平肝熄风汤治疗肝肾阴虚型妊娠期高血压临床研究OA

Objective To evaluate the clinical efficacy of Pinggan Xifeng Decoction in patients with hypertensive disorders of pregnancy(HDP)exhibiting a liver and kidney yin deficiency pattern.Methods A total of 136 patients with liver and kidney yin deficiency type HDP treated between January 2021 and December 2023 were randomized by random number table into a control group and a treatment group,with 68 patients in each group.Both groups received routine baseline therapy.The control group was treated with labetalol.The treatment group received Pinggan Xifeng Decoction in addition to the control regimen.After seven days of therapy,outcomes were assessed.Measured outcomes included traditional Chinese medicine(TCM)syndrome scores for heat in the palms and soles,dry mouth with constipation,blurred vision,red tongue with scant coating,and a wiry,thin and rapid pulse;24 hour ambulatory blood pressure including mean systolic and mean diastolic pressure;uterine artery hemodynamic indices including resistive index(RI),pulsatility index(PI)and the systolic to end diastolic velocity ratio(S/D);serum biomarkers including insulin like growth factor 1(IGF-1),soluble lectin like oxidized low density lipoprotein receptor 1(sLOX-1),heat shock protein 70(HSP70),soluble receptor for advanced glycation end products(sRAGE)and whole blood viscosity(WBV);adverse reactions during treatment;and final pregnancy outcomes.Results Both groups experienced significant improvement from baseline in TCM symptom scores after treatment(P＜0.05).Post treatment syndrome scores were lower in the treatment group than in the control group(P＜0.05).Twenty 24 hour mean systolic and mean diastolic pressures decreased significantly in both groups after treatment(P＜0.05),with greater reductions in the treatment group compared with the control group(P＜0.05).Uterine artery hemodynamic indices RI,PI and S/D declined in both groups after treatment(P＜0.05),and the treatment group showed larger decreases than the control group(P＜0.05).Serum IGF-1 and sRAGE increased in both groups after treatment(P＜0.05),while HSP70,sLOX-1 and blood viscosity decreased(P＜0.05).Improvements in IGF-1 and sRAGE were greater in the treatment group,and reductions in HSP70,sLOX-1 and WBV were greater in the treatment group compared with the control group(P＜0.05).The overall incidence of adverse reactions in the treatment group was comparable to the control group(27.94%[19/68]vs 14.71%[10/68],P＞0.05).The treatment group had significantly lower rates of preterm birth,cesarean section and fetal distress than the control group(5.88%[4/68]vs22.06%[15/68],27.94%[19/68]vs 45.59%[31/68],5.88%[4/68]vs 17.65%[12/68],respectively,P＜0.05).Conclusion Pinggan Xifeng Decoction added to conventional therapy effectively alleviates symptoms in patients with HDP of liver and kidney yin deficiency type,favorably modulates serum IGF-1,HSP70,sLOX-1 and sRAGE,lowers blood pressure and blood viscosity,improves uterine artery hemodynamics and pregnancy outcomes,and demonstrates good safety.