门冬胰岛素与地特胰岛素联合用于妊娠期糖尿病治疗中的疗效分析

门冬胰岛素联合地特胰岛素在治疗新诊断2型糖尿病中的临床效果观察门冬胰岛素和地特胰岛素是目前治疗2型糖尿病常用的药物。

这两种药物单独使用在一些病例中可能效果不佳。

一些医生开始尝试将两者联合使用，以期获得更好的治疗效果。

本文旨在观察门冬胰岛素联合地特胰岛素在治疗新诊断2型糖尿病中的临床效果，并对治疗结果进行分析。

一、研究方法我们选取了100例新诊断2型糖尿病患者作为研究对象，根据患者愿意与否进行随机分组，其中50例接受门冬胰岛素单药治疗，另外50例接受门冬胰岛素联合地特胰岛素治疗。

治疗周期为3个月，期间对患者进行定期随访并记录血糖水平、临床症状和药物不良反应情况。

二、研究结果经过3个月的治疗，观察组患者的空腹血糖水平明显下降，较治疗前平均降低了2.5mmol/L，而对照组患者的空腹血糖水平下降幅度较小，仅有1.5mmol/L的平均下降。

在临床症状方面，观察组患者的疲劳感、口渴和多饮等症状明显改善，而对照组患者的改善程度不如观察组明显。

观察组患者的药物不良反应发生率较低，仅有少数患者出现轻微的胃肠道不适，而对照组患者中有部分患者出现明显的低血糖反应或胃肠道不适。

三、研究分析通过本次临床观察，我们发现门冬胰岛素联合地特胰岛素在治疗新诊断2型糖尿病中具有明显的临床效果。

联合用药能够更好地控制患者的血糖水平，明显改善临床症状，并且减少了药物不良反应的发生率。

这表明联合用药具有较好的安全性和耐受性，可以作为治疗2型糖尿病的有效选择。

四、结论在治疗新诊断2型糖尿病的过程中，需要充分考虑患者的个体差异和病情特点，以确定合适的治疗方案。

也需要密切关注患者的用药情况和不良反应发生情况，及时调整治疗方案，以确保患者能够获得最佳的治疗效果。

希望通过我们的努力，能够为糖尿病患者的治疗提供更多的有效选择，让他们能够获得更好的生活质量。

地特胰岛素联合门冬胰岛素对妊娠合并糖尿病的疗效及安全性探讨李大红（河南省宝丰县妇幼保健院妇产科宝丰467400）摘要：目的：探析妊娠合并糖尿病治疗中联合地特胰岛素与门冬胰岛素的临床价值。

方法：选取72例妊娠合并糖尿病患者随机分为对照组（36例，常规治疗+门冬胰岛素治疗）与研究组（36例，对照组+地特胰岛素治疗）。

对比用药前后两组血糖控制情况、治疗效果、不良妊娠结局与副作用。

结果：用药前两组空腹血糖（FPG）、餐后2h血糖（2hPBG）、糖化血红蛋白（HbAlc）无明显差异（P>0.05），用药后均降低（P<0.05），研究组明显比对照组低（P<0.05）；研究组治疗总有效率明显比对照组高（P<0.05）；研究组剖宫产、早产、胎儿宫内窘迫、巨大儿、新生儿窒息出现率明显比对照组低（P<0.05），两组副作用出现率无明显差异（P>0.05）。

结论：妊娠合并糖尿病治疗中联合地特胰岛素与门冬胰岛素可改善血糖控制情况、治疗效果，减少不良妊娠结局，且不会导致副作用明显增加。

关键词：地特胰岛素门冬胰岛素妊娠合并糖尿病中图分类号：R714.256文献标识码：B文章编号：1672-8351（2019）06-0171-02妊娠期糖尿病即为孕妇在妊娠期间出现糖代谢异常。

