Article(id=1322923826039889992, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.06.010, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339218864, onlineDateStr=2026-10-30, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339218864, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339218864, creator=13701087609, updateTime=1793339218864, updator=13701087609, issue=Issue{id=1322923782029062261, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='6', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1749484800000', pubDateStr='2025-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339208371, creator='13701087609', updateTime=1793340556755, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929437859258468, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929437859258469, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=61, endPage=65, ext={EN=ArticleExt(id=1322923826266382409, articleId=1322923826039889992, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effect of Jiangzu Decoction(降阻汤)Combined with Antihypertensive Treatment on Plasma ADMA,sFlt-1/PIGF and Maternal and Infant Prognosis in Mild to Moderate Pregnancy Hypertension, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the effects of Jiangzi Decoction(降阻汤)combined with antihypertensive therapy on plasma asymmetric dimethylarginine in mild to moderate pregnancy hypertension(ADMA),soluble vascular endothelial growth factor receptor-1(sFlt-1)/placental growth factor(PIGF)and maternal and infant outcomes.

Methods

A total of 108 patients with mild to moderate gestational hypertension treated in the hospital from September 2020 to October 2023 were included as research objects.They were divided into two groups by random number table method.Fifty-four patients in the control group received routine antihypertensive treatment,and the other 54 patients in the observation group received Jiangzi Decoction combined with antihypertensive treatment.The efficacy,blood pressure,symptom scores,plasma levels of ADMA and sFlt/PIGF,ultrasound hemodynamic index of placenta and pregnancy outcome were compared between the two groups.

Results

The total effective rate of the observation group was 96.30%,much higher than that of the control group(79.63%)(P<0.05).After treatment,dizziness,waist and knee weakness,five upset and heat symptom scores and blood pressure levels in the observation group were lower than those in the control group(P<0.05).After treatment,the values of pulsatility index(PI),resistance index(RI)and S/D in the observation group were lower than those in the control group.The levels of ADMA,sFlt-1 and sFlt-1/PIGF in the observation group were lower than those in the control group,and PIGF levels were higher than those in the control group(P<0.05).The incidence of adverse pregnancy outcome was3.70% in the observation group,which was much lower than that(14.81%)in the con-trol group(P<0.05).

Conclusion

Jiangzu Decoction can nourish Yin and suppress Yang,invigorate Qi and tonify kidney,tranquilize the mind and stabilize the fetus.And when combined with antihypertensive therapy for mild to moderate pregnancy hypertension,it can effectively control blood pressure,alleviate symptoms,regulate microcirculation,improve placental hemodynamic indexes,and reduce the levels of ADMA and sFlt/PIGF,improve pregnancy outcomes and ensure the safety of mothers and infants.

, authors=Yun RONG1, Zhexia HU1, Xiao CHEN1, Jingwen JIANG1, Yuntao BU2, Xueling ZHANG1, authorsList=Yun RONG, Zhexia HU, Xiao CHEN, Jingwen JIANG, Yuntao BU, Xueling ZHANG, authorCompany=null, correspAuthors=Xueling ZHANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322923827654697044, articleId=1322923826039889992, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=降阻汤联合降压治疗对轻中度妊娠期高血压血浆ADMA、sFlt-1/PIGF及母婴预后的影响, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

分析降阻汤联合降压治疗对轻中度妊娠期高血压病血浆非对称性二甲基精氨酸(ADMA)、可溶性血管内皮生长因子受体1(sFlt-1)/胎盘生长因子(PIGF)及母婴预后的影响。

方法

纳入2020年9月—2023年10月石家庄市第四医院就诊的108例轻中度妊娠期高血压病患者为研究对象,随机数字表法将其分为两组,54例对照组采用常规降压治疗,54例观察组采用降阻汤联合降压治疗,对比两组疗效差异、血压水平、症状评分、血浆ADMA、sFlt/PIGF水平、胎盘超声血流动力学指标及妊娠结局。

结果

观察组治疗总有效率为96.30%,远高于对照组的79.63%(P<0.05);治疗后观察组头晕目眩、腰膝酸软、五心烦热症状评分及血压水平均低于对照组(P<0.05);治疗后观察组Pl、RI、S/D水平均低于对照组,观察组ADMA、sFlt-1、sFlt-1/PIGF水平低于对照组,PIGF水平高于对照组(P<0.05);观察组治疗不良妊娠结局发生率为3.70%,远低于对照组的14.81%(P<0.05)。

