摘要
目的 探讨镇肝熄风汤对子痫前期(Pre-eclampsia, PE)患者钙镁离子水平、细胞毒性因子-血管内皮功能的影响。方法 采用前瞻性研究,选取2019年1月—2021年1月期间河南省许昌中医院收治的PE患者120例,按随机数字表法分为对照组和观察组,每组各60例。对照组采用常规治疗,观察组在对照组基础上采用镇肝熄风汤治疗,两组患者治疗时间均至分娩或终止妊娠。观察比较两组患者治疗前后舒张压(Diastolic pressure, DBP)、收缩压(Systolic pressure, SBP)水平、中医证候积分、钙镁离子水平、细胞毒性因子-血管内皮功能相关指标[肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)、血清内皮素-1(ET-1)、血清胱抑素C(Cystatin C,Cys C)、同型半胱氨酸(Cystatin C,Cys C)、神经肽Y(Neuropeptide Y,NPY)、血管性血友病因子(von Willebrand factor, vWF)、一氧化氮(Nitric oxide, NO)]的变化,比较两组临床疗效及妊娠结局。结果 治疗后两组患者DBP、SBP水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组DBP、SBP水平低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者眩晕、头痛、腹部疼痛积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组眩晕、头痛、腹部疼痛积分低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者钙镁离子水平均较治疗前升高,差异有统计学意义(P<0.05);且观察组钙离子及镁离子水平高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者TNF-α、IL-6、CysC、NPY、ET-1、Hcy及vWF水平均较治疗前降低,NO水平较治疗前升高,差异有统计学意义(P<0.05);且观察组TNF-α、IL-6、CysC、NPY、ET-1、Hcy及vWF水平低于对照组,NO水平高于对照组,差异有统计学意义(P<0.05)。治疗后观察组临床总有效率96.67%(58/60)高于对照组83.33%(50/60),差异有统计学意义(P<0.05)。治疗后观察组计划外终止妊娠率20.00%(12/60)低于对照组38.33%(23/60),计划内终止妊娠率80.00%(48/60)高于对照组61.67%(37/60);观察组终止妊娠前平均延长孕周时间高于对照组,差异有统计学意义(P<0.05)。结论 镇肝熄风汤能进一步控制PE孕妇血压,改善临床症状,减少不良妊娠结局,提高治疗效果,可能与血清钙镁离子水平升高,细胞毒性因子损伤减轻,血管内皮功能改善有关。
Objective To observe the effects of Zhengan Xifeng Decoction on calcium and magnesium levels and cytotoxic factor-vascular endothelial function in pre-eclampsia(PE)patients.Methods A prospective study was con-ducted with 120 PE patients admitted to Xuchang Hospital of Traditional Chinese Medicine from January 2019 to January 2021.The random number table method was employed for grouping of the patients.The control group(n=60)received rou-tine treatment,and the observation group(n=60)additionally received Zhengan Xifeng Decoction.The treatment in both groups lasted till delivery or termination of pregnancy.The diastolic blood pressure(DBP),systolic blood pressure(SBP),TCM symptom scores,and the levels of calcium and magnesium ions and cytotoxic factor-vascular endothelial function in-dicators[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),endothelin-1(ET-1),cystatin C(CysC),homo-cysteine(Hcy),neuropeptide Y(NPY),von Willebrand factor(vWF),and nitric oxide(NO)]were compared between be-fore and after treatment as well as between the two groups.The clinical efficacy and pregnancy outcomes were compared be-tween the two groups.Results DBP and SBP in both groups after treatment declined compared with those before treatment(P<0.05),and the observation group showed lower DBP and SBP than the control group(P<0.05).The scores of dizzi-ness,headache,and abdominal pain in both groups after treatment declined compared with those before treatment(P<0.05)and the observation group showed more significant declines than the control group(P<0.05).The levels of calcium and magnesium ions in both groups after treatment elevated compared with those before treatment(P<0.05),and the lev-els in the observation group were higher than those in the control group(P<0.05).The treatment in both groups lowered the TNF-α,IL-6,CysC,NPY,ET-1,Hcy,and vWF levels and elevated the NO level(P<0.05),and the changes were more significant in the observation group(P<0.05).The total effective rate of the observation group was 96.67%(58/60),which was higher than that(83.33%,50/60)of the control group(P<0.05).The observation group had lower rate of unplanned termination of pregnancy[20.00%(12/60)vs.38.33%(23/60)],higher rate of planned termination of preg-nancy[80.00%(48/60)vs.61.67%(37/60)],and longer extension of gestational weeks before termination of pregnancy(P<0.05)than the control group.Conclusion Zhengan Xifeng Decoction can further control blood pressure,alleviate clinical symptoms,reduce adverse pregnancy outcomes,and improve the therapeutic effect on PE by elevating the serum levels of calcium and magnesium ions,reducing cytotoxic factors,and improving vascular endothelial function.
作者
李姝
仝玉珠
李平平
LI Shu;TONG Yu-zhu;LI Ping-ping(Department of Obstetrics and Gynecology,Xuchang Hospital of Traditional Chinese Medicine,Xuchang Henan 461000)
出处
《世界中西医结合杂志》
2023年第4期728-732,736,共6页
World Journal of Integrated Traditional and Western Medicine
基金
2018年度河南省医学科技攻关计划项目(2018020219)。
关键词
镇肝熄风汤
子痫前期
钙镁离子
细胞毒性因子
血管内皮功能
Zhengan Xifeng Decoction
Pre-eclampsia
Calcium and Magnesium Ions
Cytotoxic Factor
Vascular Endothelial Function
作者简介
通信作者:仝玉珠,Email:adrgees@163.com。