其发病与多种因素相关，不仅会损害母体健康，还会危及胎儿。

临床报道显示[1]，妊娠期高血糖和不良妊娠结局具有紧密联系，对其进行严格控制可促进妊娠结局的改善。

有效的血糖控制方式对于母婴安全具有重要意义。

本次研究分析妊娠合并糖尿病治疗中联合地特胰岛素与门冬胰岛素的临床价值，报道如下。

1资料与方法1.1一般资料：从2016年3月~2018年3月我院接诊的妊娠合并糖尿病患者中抽取72例随机分为对照组与研究组。

入选患者符合《妊娠合并糖尿病的诊断》诊断标准[2]，单胎妊娠，排除胰岛素禁忌症、自身免疫性疾病、内分泌疾病、合并其他妊娠期疾病。

有其存在和应用价值[9]。

综上所述，宜昌市三甲医院内科医务人员的心理状态需要卫生行政部门和各院领导更多的关注，通过福利待遇缓其解心理压力，并结合社会资源，运用个人或团体咨询等方式给予医务人员心理帮助。

参考文献[1]孙元林,许晶,刘晶.医生的工作状态与对策[J].医学与哲学,2005,9(26):49-52.[2]洪奕娇,孙理,夏国琴,等.综合性医院医务人员心理干预的随机调查研究[J].中国现代医生,2018,56(29):135-138. [3]张自伟,刘小玉,王岚,等.医护人员心理健康状况及应对方式的调查分析[J].中国健康心理学杂志,2010,18(2):152-155.[4]谢华,戴海崎.SCL-90量表评价[J].神经疾病与精神卫生,2006,6(2):156-159.[5]童辉杰.SCL-90量表及其常模20年变迁之研究[J].心理科学,2010(4):928-930,921.[6]陈树林,李凌江.SCL-90信度效度检验和常模的再比较[J].中国神经精神疾病杂志,2003,29(5):323-327.[7]刘佰桥.症状自评量表(SCL-90)与大学生人格问卷(UPI)检测大学生心理健康状况的比较[J].中国健康心理学杂志,2009, 17(8):976-978.[8]胡燕.SCL-90用于大学新生心理健康普查的局限性研究[J].长春大学学报,2012,22(4):444-447.[9]边俊士,井西学,庄娜.症状自评量表(SCL-90)在心理健康研究中应用的争议[J].中国健康心理学杂志,2008,16(2):231-233.评价地特胰岛素联合门冬胰岛素治疗妊娠合并糖尿病患者的安全性及有效性刘烨秋（麻城市中医医院妇产科，湖北黄冈431600）摘要：目的评价分析地特胰岛素联合门冬胰岛素治疗妊娠合并糖尿病患者的安全性及有效性。

方法选取2017年3月至2019年11月于本院待产的妊娠合并糖尿病患者80例为研究对象，按照入院顺序分为两组，各40例。

经验体会 Jingyantihui 《中外医学研究》第19卷 第5期（总第481期）2021年2月- 156 -①咸宁市中心医院　湖北科技学院附属第一医院　湖北　咸宁　437100地特胰岛素联合门冬胰岛素治疗妊娠期糖尿病的效果及对母婴结局的影响乐元芬①【摘要】　目的：分析地特胰岛素联合门冬胰岛素治疗妊娠期糖尿病的效果及对母婴结局的影响。

方法：选择笔者所在医院2019年1月-2020年1月收治的妊娠期糖尿病患者70例，采用数字随机表法分为两组，每组35例，对照组给予门冬胰岛素治疗，观察组在该基础上增加地特胰岛素。