结论

降阻汤滋阴潜阳、益气补肾、安神固胎,联合降压治疗轻中度妊娠期高血压病能有效控制其血压水平,缓解患者症状,调节微循环,改善胎盘血流动力学指标,降低ADMA、sFlt-1、sFlt-1/PIGF水平,改善妊娠结局,保障母婴安全。

, authors=荣赟1, 胡哲霞1, 陈晓1, 蒋静雯1, 卜云涛2, 张雪玲1, authorsList=荣赟, 胡哲霞, 陈晓, 蒋静雯, 卜云涛, 张雪玲, authorCompany=null, correspAuthors=张雪玲, authorNote=

荣赟(1982-),女,河北石家庄人,主治医师,硕士,研究方向:妊娠期高血压病。

, correspAuthorsNote=
张雪玲(1975-),女,河北石家庄人,副主任医师,硕士,研究方向:围产医学。E-mail:。
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荣赟(1982-),女,河北石家庄人,主治医师,硕士,研究方向:妊娠期高血压病。

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J Nat Med,2022,59(4):483-489., articleTitle=Ophthalmic artery Doppler at 35-37 weeks'gestation in pregnancies with small or growth-restricted fetuses, refAbstract=null)], funds=[Fund(id=1322923835170889879, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, awardId=2016YFC1000406, language=CN, fundingSource=国家重点研发计划项目(2016YFC1000406), fundOrder=null, country=null), Fund(id=1322923835279941785, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, awardId=20210271, language=CN, fundingSource=河北省医学科学研究课题计划项目(20210271), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322923827923132501, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, xref=1., ext=[AuthorCompanyExt(id=1322923827935715414, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, companyId=1322923827923132501, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.Shijiazhuang Fourth Hospital,Shijiazhuang 050000,Hebei,China), AuthorCompanyExt(id=1322923827948298327, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, companyId=1322923827923132501, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.石家庄市第四医院,河北 石家庄 050000)]), AuthorCompany(id=1322923828015407192, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, xref=2., ext=[AuthorCompanyExt(id=1322923828044767321, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, companyId=1322923828015407192, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.980th Hospital of The Joint Logistics Support Force of The People's Liberation Army of China,Shijiazhuang 050000,Hebei,China), AuthorCompanyExt(id=1322923828057350234, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, companyId=1322923828015407192, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.中国人民解放军联勤保障部队第980医院,河北 石家庄 050000)])], figs=[ArticleFig(id=1322923832587198600, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数显效有效无效总有效
观察组5441(75.93)11(20.37)2(3.70)52(96.30)
对照组5429(53.70)14(25.93)11(20.37)43(79.63)
χ2值----11.048 2
P值----0.024 8
), ArticleFig(id=1322923832666890377, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, language=CN, label=表1, caption=

两组妊娠高血压病患者治疗效果比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数显效有效无效总有效
观察组5441(75.93)11(20.37)2(3.70)52(96.30)
对照组5429(53.70)14(25.93)11(20.37)43(79.63)
χ2值----11.048 2
P值----0.024 8
), ArticleFig(id=1322923834323640458, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数收缩压t值P值舒张压t值P值
治疗前治疗后治疗前治疗后
观察组54149.72±9.62121.52±9.6215.251 70.000 099.62±8.6281.62±5.1217.468 20.000 0
对照组54149.76±10.13135.59±8.6311.014 80.000 098.45±7.6289.92±6.529.146 20.000 0
t值-0.322 18.152 3--0.327 37.132 6-
P值-0.748 50.000 0--0.489 20.000 0--
), ArticleFig(id=1322923834415915148, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, language=CN, label=表2, caption=

两组妊娠高血压病患者血压水平比较(±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数收缩压t值P值舒张压t值P值
治疗前治疗后治疗前治疗后
观察组54149.72±9.62121.52±9.6215.251 70.000 099.62±8.6281.62±5.1217.468 20.000 0
对照组54149.76±10.13135.59±8.6311.014 80.000 098.45±7.6289.92±6.529.146 20.000 0
t值-0.322 18.152 3--0.327 37.132 6-
P值-0.748 50.000 0--0.489 20.000 0--
), ArticleFig(id=1322923834495606925, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间头晕目眩腰膝酸软五心烦热
观察组54治疗前4.02±0.153.98±0.183.13±0.16
治疗后0.92±0.110.79±0.140.59±0.19
t值13.525 424.876 719.482 2
P值0.000 00.000 00.000 0
对照组54治疗前4.03±0.163.97±0.143.14±0.17
治疗后1.59±0.121.75±0.141.42±0.17
t值9.155 711.486 213.426 7
P值0.000 00.000 00.000 0
两组治疗前t值0.295 20.178 20.378 5
两组治疗前P值0.826 70.276 30.249 6
两组治疗后t值9.529 713.582 612.826 4
两组治疗后P值0.000 00.000 00.000 0
), ArticleFig(id=1322923834566910095, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, language=CN, label=表3, caption=

