【目的】观察天麻钩藤饮联合硫酸镁、拉贝洛尔对妊娠期高血压患者的降压效果及血液流变学的影响。【方法】将90例 妊娠期高血压肝阳偏亢型患者随机分为联合组和对照组，每组各45例。对照组给予硫酸镁联合拉贝洛尔治疗，联合组在对 照组的基础上加用天麻钩藤饮治疗，疗程为5 d。观察2组患者治疗前后收缩压、舒张压、尿蛋白水平及血液流变学指标的 变化情况，比较2组患者的不良妊娠结局、不良反应及满意度情况，并以Logistic回归分析法探讨妊娠期高血压患者不良妊 娠结局的影响因素。【结果】（1）降压效果方面，治疗后，2组患者的收缩压、舒张压和尿蛋白水平均较治疗前明显降低（P＜ 0.05），且联合组的降低程度均明显优于对照组（P＜0.01）。（2）血液流变学方面，治疗后，2组患者的血浆黏度、全血黏度和 红细胞比容均较治疗前明显降低（P＜0.05），且联合组的降低程度均明显优于对照组（P＜0.05或P＜0.01）。（3）不良妊娠结局 方面，联合组的不良妊娠结局总发生率为11.11%（5/45），明显低于对照组的33.33%（15/45），差异有统计学意义（P＜0.05）。 （4）满意度方面，联合组的满意度为97.78%（44/45），明显高于对照组的84.44%（38/45），差异有统计学意义（P＜0.05）。（5）不 良反应方面，联合组的不良反应总发生率为13.33%（6/45），对照组为8.89%（4/45），组间比较，差异无统计学意义（P＞ 0.05）。（6）影响因素方面，经Logistic回归分析，未使用天麻钩藤饮联合拉贝洛尔、硫酸镁治疗及降压效果不佳均是妊娠期高 血压患者不良妊娠结局的独立危险因素（均OR＞1，P＜0.05）。【结论】天麻钩藤饮联合拉贝洛尔、硫酸镁中西医结合治疗妊 娠期高血压患者的降压效果确切，能有效改善血液流变学指标以及不良妊娠结局，提升患者的满意度。

Objective To observe the effects of Tianma Gouteng Decoction combined with magnesium sulfate and Labetalol on lowering blood pressure and improving hemorheology in patients with gestational hypertension. Methods Ninety patients with gestational hypertension of liver-yang hyperactivity type were randomly divided into the combination group and the control group， with 45 cases in each group. The control group was treated with magnesium sulfate combined with Labetalol， and the combination group was treated with Tianma Gouteng 广州中医药大学学报 Journal of Guangzhou University of Traditional Chinese Medicine 2024年3月第41卷第3期 612 March 2024，Vol. 41，No. 3 Decoction on the basis of treatment for the control group. The course of treatment lasted for 5 days. The changes of systolic blood pressure（SBP）， diastolic blood pressure（DBP）， urinary protein level， and hemorheological indicators of the two groups were observed before and after the treatment. Moreover， the adverse pregnancy outcomes， adverse reactions， and patients’satisfaction of the two groups were compared. Finally， the influencing factors of patients’adverse pregnancy outcomes were investigated by logistic regression analysis. Results （1）After treatment， the SBP， DBP and urinary protein level of patients in the two groups were significantly decreased compared with those before treatment（P＜0.05）， and the decrease in the combination group was significantly superior to that in the control group（P＜0.01）.（2）After treatment，the hemorheological indicators of plasma viscosity，whole blood viscosity and hematocrit of patients in the two groups were significantly decreased compared with those before treatment（P＜0.05）， and the decrease in the combination group was significantly superior to that in the control group（P＜0.05 or P＜0.01）.（3） The total incidence of adverse pregnancy outcomes in the combination group was 11.11%（5/45），which was significantly lower and that in the control group（33.33%， 15/45）， the difference being statistically significant（P＜0.05）.（4） The patients’ satisfaction of the combination group was 97.78%（44/45），which was significantly higher than that of the control group（84.44%，38/45），and the difference was statistically significant（P＜0.05）.（5）The total incidence of adverse reactions in the combination group was 13.33%（6/45）and that in the control group was 8.89%（4/45），but the intergroup comparison showed no significant difference between the two groups （P＞0.05）.（6） Logistic regression analysis of influencing factors showed that no medication of Tianma Gouteng Decoction combined with Labetalol and magnesium sulfate，and poor antihypertensive effect were the independent risk factors for adverse pregnancy outcomes in patients with gestational hypertension （all OR＞1， P＜0.05）. Conclusion Tianma Gouteng Decoction combined with magnesium sulfate and Labetalol in treating gestational hypertension exerts certain antihypertensive effect， and the therapy can effectively improve the hemorheological indicators and the adverse pregnancy outcomes，and enhance the patients’satisfaction.

R271.9

国家自然科学基金面上项目（编号：81471474）；河北省衡水市科技计划项目（编号：2020014047Z）