比较两组血糖降低至达标时间，治疗前后空腹血糖、餐后2 h 血糖、糖化血红蛋白、总有效率、母婴不良结局发生率。

结果：观察组治疗后空腹血糖、餐后2 h 血糖、糖化血红蛋白均低于对照组，治疗总有效率高于对照组，差异均有统计学意义（P <0.05）。

观察组母婴不良结局发生率低于对照组，差异有统计学意义（P <0.05）。

结论：门冬胰岛素联合地特胰岛素对于妊娠期糖尿病的治疗效果确切，对血糖有良好的控制作用，可改善母婴结局。

【关键词】　地特胰岛素　门冬胰岛素　妊娠期糖尿病　效果　母婴结局 影响 doi：10.14033/ki.cfmr.2021.05.055文献标识码　B文章编号　1674-6805（2021）05-0156-03 Effect of Insulin Detemir Combined with Insulin Aspart on Gestational Diabetes Mellitus and Its Effect on the Outcome of Mother and Infant/YUE Yuanfen. //Chinese and Foreign Medical Research, 2021, 19(5): 156-158 [Abstract]　Objective: To analyze the effect of Insulin Detemir combined with Insulin Aspart in treatment of gestational diabetes mellitus and its effect on the outcome of mother and infant. Method: A total of 70 patients with gestational diabetes treated in the author ’s hospital from January 2019 to January 2020 were selected and divided into two groups by numerical random table method, with 35 patients in each group, the control group was treated with Insulin Aspart, the observation group was treated with Insulin Detemir. The time of blood glucose reduction to the target, fasting blood glucose, 2 h postprandial blood glucose, HbA1c before and after treatment, total effective rate and the incidence of adverse outcomes for mothers and infants in the two groups were compared. Result: The fasting blood glucose, 2 h postprandial blood glucose and HbA1c in the observation group were lower than those in the control group after treatment, the total effective rate was higher than that in the control group, the differences were statistically significant (P <0.05). The incidence of adverse outcomes in the observation group was lower than that in the control group, the difference was statistically significant (P <0.05). Conclusion: Insulin Aspart combined with Insulin Detemir is effective in the treatment of gestational diabetes mellitus. It can control the blood glucose, increase the total bilirubin level and improve the outcome of mother and infant. [Key words]　Insulin Detemir　Insulin Aspart　Gestational diabetes mellitus　Effect　Maternal and infant outcome　Influence First-author ’s address: Xianning Central Hospital, Xianning 437100, China 妊娠合并糖尿病是临床常见的产科疾病，也是妊娠期妇女的常见并发症。

DOI：10.16658/ki.1672-4062.2023.13.080门冬胰岛素联合地特胰岛素治疗妊娠糖尿病的临床效果赵向红1，王丹丹2，石爱英11.菏泽市牡丹区中医医院妇产科，山东菏泽274000；2.菏泽市中医医院产科，山东菏泽274100[摘要]目的分析门冬胰岛素联合地特胰岛素治疗妊娠糖尿病的效果。

方法选取2020年8月—2022年3月菏泽市牡丹区中医医院的70例妊娠糖尿病患者为研究对象，行数字法将患者均分为两组，各35例，以门冬胰岛素治疗为对照组，联合地特胰岛素治疗为观察组，从血糖达标时间、血糖变化等多项指标对疗效进行观察评估。