两组妊娠高血压病患者症状积分比较(±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间头晕目眩腰膝酸软五心烦热
观察组54治疗前4.02±0.153.98±0.183.13±0.16
治疗后0.92±0.110.79±0.140.59±0.19
t值13.525 424.876 719.482 2
P值0.000 00.000 00.000 0
对照组54治疗前4.03±0.163.97±0.143.14±0.17
治疗后1.59±0.121.75±0.141.42±0.17
t值9.155 711.486 213.426 7
P值0.000 00.000 00.000 0
两组治疗前t值0.295 20.178 20.378 5
两组治疗前P值0.826 70.276 30.249 6
两组治疗后t值9.529 713.582 612.826 4
两组治疗后P值0.000 00.000 00.000 0
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组别例数时间PIRIS/D
观察组54治疗前1.35±0.240.72±0.123.05±0.40
治疗后0.91±0.130.53±0.092.35±0.18
t值11.846 09.308 111.727 1
P值0.000 00.000 00.000 0
对照组54治疗前1.33±0.310.74±0.103.02±0.38
治疗后1.06±0.180.60±0.072.78±0.22
t值5.534 98.428 14.016 6
P值0.000 00.000 00.000 1
两组治疗前t值0.374 90.940 90.399 6
两组治疗前P值0.708 50.348 90.690 3
两组治疗后t值4.964 44.511 511.116 3
两组治疗后P值0.000 00.000 00.000 0
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两组妊娠高血压病患者胎盘血流动力学指标比较(±s)

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组别例数时间PIRIS/D
观察组54治疗前1.35±0.240.72±0.123.05±0.40
治疗后0.91±0.130.53±0.092.35±0.18
t值11.846 09.308 111.727 1
P值0.000 00.000 00.000 0
对照组54治疗前1.33±0.310.74±0.103.02±0.38
治疗后1.06±0.180.60±0.072.78±0.22
t值5.534 98.428 14.016 6
P值0.000 00.000 00.000 1
两组治疗前t值0.374 90.940 90.399 6
两组治疗前P值0.708 50.348 90.690 3
两组治疗后t值4.964 44.511 511.116 3
两组治疗后P值0.000 00.000 00.000 0
), ArticleFig(id=1322923834801791122, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间血浆ADMA/(μmol/L)sFlt-1/(ng/mL)PIGF/(ng/mL)sFlt-1/PIGF
观察组54治疗前2.31±0.561 419.52±328.4537.21±5.2139.82±5.72
治疗后0.75±0.111 129.85±298.8254.52±8.4820.82±4.62
t值18.492 215.268 816.782 222.148 7
P值0.000 00.000 00.000 00.000 0
对照组54治疗前2.34±0.511 422.42±329.7837.42±4.2438.42±4.22
治疗后1.79±0.251 324.52±348.8741.02±7.8229.72±7.44
t值8.564 312.496 29.789 511.592 5
P值0.000 00.000 00.000 00.000 0
两组治疗前t值0.287 90.186 20.247 90.249 5
两组治疗前P值0.794 70.249 70.397 50.478 2
两组治疗后t值19.782 25.975 815.482 623.749 5
两组治疗后P值0.000 00.000 00.000 00.000 0
), ArticleFig(id=1322923834885677203, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, language=CN, label=表5, caption=

两组妊娠高血压病患者血浆ADMA、sFlt-1及PIGF水平比较(±s)

