目的 探讨黄芪注射液联合盐酸拉贝洛尔和硫酸镁治疗妊娠高血压综合征的临床疗效。方法 选取2013年9月-2015年9月在宝鸡市中心医院妇产科进行治疗的妊娠高血压综合征患者98例,按治疗方案不同分为对照组和治疗组,每组各49例。对照组静脉滴注盐酸拉贝洛尔注射液100 mg,加入5%葡萄糖溶液250 mL,1次/d;同时静脉滴注硫酸镁注射液,30 mL加入5%葡萄糖溶液500 mL,1次/d,根据血压的变化情况调节滴速。治疗组在对照组治疗基础上静脉滴注黄芪注射液,30 mL加入5%葡萄糖溶液150 mL,1次/d。两组均连续治疗10 d。观察两组的临床疗效,同时比较治疗前后两组全血黏度、血浆黏度、红细胞比容(HCT)、一氧化氮(NO)、丙二醛(MDA)、血浆内皮素-1(ET-1)、超氧化物歧化酶(SOD)的变化。比较两组平均动脉压(MAP)和24 h尿蛋白(Upro)的下降幅度,同时比较两组的母婴结局。结果 治疗后,对照组和治疗组的总有效率分别为83.67%、95.92%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者全血黏度、血浆黏度、HCT、ET-1、MDA均较同组治疗前显著降低,NO、SOD均较同组治疗前显著升高,同组治疗前后差异具有统计学意义(P<0.05);且治疗组这些指标的改善程度优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗组患者Upro、MAP的下降幅度均显著优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗组胎心异常、新生儿窒息和剖宫产发生率明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论 黄芪注射液联合盐酸拉贝洛尔和硫酸镁治疗妊娠高血压综合征具有较好的临床疗效,能够改善患者血管内皮功能,降低氧自由基,进而起到降压和减轻尿蛋白的作用,具有一定的临床推广应用价值。

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.