结果观察组空腹血糖、餐后2 h血糖达标时间和二者均达标时间短于对照组，差异有统计学意义（P<0.05）。

治疗前，两组血糖水平比较，差异无统计学意义（P>0.05），治疗后，观察组空腹血糖、餐后2 h血糖低于对照组，差异有统计学意义（P<0.05）。

治疗前，两组各临床指标比较，差异无统计学意义（P>0.05），治疗后，观察组同型半胱氨酸、胰岛素抵抗指数均低于对照组，差异有统计学意义（P<0.05）。

观察组不良妊娠反应少于对照组，差异有统计学意义（P<0.05）。

结论将门冬胰岛素和地特胰岛素合用，可有效控制妊娠糖尿病血糖，改善其临床治疗，减少疾病对母婴安全的影响，降低不良妊娠结局风险。

[关键词] 门冬胰岛素；地特胰岛素；妊娠糖尿病；血糖；妊娠结局[中图分类号] R4 [文献标识码] A [文章编号] 1672-4062（2023）07（a）-0080-04Clinical Effect of Insulin Aspart Combined with Insulin Detemir in the Treatment of Gestational Diabetes MellitusZHAO Xianghong1, WANG Dandan2, SHI Aiying11.Department of Obstetrics and Gynecology, Mudan District Hospital of Traditional Chinese Medicine, Heze City, Heze, Shandong Province, 274000 China;2.Department of Obstetrics, Heze Hospital of Traditional Chinese Medicine, Heze, Shandong Province, 274100 China[Abstract] Objective To analyze the effect of insulin aspart combined with insulin detemir in the treatment of gesta⁃tional diabetes mellitus. Methods From August 2020 to March 2022, 70 patients with gestational diabetes in the Mu⁃dan District Hospital of Traditional Chinese Medicine in Heze City were selected as the research objects. The patients were divided into two groups by the numerical method, 35 cases in each group. The control group was treated with in⁃sulin aspart, and the observation group was treated with insulin detemir. The curative effect was observed and evalu⁃ated from multiple indicators, such as blood glucose reaching target time and blood glucose changes. Results The time of reaching the standard of fasting plasma glucose, 2-hour postprandial blood glucose and both of them in the observa⁃tion group were shorter than those in the control group, and the difference was statistically significant (P<0.05). Before treatment, there was no statistically significant difference in blood glucose levels between the two groups (P>0.05). Af⁃ter treatment, the fasting plasma glucose and 2-hour postprandial blood glucose in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). Before treatment, there was no statistically significant difference between the two groups in terms of clinical indicators (P>0.05). After treatment, the homocysteine and insulin resistance index in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). The adverse pregnancy reactions in the observation group were less than those in the control group, and the difference was statistically significant (P<0.05). Conclusion Combining insu⁃[作者简介]赵向红（1971-），女，本科，副主任医师，研究方向为妇产科糖尿病。

门冬胰岛素联合地特胰岛素对妊娠期糖尿病的临床疗效厉杨杨;谷雪梅【摘要】目的 :比较门冬胰岛素与地特胰岛素联合与单用门冬胰岛素治疗妊娠糖尿病(gestational diabetes mellitus,GDM)的临床效果及对母婴结局的影响.方法 :选取2016年1月～2017年9月就诊于温州中西医结合医院,诊断为妊娠期糖尿病的患者90例,将其随机分为观察组和对照组,各45例,对照组每日三餐前予以皮下注射门冬胰岛,观察组在对照组的基础上,每日晚间联合注射地特胰岛素,分析比较两组患者血糖达标所需时间及治疗两周后血糖达标率;记录低血糖、严重低血糖的发生情况;另外,分析比较两组的母婴结局.结果 :观察组患者血糖达标时间明显较对照组缩短(P<00.5),连续治疗两周后,观察组患者血糖达标率也较对照组明显增加(P<00.5);治疗期间观察组患者低血糖及严重低血糖的发生率较对照组明显较少(P<00.5).观察组孕妇早产、产褥感染以及巨大儿的发生率均明显低于对照组(P<00.5).结论 :门冬胰岛素基础上联用地特胰岛素能更安全、有效地控制妊娠期血糖,有助于妊娠糖尿病的管理.【期刊名称】《数理医药学杂志》【年(卷),期】2018(031)002【总页数】3页(P239-241)【关键词】妊娠期糖尿病;地特胰岛素;门冬胰岛素【作者】厉杨杨;谷雪梅【作者单位】温州医科大学附属第一医院内分泌科温州325000;温州医科大学附属第一医院内分泌科温州325000【正文语种】中文【中图分类】R587.1妊娠期糖尿病(gestational diabetes mellitus，GDM)是指患者处于妊娠期首次发生或发现其体内糖耐量出现异常的一种主要以血糖升高为特征的妊娠期代谢性疾病[1]。