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组别例数时间血浆ADMA/(μmol/L)sFlt-1/(ng/mL)PIGF/(ng/mL)sFlt-1/PIGF
观察组54治疗前2.31±0.561 419.52±328.4537.21±5.2139.82±5.72
治疗后0.75±0.111 129.85±298.8254.52±8.4820.82±4.62
t值18.492 215.268 816.782 222.148 7
P值0.000 00.000 00.000 00.000 0
对照组54治疗前2.34±0.511 422.42±329.7837.42±4.2438.42±4.22
治疗后1.79±0.251 324.52±348.8741.02±7.8229.72±7.44
t值8.564 312.496 29.789 511.592 5
P值0.000 00.000 00.000 00.000 0
两组治疗前t值0.287 90.186 20.247 90.249 5
两组治疗前P值0.794 70.249 70.397 50.478 2
两组治疗后t值19.782 25.975 815.482 623.749 5
两组治疗后P值0.000 00.000 00.000 00.000 0
), ArticleFig(id=1322923834973757588, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
分组例数早产自然流产胎盘早剥产后出血总发生
观察组541(1.85)0(0)0(0)1(1.85)2(3.70)
对照组543(5.56)2(3.70)1(1.85)2(3.70)8(14.81)
χ2值-----3.967 3
P值-----0.046 4
), ArticleFig(id=1322923835040866454, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923826039889992, language=CN, label=表6, caption=

两组妊娠高血压病患者妊娠结局比较

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分组例数早产自然流产胎盘早剥产后出血总发生
观察组541(1.85)0(0)0(0)1(1.85)2(3.70)
对照组543(5.56)2(3.70)1(1.85)2(3.70)8(14.81)
χ2值-----3.967 3
P值-----0.046 4
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降阻汤联合降压治疗对轻中度妊娠期高血压血浆ADMA、sFlt-1/PIGF及母婴预后的影响
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荣赟 1 , 胡哲霞 1 , 陈晓 1 , 蒋静雯 1 , 卜云涛 2 , 张雪玲 1
中华中医药学刊 | 国家项目点击 2025,43(6): 61-65
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中华中医药学刊 |国家项目点击 2025 , 43 (6) : 61 -65
降阻汤联合降压治疗对轻中度妊娠期高血压血浆ADMA、sFlt-1/PIGF及母婴预后的影响
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荣赟(1982-),女,河北石家庄人,主治医师,硕士,研究方向:妊娠期高血压病。

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荣赟(1982-),女,河北石家庄人,主治医师,硕士,研究方向:妊娠期高血压病。

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荣赟1, 胡哲霞1, 陈晓1, 蒋静雯1, 卜云涛2, 张雪玲1
作者信息
  • 1.石家庄市第四医院,河北 石家庄 050000
  • 2.中国人民解放军联勤保障部队第980医院,河北 石家庄 050000
通讯作者:
张雪玲(1975-),女,河北石家庄人,副主任医师,硕士,研究方向:围产医学。E-mail:。
作者简介:

荣赟(1982-),女,河北石家庄人,主治医师,硕士,研究方向:妊娠期高血压病。

Effect of Jiangzu Decoction(降阻汤)Combined with Antihypertensive Treatment on Plasma ADMA,sFlt-1/PIGF and Maternal and Infant Prognosis in Mild to Moderate Pregnancy Hypertension
Yun RONG1, Zhexia HU1, Xiao CHEN1, Jingwen JIANG1, Yuntao BU2, Xueling ZHANG1
Affiliations
  • 1.Shijiazhuang Fourth Hospital,Shijiazhuang 050000,Hebei,China
  • 2.980th Hospital of The Joint Logistics Support Force of The People's Liberation Army of China,Shijiazhuang 050000,Hebei,China
出版时间: 2025-06-10 doi: 10.13193/j.issn.1673-7717.2025.06.010
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目的

分析降阻汤联合降压治疗对轻中度妊娠期高血压病血浆非对称性二甲基精氨酸(ADMA)、可溶性血管内皮生长因子受体1(sFlt-1)/胎盘生长因子(PIGF)及母婴预后的影响。

方法

纳入2020年9月—2023年10月石家庄市第四医院就诊的108例轻中度妊娠期高血压病患者为研究对象,随机数字表法将其分为两组,54例对照组采用常规降压治疗,54例观察组采用降阻汤联合降压治疗,对比两组疗效差异、血压水平、症状评分、血浆ADMA、sFlt/PIGF水平、胎盘超声血流动力学指标及妊娠结局。

结果

观察组治疗总有效率为96.30%,远高于对照组的79.63%(P<0.05);治疗后观察组头晕目眩、腰膝酸软、五心烦热症状评分及血压水平均低于对照组(P<0.05);治疗后观察组Pl、RI、S/D水平均低于对照组,观察组ADMA、sFlt-1、sFlt-1/PIGF水平低于对照组,PIGF水平高于对照组(P<0.05);观察组治疗不良妊娠结局发生率为3.70%,远低于对照组的14.81%(P<0.05)。

