妊娠高血压综合征的PWV早期诊断及中西医结合综合防治研究

Early diagnosis of PWV in hypertension syndrome of pregnancy and integrated control of combination of TCM with Western medicine

目的探讨中西医结合综合疗法防治通过测量脉搏波传导速度（PWV）早期诊断妊娠高血压综合征（以下简称妊高征）的临床疗效和意义。方法将226例妊娠8～12周，通过测量PWV早期诊断为妊高征的早孕患者分为2组，对照组109例予孕早期常规饮食及保健，治疗组117例同时予饮食管理及睡眠体位指导，并予杞菊地黄丸6g，每日1次口服，阿司匹林肠溶片25mg，每日1次口服，多酶片2片，每日3次口服。分别于妊娠20周、妊娠28周观察2组血压、尿蛋白、体质量、胎儿发育情况，以及分娩情况。结果妊高征发生率治疗组15．38％，对照组89．91％，对照组明显高于治疗组（P〈0．05）；与本组妊娠8—12周及治疗组同期比较．对照组妊娠20周、妊娠28周血压升高，24h尿蛋白定量增加（P〈0．05）；与妊娠8～12周比较，2组妊娠20周、妊娠28周体质量均增加（P〈0．05），但对照组增加明显且超出正常指标，说明有水肿发生；2组妊娠20周、妊娠28周胎儿双顶径、股骨长径均符合妊娠发展，但治疗组妊娠28周双顶径、股骨长径与对照组比较差异均有统计学意义（P〈0．05），治疗组优于对照组，说明对照组胎儿发育受到妊高征影响。结论通过测量PWV可早期诊断妊娠高血压综合征，方法简便，而且采取中西医结合综合防治疗效确切，值得推广。

Objective To explore effect and significance of combination of TCM with Western medicine on early diagnosis of PWV in hypertension syndrome of pregnancy. Methods 226 patients with 8 - 12 weeks of pregnancy were hypertension syndrome of pregnancy by early diagnosis of PWV, randomly divided into two groups. Cases in control group （ n = 109） were treated by early pregnancy normal diet and health. Cases in treatment group （ n = 117） were treated by combination of routine therapy and Lycii and Chrysanthemi and Rehmanniae Bolus, 6g, once a day, polyzyme tablets, 2 pills, thrice a day, and Aspirin Enteric - coated Tablets, 25 mg, once a day. At 20th, 28th weeks of pregnancy, blood pressure, urine protein, weight, foetus status and accouchement status were observed. Results Incidence rate in treatment group （ 15.38% ） was lower than that in control group （89.91%, P 〈 0.05 ）. Blood pressure increased and urine protein were increased in control group at 20th, 28th weeks of pregnancy in comparison with treatment group and control group at 8 - 12 weeks of pregnancy （ P 〈 0.05 ）. Weight was increased in two groups at 20th, 28th weeks of pregnancy, and that in control group was obvious. Development of BPD and FL in treatment group were superior to those in control group at 20th, 28th weeks of pregnancy （ P 〈 0.05）. Conclusion Hypertension syndrome of pregnancy can be early diagnosed by PWV. And combination of TCM with Western medicine has definite effect on hypertension syndrome of pregnancy.