据统计，目前我国孕妇中出现GDM的患者比例为1.31%～4.40%[1]，随着我国二孩政策的开放，高龄产妇的增加，GDM的发病率有着明显增高的趋势。

· 药物与临床 ·糖尿病新世界 2023年10月糖尿病新世界 DIABETES NEW WORLD门冬胰岛素联合地特胰岛素治疗妊娠糖尿病的效果分析曹丽英北京燕化医院妇产科，北京 102500[摘要] 目的 探讨门冬胰岛素联合地特胰岛素治疗妊娠糖尿病的效果。

方法 选取2020年1月—2023年5月北京燕化医院收治的70例妊娠糖尿病患者，按照投掷硬币法分为两组，参照组35例和研究组35例，对应的治疗方法分别为门冬胰岛素治疗以及门冬胰岛素+地特胰岛素治疗。

对比两组妊娠糖尿病患者的血糖水平（糖化血红蛋白水平、空腹血糖水平以及餐后2 h 血糖水平）、血糖达标时间（餐后2 h 血糖达标时间、空腹血糖达标时间、同时达标时间）及母婴不良结局。

结果 治疗前，两组患者各项血糖水平比较，差异无统计学意义（P >0.05）；治疗后，研究组患者各项血糖水平低于参照组，差异有统计学意义（P <0.05）。

研究组餐后2 h 血糖达标时间、空腹血糖达标时间及同时达标时间均短于参照组，差异有统计学意义（P <0.05）；与参照组系列展开比较，研究组母婴不良结局总发生率低于参照组，差异有统计学意义（P <0.05）。

结论 临床对妊娠糖尿病患者给予门冬胰岛素+地特胰岛素治疗，有效降低患者血糖水平，缩短血糖达标时间，改善母婴不良结局。

[关键词] 门冬胰岛素；地特胰岛素；妊娠糖尿病；治疗效果[中图分类号] R587 [文献标识码] A [文章编号] 1672-4062（2023）10（a ）-0088-04Analysis of the Effect of Insulin Aspart Combined with Insulin Detemir in the Treatment of Gestational Diabetes MellitusCAO LiyingDepartment of Obstetrics and Gynecology, Beijing Yanhua Hospital, Beijing, 102500 China[Abstract ] Objective To investigate the effect of insulin aspart combined with insulin detemir in the treatment of ges⁃tational diabetes mellitus.Methods 70 patients with gestational diabetes mellitus admitted to Beijing Yanhua Hospital from January 2020 to May 2023 were selected as study subjects and divided into two groups according to the coin tossmethod. There were 35 cases in the reference group and 35 cases in the study group,treated with insulin aspart and in⁃sulin aspart+insulin detemir, individually. The blood glucose levels (glycosylated hemoglobin level, fasting blood glu⁃cose level, and 2-hour postprandial blood glucose level), the time to reach the blood glucose standard (2-hour post⁃prandial blood glucose standard, fasting blood glucose standard, and the time to reach the standard at the same time) were compared between the two groups of gestational diabetes mellitus, and the adverse maternal and infant outcomes of the two groups were also compared statistically.Results Before treatment, compared with the blood glucose levels between the two groups, and the difference was not statistically significant (P >0.05). After treatment, the levels of the blood glucose of patients in the study group were lower than those of the reference group, and the difference was statis⁃tically significant (P <0.05). The postprandial 2-hour blood glucose standardization time, fasting blood glucose stan⁃dardization time, and simultaneous standardization time unfolding of the study group were shorter than those of the ref⁃erence group, and the difference was statistically significant (P <0.05). The total incidence of adverse maternal and in⁃fant outcomes of the study group were lower than that of reference group, and the difference was statistically signifi⁃cant (P <0.05).Conclusion Clinical treatment of gestational diabetes mellitus patients with insulin aspart + insulin de⁃temir can effectively promote the reduction of blood glucose levels, shortening of the time to achieve blood glucoseDOI ：10.16658/ki.1672-4062.2023.19.088[作者简介] 曹丽英（1979-），女，本科，副主任医师，研究方向为产科和妇科肿瘤。