结论

降阻汤滋阴潜阳、益气补肾、安神固胎,联合降压治疗轻中度妊娠期高血压病能有效控制其血压水平,缓解患者症状,调节微循环,改善胎盘血流动力学指标,降低ADMA、sFlt-1、sFlt-1/PIGF水平,改善妊娠结局,保障母婴安全。

降阻汤  /  降压治疗  /  妊娠期高血压病  /  血浆非对称性二甲基精氨酸  /  可溶性血管内皮生长因子受体1  /  胎盘生长因子  /  母婴结局
Objective

To analyze the effects of Jiangzi Decoction(降阻汤)combined with antihypertensive therapy on plasma asymmetric dimethylarginine in mild to moderate pregnancy hypertension(ADMA),soluble vascular endothelial growth factor receptor-1(sFlt-1)/placental growth factor(PIGF)and maternal and infant outcomes.

Methods

A total of 108 patients with mild to moderate gestational hypertension treated in the hospital from September 2020 to October 2023 were included as research objects.They were divided into two groups by random number table method.Fifty-four patients in the control group received routine antihypertensive treatment,and the other 54 patients in the observation group received Jiangzi Decoction combined with antihypertensive treatment.The efficacy,blood pressure,symptom scores,plasma levels of ADMA and sFlt/PIGF,ultrasound hemodynamic index of placenta and pregnancy outcome were compared between the two groups.

Results

The total effective rate of the observation group was 96.30%,much higher than that of the control group(79.63%)(P<0.05).After treatment,dizziness,waist and knee weakness,five upset and heat symptom scores and blood pressure levels in the observation group were lower than those in the control group(P<0.05).After treatment,the values of pulsatility index(PI),resistance index(RI)and S/D in the observation group were lower than those in the control group.The levels of ADMA,sFlt-1 and sFlt-1/PIGF in the observation group were lower than those in the control group,and PIGF levels were higher than those in the control group(P<0.05).The incidence of adverse pregnancy outcome was3.70% in the observation group,which was much lower than that(14.81%)in the con-trol group(P<0.05).

Conclusion

Jiangzu Decoction can nourish Yin and suppress Yang,invigorate Qi and tonify kidney,tranquilize the mind and stabilize the fetus.And when combined with antihypertensive therapy for mild to moderate pregnancy hypertension,it can effectively control blood pressure,alleviate symptoms,regulate microcirculation,improve placental hemodynamic indexes,and reduce the levels of ADMA and sFlt/PIGF,improve pregnancy outcomes and ensure the safety of mothers and infants.

