deficiency of spleen and kidney， and deficiency of spleen and kidney. Common prescriptions： Huangqi Sijunzi Soup， Liuwei Dihuang pills， Sijunzi soup， Seven taste Atractylodes powder， Taishan Rock powder， Yuye soup; Common traditional Chinese medicines used in the first 4 syndromes of gestation diabetes are qi and Yin deficiency syndrome （astragalus membranaceus， rehmannia glutinosa， Atractylodes rhizome， atractylodes rhizome）， liver and kidney Yin deficiency syndrome （rehmannia glutinosa， Radix codonopsis， Chinese yam and Angelica angelica）， spleen and kidney deficiency syndrome （astragalus membranaceus， Radix codonopsis， Chinese yam and Angelica angelica）， spleen and kidney deficiency syndrome （poria， licorice， Chinese yam and atractylodes rhizome）.Conclusion The occurrence of gestational diabetes mellitus is closely related to Yin deficiency， liver， spleen and kidney dysfunction. The deficiency of qi and Yin is the main one. The treatment is based on the formula syndrome relationship.

Keywords：Gestational Diabetes Mellitus;Oral Administration of Chinese Medicine;Medication Rule;Literature Research

妊娠前糖代谢正常，妊娠期才出现的糖尿病，称为妊娠期糖尿病（Gestational diabetes mellitus，GDM），糖尿病孕妇中90%以上是GDM，我国GDM的发生率约1%～5%[1]，近些年有明显增高的趋势。患者临床可出现多饮、多食、多尿的三多症状，也出现反复发作的外阴阴道假丝酵母菌感染。通过长期的医疗实践发现GDM对孕妇、胎儿及新生儿会产生很多不良影响，如：孕期感染、流产和早产、羊水过多、巨大胎儿、胎儿生长受限（FGR）、胎儿畸形、新生儿低血糖等，病情严重时，孕妇会发生酮症酸中毒，进而危及孕妇和胎儿的生命。……