研究天麻钩藤饮对妊娠期高血压肝阳偏亢型患者的血压及电解质、肾素活性（PRA）、血管紧张素Ⅱ（AngⅡ）和 尾加压素Ⅱ（UⅡ）水平变化的影响。【方法】 将468例妊娠期高血压肝阳偏亢型患者随机分为研究组和对照组，每组各234例。 对照组给予硫酸镁联合拉贝洛尔治疗，研究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（SBP）、舒张压（DBP）及电解质和血清PRA、AngⅡ、UⅡ水平的变化情况，并分析2组患者的临床疗效和不良反应发 生情况。【结果】（1）疗效方面：治疗5 d后，研究组的痊愈率和总有效率分别为12.82%（30/234）、95.30%（223/234），对照组 分别为5.56%（13/234）、82.05%（192/234）；组间比较，研究组的痊愈率、总有效率（χ2 检验）和总体疗效（秩和检验）均明显优 于对照组（P＜0.05或P＜0.01）。（2）血压方面：治疗后，2组患者的SBP、DBP水平均较治疗前降低（P＜0.01），且研究组治疗 后的SBP、DBP水平均明显低于对照组（P＜0.01）。（3）电解质水平方面：治疗后，2组患者的血浆钙离子、镁离子以及红细胞 钙离子、镁离子水平均较治疗前升高（P＜0.01），但研究组治疗后的血浆钙离子、镁离子以及红细胞镁离子水平均明显低于 对照组（P＜0.01）。（4）血清 PRA、AngⅡ和 UⅡ水平方面：治疗后，2组患者的血清 PRA、AngⅡ和 UⅡ水平均较治疗前降低 （P＜0.01），且研究组治疗后的血清 PRA、AngⅡ和 UⅡ水平均明显低于对照组（P＜0.01）。（5）不良反应方面：2组患者的头 痛、失眠、咳嗽、心悸等不良反应发生率及总发生率比较，差异均无统计学意义（P＞0.05）。【结论】 天麻钩藤饮在改善妊娠 期高血压肝阳偏亢型患者的血压、电解质水平以及血清PRA、AngⅡ、UⅡ水平方面效果显著，且不会增加不良反应发生风险。

To observe the effect of Tianma Gouteng Decoction on blood pressure and levels of electrolytes， plasma renin activity（PRA）， angiotensin Ⅱ（Ang Ⅱ） and urotensin Ⅱ（U Ⅱ） in patients with gestational hypertension of liver-yang hyperactivity type. Methods A total of 468 patients with gestational hypertension of liver-yang hyperactivity type were randomly divided into study group and control group， with 234 cases in each group. The control group was treated with Magnesium Sulfate plus Labetalol， and the study group was treated with Tianma Gouteng Decoction together with Magnesium Sulfate plus Labetalol. The course of treatment for the two groups lasted for 5 days. The changes of systolic blood pressure （SBP）， diastolic blood pressure （DBP），and levels of electrolytes and serum PRA，AngⅡ and UⅡ in the two groups before and after treatment were observed. After treatment，the clinical efficacy and the incidence of adverse reactions of the two groups were evaluated. Results （1）After 5 days of treatment，the cure rate and total effective rate of the study group were 12.82% （30/234） and 95.30% （223/234），respectively，while those of the control group were 5.56% （13/234） and 82.05%（192/234）， respectively. The intergroup comparison showed that the cure rate， total effective rate （tested by chi-square test） and overall efficacy （tested by rank sum test） of the study group were significantly superior to those of the control group （P＜0.05 or P＜0.01）.（2）After treatment，the levels of SBP and DBP in the two groups were lower than those before treatment（P＜0.01），and the levels of SBP and DBP in the study group were significantly lower than those in the control group （P＜0.01）.（3）After treatment， the electrolyte levels of calcium ion and magnesium ion in the plasma and erythrocytes of the two groups were higher than those before treatment（P＜0.01）， and the levels of calcium ion and magnesium ion in the plasma and erythrocytes of the study group were significantly lower than those of the control group（P＜0.01）.（4）After treatment，the levels of serum PRA，AngⅡ and UⅡ in the two groups were lower than those before treatment （P＜0.01），and the levels of serum PRA，AngⅡ and UⅡ in the study group were significantly lower than those in the control group（P＜0.01）.（5） In terms of adverse reactions， the incidence of adverse reactions such as headache，insomnia，cough and palpitation and the total incidence in the study group did not differ from those in the control group（P＞0.05）. Conclusion Tianma Gouteng Decoction has a significant effect on improving blood pressure，electrolyte level and serum PRA，AngⅡ and UⅡ levels in patients with gestational hypertension of liver-yang hyperactivity type，and does not increase the incidence of adverse reactions.

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）