Jiangzu Decoction(降阻汤)  /  antihypertensive therapy  /  hypertension during pregnancy  /  plasma asymmetric dimethylarginine  /  soluble vascular endothelial growth factor receptor 1  /  placental growth factor  /  maternal and infant outcome
荣赟, 胡哲霞, 陈晓, 蒋静雯, 卜云涛, 张雪玲. 降阻汤联合降压治疗对轻中度妊娠期高血压血浆ADMA、sFlt-1/PIGF及母婴预后的影响. 中华中医药学刊, 2025 , 43 (6) : 61 -65 . DOI: 10.13193/j.issn.1673-7717.2025.06.010
Yun RONG, Zhexia HU, Xiao CHEN, Jingwen JIANG, Yuntao BU, Xueling ZHANG. Effect of Jiangzu Decoction(降阻汤)Combined with Antihypertensive Treatment on Plasma ADMA,sFlt-1/PIGF and Maternal and Infant Prognosis in Mild to Moderate Pregnancy Hypertension[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (6) : 61 -65 . DOI: 10.13193/j.issn.1673-7717.2025.06.010
妊娠期高血压病为妊娠期女性常见疾病之一,若不及时治疗可导致胎儿发育迟缓、难产等不良妊娠结局,威胁母婴安全。降低血压是临床治疗妊娠期高血压病的主要原则[1],而常规西药治疗虽有一定效果,但可能会影响胎盘灌注和胎儿生长,存在一定局限性。近年来中医在临床广泛应用,中医认为该病的发生与肝失所养、肾气、精血不足等存在密切关系,降阻汤具有滋阴潜阳、益气补肾的作用,对改善患者症状有积极作用[2]。子痫前期作为妊娠期高血压病疾病的严重类型,一旦发生,将对母体及胎儿产生严重影响,因此目前有较多生物学标记物被用于预测子痫前期的发生,其中以sFlt-1/PIGF比值的预测价值较高[3-4]。那么,在轻中度妊娠期高血压病患者中,降压治疗对上述指标有何影响,及其变化是否与母婴预后相关,国内未见相关研究报道。鉴于此,本次研究降阻汤联合降压治疗对轻中度妊娠期高血压病患者血浆ADMA(asymmetric dimethylarginine,ADMA,非对称性二甲基精氨酸)、sFlt-1(soluble Fms-like tyrosine kinase,sFlt-1,可溶性Fms样酪氨酸激酶),PIGF(plasma placental growth factor,PLGF,胎盘生长因子)及母婴预后的影响,为联合方案是否可使母婴进一步获益,提供实践依据。现报道如下。
纳入2020年9月—2023年10月我院就诊的108例轻中度妊娠期高血压病患者为研究对象,随机数字表法将其分为两组,纳入标准:①患者均符合《高血压学组妊娠期高血压疾病血压管理专家共识(2019)》[5]中关于妊娠期高血压病的相关诊断标准,孕20周后新发的血压升高,静息状态下测量收缩压≥140 mmHg,和(或)舒张压≥90 mmHg;②单胎妊娠;③符合《中药新药临床研究指导原则》[6]中关于妊娠期高血压病的相关诊断标准,辨证为肝肾阴虚,主症头晕目眩、腰膝酸软、五心烦热、次症耳鸣健忘、失眠多梦,舌质红,苔薄,脉细数,符合上述主症及两项以上次症即可明确诊断。排除标准:①妊娠前已有高血压病或血压异常病史;②心功能不全;③严重肝肾功能障碍;④合并甲状腺功能亢进、多囊卵巢综合征等内分泌代谢性疾病及慢性高血压病;⑤多胎妊娠;⑥严重精神、神经系统疾病者,不能配合参与研究者。对照组54例,年龄24~34岁,平均(27.54±3.24)岁,孕周22~26周,平均(25.82±3.23)周,体质量指数(BMI)20~28 kg/m2,平均(24.61±1.55)kg/m2,其中初产妇28例,经产妇26例;观察组54例,年龄23~35岁,平均(28.72±3.27)岁,孕周21~27周,平均(25.14±3.27)周,体质量指数(BMI)20~29 kg/m2,平均(24.73±1.67)kg/m2,其中初产妇30例,经产妇24例。两组患者上述资料比较,差异无统计学意义(P>0.05),可比性较好。
给予郑州凯利药业有限公司所生产的拉贝洛尔(国药准字H41024906)口服,每次100 mg,每天2次,持续治疗28 d。
