平肝熄风汤合硫酸镁对肝肾阴虚型妊娠期高血压患者血液动力学、糖脂代谢及妊娠结局的影响

Effect of Pingganxifeng Decoction Combined with Magnesium Sulfate on Hemodynamics,Glucose and Lipid Metabolism and Pregnancy Outcome in Patients with Gestational Hypertension with Deficiency of Liver and Kidney Yin

目的:探讨平肝熄风汤联合硫酸镁对肝肾阴虚型妊娠期高血压(GH)患者血液动力学、糖脂代谢及妊娠结局的影响。方法:选取2018年3月~2019年10月期间兰州市第二人民医院收治的GH患者119例随机分为对照组(n=59)和研究组(n=60),对照组给予硫酸镁治疗,研究组在对照组的基础上联合平肝熄风汤治疗,比较两组患者疗效、血液动力学、糖脂代谢、血压、心率、中医证候积分及妊娠结局。结果:研究组治疗7 d后的临床总有效率为91.67%(55/60),明显高于对照组的77.97%(46/59)(P<0.05)。两组治疗7 d后收缩压、舒张压、平均动脉压、心率均下降,且研究组低于对照组(P<0.05)。两组治疗7 d后心输出量(CO)、心脏指数(CI)均下降,且研究组低于对照组(P<0.05)。两组治疗7 d后甘油三酯(TG)、低密度脂蛋白(LDL-C)、空腹血糖、总胆固醇(TC)水平降低,高密度脂蛋白(HDL-C)水平升高(P<0.05),且研究组变化程度大于对照组(P<0.05)。两组治疗7 d后视物模糊、手足心热、脉弦细数、口干便结、舌红苔少等症状评分均下降,且研究组低于对照组(P<0.05)。研究组不良妊娠结局发生率低于对照组(P<0.05)。结论:平肝熄风汤联合硫酸镁治疗肝肾阴虚型GH,疗效显著,可有效改善患者临床症状、血液动力学、糖脂代谢,同时还可减少不良妊娠结局发生率,临床应用价值较高。

Objective:To investigate the effect of pingganxifeng decoction combined with magnesium sulfate on hemodynamics,glucose and lipid metabolism and pregnancy outcome in patients with pregnancy induced hypertension(GH) with deficiency of liver and kidney yin.Methods:119 patients with GH who were admitted to Lanzhou Second People’s Hospital from March 2018 to October 2019were selected,and they were randomly divided into control group(n=59) and study group(n=60).The control group was treated with magnesium sulfate.The study group was treated with pingganxifeng decoction on the basis of the control group.The efficacy,hemodynamics,glycolipid metabolism,blood pressure,heart rate and TCM Syndromes scores and pregnancy outcome of the two groups were compared.Results:The total clinical effective rate of the study group was 91.67%(55/60),which was significantly higher than that of the control group 77.97%(46/59)(P<0.05).The systolic pressure,diastolic pressure,mean arterial pressure and heart rate of the two groups decreased at 7 days after treatment,and those in the study group were lower than those in the control group(P<0.05).7 days after treatment,the cardiac output(CO) and cardiac index(CI) of the two groups decreased,and those of the study group were lower than those of the control group(P<0.05).Triglyceride(TG),low-density lipoprotein(LDL-C),fasting glucose,total cholesterol(TC) decreased and high-density lipoprotein(HDL-C) increased in the two groups at 7 days after treatment(P<0.05),and the change degree of the above indexes in the study group was greater than that in the control group(P<0.05).7 days after treatment,the symptom scores of blurred vision,hot hands and feet,fine pulse,dry mouth and constipation,and little red tongue and moss of the two groups decreased,and those in the study group were lower than those in the control group(P<0.05).The incidence of adverse pregnancy outcome in the study group was lower than that in the control group(P<0.05).Conclusion:Pingganxifeng decoction combined with magnesium sulfate is effective in the treatment of GH with deficiency of liver and kidney yin.It can effectively improve the clinical symptoms,hemodynamics,glucose and lipid metabolism of the patients,and reduce the incidence of adverse pregnancy outcomes,the clinical application value is higher.