目的 探討甲基多巴聯(lián)合尼卡地平治療妊娠期高血壓的臨床療效。方法 選取2017年2月—2020年3月駐馬店市中醫(yī)院收治的124例妊娠期高血壓患者，隨機(jī)分為對(duì)照組（62例）和治療組（62例）。對(duì)照組患者靜脈滴注鹽酸尼卡地平注射液，起始劑量為40 mg/次，2次/d，之后根據(jù)患者血壓情況調(diào)整劑量。治療組在對(duì)照組基礎(chǔ)上口服甲基多巴片，0.25 g/次，3次/d。兩組患者持續(xù)治療兩周。觀察兩組患者臨床療效，比較治療前后兩組患者血壓情況、血流動(dòng)力學(xué)、凝血功能，血清炎癥因子白細(xì)胞介素-6（IL-6）、C反應(yīng)蛋白（CRP）和腫瘤壞死因子-α（TNF-α）水平及妊娠結(jié)局。結(jié)果 治療后，治療組總有效率為93.55%，顯著高于對(duì)照組的79.03%（P<0.05）；治療后，兩組收縮壓（SBP）、舒張壓（DBP）、臍血流和阻力指數(shù)較治療前顯著降低（P<0.05），且治療組明顯低于對(duì)照組（P<0.05）；心臟指數(shù)較治療前顯著提高（P<0.05），治療組高于對(duì)照組（P<0.05）；治療后，兩組凝血酶原時(shí)間（PT）、凝血酶時(shí)間（TT）、活化部分凝血活酶時(shí)間（APTT）水平較治療前明顯延長(zhǎng)（P<0.05），治療組較對(duì)照組顯著延長(zhǎng)（P<0.05）；治療后，兩組患者血清IL-6、CRP、TNF-α水平低于治療前（P<0.05），且治療組低于對(duì)照組（P<0.05）；治療組早產(chǎn)、剖宮產(chǎn)、產(chǎn)后出血、胎盤(pán)早剝、胎兒宮內(nèi)窘迫、新生兒窒息發(fā)生例數(shù)低于對(duì)照組（P<0.05）。結(jié)論 甲基多巴配合尼卡地平治療妊娠期高血壓患者療效顯著，可明顯降低血壓，改善血流動(dòng)力學(xué)，減輕炎癥反應(yīng)，減少不良妊娠結(jié)局。

Objective To explore the clinical effect of methyldopa combined with nicardipine in treatment of hypertension during pregnancy. Methods Patients (124 cases) with hypertension during pregnancy in Zhumadian TCM Hospital from February 2017 to March 2020 were randomly divided into control (62 cases) and treatment (62 cases) groups. Patients in the control group were iv administered with Nicardipine Hydrochloride Injection, and the initial dose was 40 mg/time, twice daily, then adjusted the dose according to the patient's blood pressure. Patients in the treatment group were po administered with Methytdopa Tablets on the basis of the control group, 0.25 g/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the blood pressure, hemodynamic index levels, coagulation function index levels, the serum inflammatory factor IL-6, CRP and TNF-α levels, and pregnancy outcomes in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was 93.55%, which was significantly higher than 79.03% in the control group (P<0.05). After treatment, the systolic blood pressure (SBP), diastolic blood pressure (DBP), umbilical blood flow and resistance index in the two groups were significantly lower than those before treatment (P<0.05), and which in the treatment group were significantly lower than that in the control group (P<0.05), the cardiac indexes in the treatment group were significantly higher than that in the control group (P<0.05), which in the treatment group were significantly higher than that in the control group (P<0.05). After treatment, the levels of PT, TT, and APTT in two groups were significantly longer than those before treatment (P<0.05), and which in the treatment group was longer than those in the control group (P<0.05). After treatment, the serum levels of IL-6, CRP and TNF-α in two groups were lower than that before treatment (P<0.05), and which in the treatment group was lower than those in the control group (P<0.05). The cases of premature delivery, cesarean section, postpartum hemorrhage, placental abruption, fetal distress and neonatal asphyxia in the treatment group were lower than those in the control group (P<0.05). Conclusion Methyldopa combined with nicardipine has a significant effect in treatment of hypertension during pregnancy, can significantly reduce blood pressure, improve hemodynamics, reduce inflammation, and significantly reduce adverse pregnancy outcomes.

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