方药组成如下:包括黄芪20 g,丹参15 g,菟丝子20 g,当归10 g,桑寄生10 g,断续10 g,白芍10 g,茯苓9 g,川芎6 g,砂仁3 g,红参3 g,甘草3 g。将上述中药用冷水浸泡15 min,然后在大火煮沸后小火慢煎,煎煮至400 mL,分早晚服用,每天1剂,持续治疗28 d。
对两组患者及家属均医嘱定期血压监测、体重控制管理,避免高脂高糖高盐饮食,适度散步适度活动,家人疏导减轻患者心理压力,保持良好心情。一旦突然出现水肿、持续头痛、上腹痛或视觉变化立即予以对症干预治疗,降低发展为更严重状况的风险。
①疗效评价参考《中药新药临床研究指导原则》[6]:经过治疗后患者水肿、头晕症状改善,血压处于正常范围内,则为治疗显效;治疗后患者水肿、头晕症状改善,舒张压下降范围在10~19 mmHg,表示治疗有效;治疗后症状并无缓解,血压仍处于较高水平,则为治疗无效。总有效率=显效率+有效率。②血压水平:静息状态下测量两组血压水平,测量3次取平均值,观察其舒张压、收缩压水平变化情况;③症状评分:本次研究以头晕目眩,腰膝酸软,五心烦热3项主要症状依据无、轻、中、重严重程度进行量化评分,分别计0、2、4、6分,分值越高表示其症状越严重[7]。④血浆ADMA、sFlt-1及PIGF水平检测:采集两组空腹静脉血3 mL,抗凝后进行离心处理,3000 r/min离心时间10 min,分离血浆,采用酶联免疫吸附实验检测血浆ADMA、sFlt-1及PIGF水平,观察两组治疗前后上述指标水平变化情况。⑤胎盘超声血流动力学指标:在胎儿相对安静的状态下,用彩色多普勒超声仪对胎盘血流动力学指标进行检测,分别检测胎儿脐动脉搏动指数(pulsatility index,PI,搏动指数)、胎儿血管阻力指数(Resistance Index,RI,血管阻力指数)以及收缩末期最大流速/舒张末期最大流速(S/D)。⑥妊娠结局:观察两组妊娠结局,包括早产、胎盘早剥、产后出血、自然流产等发生情况,将其记录进行统计分析。
采用SPSS 25.0软件完成统计学分析。治疗总有效率用[例(%)]表示,采用χ2 检验;血压水平、症状评分、血浆ADMA、sFlt-1、PIGF等连续变量遵循正态分布的指标用()表示,当数据满足方差齐性假设时,同组间采用配对样本t检验进行比较,两组之间的数据则采用LSD检验方法进行比较。对于不满足方差齐性假设的情况,我们使用Tamhane's T2多重比较法来进行组间比较。P<0.05为差异有统计学意义。
持续治疗28 d后,两组疗效相比较,观察组治疗总有效率为96.30%(52/54),高于对照组的79.63%(43/54),组间比较差异有统计学意义(P<0.05)。见表1。
治疗前两组患者收缩压和舒张压值相比较差异无统计学意义(P>0.05);治疗后两组患者收缩压、舒张压水平均较治疗前降低(P<0.05),相较于对照组,观察组降低更为显著。见表2。
治疗前两组头晕目眩,腰膝酸软,五心烦热症状评分比较差异无统计学意义(P>0.05);治疗后上述症状分值均降低(P<0.05),与对照组比较,观察组降低更为明显,组间比较差异有统计学意义(P<0.05)。见表3。
治疗前两组胎盘血流动力学指标P1、RI、S/D水平差异无统计学意义(P>0.05);治疗后观察组Pl、RI、S/D水平均低于对照组,组间比较差异有统计学意义(P<0.05)。见表4。
治疗前两组血浆ADMA、sFlt-1、PIGF、sFlt-1/PIGF水平比较差异无统计学意义(P>0.05);治疗后观察组ADMA、sFlt-1、sFlt-1/PIGF水平低于对照组,PIGF水平高于对照组,组间比较差异有统计学意义(P<0.05)。见表5。
观察组治疗不良妊娠结局发生率为3.70%,远低于对照组的14.81%,组间比较差异有统计学意义(P<0.05)。见表6。
妊娠期高血压病为妊娠期常见并发症之一,表现为血压升高,伴或不伴蛋白尿和水肿,导致该病发生的原因较为复杂,可能与营养不良[8]、家族高血压病史[9]、中枢神经系统功能紊乱[10]等存在密切联系。近年来受环境变化、生活方式改变等因素影响,妊娠期高血压病的发病率呈增加趋势,我国发病率达到9.4%[11-13]。目前临床针对妊娠高血压病尚无特效治疗方式,主要以控制血压,改善母体生化指标及胎儿预后为主。