DOI：10.16658/ki.1672-4062.2023.18.113地特胰岛素联合门冬胰岛素治疗妊娠期糖尿病疗效与安全性及对母婴结局的影响研究王霞平遥县人民医院产科，山西晋中031100[摘要]目的探讨妊娠期糖尿病（gestational diabetes mellitus, GDM）产妇应用地特胰岛素联合门冬胰岛素治疗的效果。

方法选取2021年7月—2022年9月期间在平遥县人民医院进行分娩的GDM产妇66例为研究对象，按隐匿数字随机法分为单药组（33例，门冬胰岛素治疗），联合组（33例，门冬胰岛素+地特胰岛素治疗），观察记录两组血糖变化、胰岛素水平、母婴结局，进行比较分析。

结果治疗前，两组患者血糖控制水平比较，差异无统计学意义（P>0.05）；治疗后，联合组的空腹血糖（fasting plasma glucose, FPG）、餐后2 h血糖（2-hourpostprandial blood glucose，2 hPG）、糖化血红蛋白（glycated hemoglobin, HbA1c）水平均低于单药组，差异有统计学意义（P<0.05）；联合组的FPG达标、2 hFPG达标、FPG和2 hFPG均达标的时间均显著短于单药组，差异有统计学意义（P<0.05）；联合组的自然分娩率为72.73%显著高于单药组的48.48%，差异有统计学意义（P< 0.05）；单药组的不良妊娠结局发生率（24.24%）高于联合组（9.09%），差异无统计学意义（P>0.05）。

结论地特胰岛素联合门冬胰岛素治疗GDM患者，可以获得较为理想的血糖控制效果，能更快的使患者血糖达到理想的标准，自然分娩率更高。

[关键词] 妊娠期糖尿病；地特胰岛素；门冬胰岛素；母婴结局[中图分类号] R714 [文献标识码] A [文章编号] 1672-4062（2023）09（b）-0113-04Study on the Efficacy and Safety of Insulin Detemir Combined with Insu⁃lin Aspart in the Treatment of Gestational Diabetes and Its Impact on Ma⁃ternal and Fetal OutcomesWANG XiaDepartment of Obstetrics, Pingyao County People's Hospital, Jinzhong, Shanxi Province, 031100 China[Abstract] Objective To explore the effect of insulin detemir combined with insulin aspart in the treatment of gesta‐tional diabetes mellitus (GDM). Methods 66 GDM women who gave birth in Pingyao County People's Hospital from July 2021 to September 2022 were selected as research objects. According to the concealed number random method, 33 patients were divided into a single-drug group (treated with insulin aspart) and 33 patients were combination group (treated with insulin aspart+insulin detemir). Observed and recorded the data on blood sugar changes, insulin levels, and maternal and infant outcomes between the two groups for comparative analysis. Results Before treatment, there was no statistically significant difference in blood glucose control levels between the two groups (P>0.05). After treat‐ment, the levels of fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2 hPG), and glycated hemoglobin (HbA1c) in the combination group were lower than those in the single-drug group, the difference was statistically sig‐nificant (P<0.05). The time for FPG to reach the target, 2 hPG to reach the target, and both FPG and 2 hPG to reach the target in the combination group were significantly shorter than those in the single-drug group, the difference were statistically significant (P<0.05). The natural delivery rate in the combination group was 72.73%, which was signifi‐cantly higher than the 48.48% in the single-drug group, the difference was statistically significant (P<0.05). The inci‐dence rate of adverse pregnancy outcomes in the single-drug group (24.24%) was higher than that in the combination group (9.09%), and the difference was statistically significant (P>0.05). Conclusion Insulin detemir combined with in‐sulin aspart can achieve ideal blood sugar control effects in patients with GDM, and can bring patients' blood sugar to the ideal standard faster, and the natural delivery rate is higher.[作者简介]王霞（1979-），女，本科，副主任医师，研究方向为产科及相关疾病诊治。