目的 探討黃芪注射液聯(lián)合鹽酸拉貝洛爾和硫酸鎂治療妊娠高血壓綜合征的臨床療效。方法 選取2013年9月-2015年9月在寶雞市中心醫(yī)院婦產(chǎn)科進(jìn)行治療的妊娠高血壓綜合征患者98例,按治療方案不同分為對(duì)照組和治療組,每組各49例。對(duì)照組靜脈滴注鹽酸拉貝洛爾注射液100 mg,加入5%葡萄糖溶液250 mL,1次/d;同時(shí)靜脈滴注硫酸鎂注射液,30 mL加入5%葡萄糖溶液500 mL,1次/d,根據(jù)血壓的變化情況調(diào)節(jié)滴速。治療組在對(duì)照組治療基礎(chǔ)上靜脈滴注黃芪注射液,30 mL加入5%葡萄糖溶液150 mL,1次/d。兩組均連續(xù)治療10 d。觀察兩組的臨床療效,同時(shí)比較治療前后兩組全血黏度、血漿黏度、紅細(xì)胞比容(HCT)、一氧化氮(NO)、丙二醛(MDA)、血漿內(nèi)皮素-1(ET-1)、超氧化物歧化酶(SOD)的變化。比較兩組平均動(dòng)脈壓(MAP)和24 h尿蛋白(Upro)的下降幅度,同時(shí)比較兩組的母嬰結(jié)局。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為83.67%、95.92%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者全血黏度、血漿黏度、HCT、ET-1、MDA均較同組治療前顯著降低,NO、SOD均較同組治療前顯著升高,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些指標(biāo)的改善程度優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療組患者Upro、MAP的下降幅度均顯著優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療組胎心異常、新生兒窒息和剖宮產(chǎn)發(fā)生率明顯低于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 黃芪注射液聯(lián)合鹽酸拉貝洛爾和硫酸鎂治療妊娠高血壓綜合征具有較好的臨床療效,能夠改善患者血管內(nèi)皮功能,降低氧自由基,進(jìn)而起到降壓和減輕尿蛋白的作用,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Huangqi Injection combined with labetalol hydrochloride and magnesium sulfate in treatment of pregnancy induced hypertension syndrome. Methods Patients (98 cases) with pregnancy induced hypertension syndrome in the Department of Obstetrics and Gynecology of Baoji Central Hospital from September 2013 to September 2015 were enrolled in this study. According to the different treatment plans, patients were divided into treatment group (49 cases) and control group (49 cases). The patients in the control group were iv administered with Labetalol Hydrochloride Injection, 100 mg Labetalol Hydrochloride Injection added into 5% glucose solution 250 mL, once daily. And they were iv administered with Magnesium Sulfate Injection, 30 mL Magnesium Sulfate Injection added into 5% glucose solution 500 mL, once daily, and drop speed was adjusted according to the change of blood pressure. The patients in the treatment group were iv administered with Huangqi Injection on the basis of control group, 30 mL Huangqi Injection added into 5% glucose solution 150 mL, once daily. The patients in two groups were treated for 10 d. After treatment, the clinical efficacies were evaluated, and whole blood viscosity, plasma viscosity, the changes of HCT, NO, MDA, ET-1, and SOD in two groups before and after treatment were compared. The descending degrees of MAP and Upro in two groups were compared, and outcomes of maternal and neonatal in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 83.67% and 95.92%, respectively, and there were differences between two groups (P < 0.05). After treatment, whole blood viscosity, plasma viscosity, HCT, ET-1, and MDA in two groups were significantly decreased, NO and SOD were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). The descending degrees of MAP and Upro in treatment groups were significantly better than those in the control group, with significant difference between two groups (P < 0.05). The incidences of cardiac abnormalities, neonatal asphyxia and cesarean section in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Huangqi Injection combined with labetalol hydrochloride and magnesium sulfate has clinical curative effect in treatment of pregnancy induced hypertension syndrome, and can improve vascular endothelial function, also can reduce the oxygen free radicals, in turn has the effect of decompression and reduce the urine protein, which has a certain clinical application value.