中医学依据其症状将其归为“子晕”“子满”等范畴。《内径》指出:“诸风掉眩,皆属于肝”。《素问·至真要大论篇》也指出:“诸湿肿满,皆属于脾”,《素问·水热穴论篇》云:“肾者胃之关也,关门不利,故聚水而从其类也。上下溢于皮肤,故为脍肿。”由此可见妊娠期高血压病的发病与肾、脾、肺三者存在密切联系[14-16]。中医认为妊娠后妇女易脾虚湿盛,加之胎元渐长,对脾胃升降功能产生一定影响,脾虚则水湿不能布散于四肢,精微物质下陷,使得水谷之精气不能养于头目,致清阳不升,精气不布;且妊娠后精血下注冲任以养胞宫,肝肾气血渐亏,水不涵木,气血生化乏源,上扰清窍,而致疾病发生。因此对妊娠期高血压病应采取滋阴潜阳、益气补肾的治疗原则[17-18]。本次研究采用降阻汤联合降压治疗轻中度妊娠期高血压病,结果表明治疗后观察组头晕目眩、腰膝酸软、五心烦热症状评分及血压水平均低于对照组(P<0.05),可见该种治疗方式能改善患者头晕目眩等相关症状,控制血压水平。这是由于降阻汤中黄芪[19]甘微,具有补气升阳、固表止汗、利水消肿、生津养血的功效,现代研究表明[20],黄芪可增强机体免疫能力,扩张外周血管、降血压、改善微循环的作用。丹参[21]具有清心除烦的作用,现代研究表明[22],丹参可扩张外周血管,增加血流量,改善血液循环;菟丝子[23]具有补益肝肾的作用,《本草汇言》指出:“菟丝子,补肾养肝,温脾助胃之药也。”当归[24]性温,具有补血活血,可调益荣卫,滋养气血,《本草正》曰:“当归,其味甘而重,故专能补血”。桑寄生[25]具有安胎元、补肝肾祛风湿的作用;白芍[26]养血柔肝。茯苓[27]利水渗湿,健脾益气,宁心安神;川芎为经典补益药,《太平惠民和剂局方》及现代药理学表明川芎具有降低血管阻力、改善微循环的作用[28-29];砂仁可滋阴清热、固肾安胎之功效[30];红参[31]补元气、固脱生津安神;甘草调和诸药。诸药合用共奏滋阴潜阳、益气补肾、安神固胎之效用。
妊娠期高血压病疾病的基本变化为全身小动脉痉挛,血管内膜纤维性增厚,管腔狭窄,导致脏器缺血缺氧。脐带、胎盘是胎儿从母体获取营养的唯一方式,对胎盘血流动力学监测是评价胎儿宫内血液、营养供应的有效方法。脐动脉的PI、RI和S/D主要是反映了胎盘阻力的状况。正常情况下,胎盘阻力低,当出现胎盘床绒毛动脉血管内膜纤维性增厚,管腔狭窄、栓塞等情况时,导致胎盘循环阻力增高,胎盘血流灌注不足,最终致使胎儿窘迫、胎儿宫内发育迟缓,甚至围产儿死亡。本研究中,治疗前两组无明显差异,治疗后两组均降低,但观察组低于对照组(P<0.05)。可见降阻汤联合降压治疗后患者胎盘供血情况更好,考虑与中药滋阴潜阳、益气补肾、安神固胎的功效有关,丹参等药物能有效扩张外周血管,增加血流量,改善血液循环,但具体机制还需进一步研究。
ADMA[32-33]属于内源性一氧化氮合酶的抑制剂,其浓度将直接影响体内重要的舒血管物质一氧化氮的产生,高表达引起血管内皮损伤。相关研究表明[34-36],患者血压水平与ADMA水平呈正相关。sFlt[37-38]、PIGF[39-40]在血管形成及促进胎盘功能发挥中具有重要作用,PIGF能促进胎盘细胞的增殖,而sFlt则可拮抗PIGF,引起内皮功能障碍,导致高血压病和蛋白尿。因此sFlt-1、PIGF之间的平衡对胎盘血管建构、血管壁完整性具有重要意义。本组治疗后观察组ADMA、sFlt-1、sFlt-1/PIGF水平低于对照组,PIGF水平高于对照组(P<0.05)。可见该种联合治疗方式能更有效降低血浆ADMA、sFlt-1、sFlt-1/PIGF水平,保护内皮功能。这是由于降阻汤具有利水消肿、改善微循环、补肝益肾等功效,与降压药联合应用,充分发挥其优势。
总之,降阻汤滋阴潜阳、益气补肾、安神固胎,联合降压治疗轻中度妊娠期高血压病能有效控制其血压水平,缓解患者症状,降低血浆ADMA、sFlt-1、sFlt-1/PIGF水平,调节微循环、改善胎盘血流灌注,改善妊娠结局,保障母婴安全。本次研究未对降阻汤作用机制深入探究,未来将在本研究基础上进行动物实验,对降阻汤改善妊娠高血压病的作用机制进行深度探索。
  • 国家重点研发计划项目(2016YFC1000406)
  • 河北省医学科学研究课题计划项目(20210271)
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2025年第43卷第6期
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doi: 10.13193/j.issn.1673-7717.2025.06.010
  • 首发时间:2026-10-30
  • 出版时间:2025-06-10
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国家重点研发计划项目(2016YFC1000406)
河北省医学科学研究课题计划项目(20210271)
作者信息
    1.石家庄市第四医院,河北 石家庄 050000
    2.中国人民解放军联勤保障部队第980医院,河北 石家庄 050000

通讯作者:

张雪玲(1975-),女,河北石家庄人,副主任医师,硕士,研究方向:围产医学。E-mail:。
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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