加味天麻钩藤饮联合小剂量阿司匹林对子痫前期高危人群患者临床疗效及母婴结局的影响  

The clinical effect and the impact on maternal and infant outcome of Tianma-Gouteng Decoction combined low-dose aspirin for the high-risk patients with pre-eclampsia

作　　者：鲁红梅 曹红云 刘晓会 韦达 信红丽 Lu Hongmei;Cao Hongyun;Liu Xiaohui;Wei Da;Xin Hongli(Department of Obstetrics and Gynecology,the People's Hospital of Zhengding County,Shijiazhuang 050800,China)

机构地区：[1]河北省正定县人民医院妇产科,石家庄050800

出　　处：《国际中医中药杂志》2020年第3期217-220,共4页International Journal of Traditional Chinese Medicine

基　　金：河北省医学研究重点课题计划项目(20181103)。

摘　　要：目的观察加味天麻钩藤饮联合小剂量阿司匹林对子痫前期(pre-eclampsia,PE)高危人群患者疗效及母婴结局的影响。方法将2017年1月-2019年1月本院94例符合PE诊断标准的高危人群患者采用随机数字表法分为2组,每组47例。对照组在对症治疗基础上每日口服75 mg阿司匹林肠溶片,观察组在对照组基础上联用加味天麻钩藤饮,2组均服药至孕28周时停止。采用免疫比浊法检测D-二聚体(D-dimer,D-D),采用Claus法检测纤维蛋白原(fibrinogen,Fib);以血压计测量收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP);观察并记录母婴不良结局。结果治疗后,观察组血浆D-D[(0.50±0.12)μg/L比(0.60±0.30)μg/L;t=2.122,P=0.037]、Fib[(2.37±0.22)g/L比(4.43±0.56)g/L;t=23.473,P<0.01]水平均低于对照组;SBP[(83.43±4.01)mmHg比(96.30±5.34)mmHg,t=13.212]、DBP[(113.77±3.90)mmHg比(126.52±4.43)mmHg,t=14.810]低于对照组(P<0.01)。观察组胎儿及新生儿不良结局发生率为10.6%(5/47)、对照组为25.5%(12/47),2组比较差异有统计学意义(χ^2=3.519,P<0.05);母亲不良结局发生率为31.9%(15/47)、对照组为55.3%(26/47),2组比较差异有统计学意义(χ^2=4.326,P<0.01)。结论加味天麻钩藤饮联合小剂量阿司匹林肠溶片可改善PE高危人群患者的凝血功能、有效调节血压,提高疗效,减少母婴不良结局的发生。Objective To investigate the effects and the impact on maternal and infant outcome of Tianma-Gouteng Decoction combined low-dose aspirin for high-risk patients with pre-eclampsia(PE).Methods A total of 94 high-risk patients who met the diagnose cretieria of PE from January 2017 to January 2019 in our hospital were divided into two groups by the random number table method,each group 47 cases.The control group based on symptomatic treatment,received daily 75 mg of aspirin enteric-coated metformin hydrochloride additionally;and the observation group took Tianma-Gouteng Decoction based on the control group.Both groups stopped taking medicine after 28th week of gestation.Immune turbidimetric method was used to detect D-dimer(D-D),the Claus method was used for detecting fibrinogen(Fib).The blood pressure meter was used to measure systolic blood pressure(SBP)and diastolic blood pressure(DBP).The poor maternal and infant outcomes were recorded.Results After the treatment,the plasma D-D(0.50±0.12mg/L vs.0.60±0.30mg/L;t=2.122,P=0.037),Fib(2.37±0.22 g/L vs.4.43±0.56 g/L;t=23.473,P<0.01)in the observation group were significantly lower than the control group.The SBP(83.43±4.01 mmHg vs.96.30±5.34 mmHg,t=13.212),DBP(113.77±3.90 mmHg vs.126.52±4.43 mmHg,t=14.810)in the observation group were significantly lower than the control group(P<0.01).The incidence of fetal and neonatal adverse outcomes in the observation group was 10.6%(5/47),the control group was 25.5%(12/47),and there was statistically significant between two groups(χ^2=3.519,P<0.05).The incidence of adverse outcome in the observation group was 31.9%(15/47),the control group was 55.3%(26/47),and there was statistically significant between two groups(χ^2=4.326,P<0.01).Conclusions Tianma-Gouteng Decoction combined low-dose aspirin enteric-coated metformin hydrochloride can improve coagulation function,lower blood pressure,improve clinical efficacy,reduce the occurrence of advers outcomes for high-risk patients with PE.

关 键 词：先兆子痫 妊娠 高危 高血压 妊娠 蛋白尿 天麻钩藤饮 阿司匹林 妊娠结局 

分 类 号：R714[医药卫生—妇产科学]