A Clinical Study On Effect Of Eucommia Particles Therapy In Patients With Hypertensive Disorder Complicating Pregnancy

Background and ObjectiveHypertensive disorder complicating pregnancy(HDCP) is a characteristic disease during gestational period. In our country the incidence of9.4%-10.4%,7%-12%abroad, which is seriously affect the safety of fetal and maternal morbidity and badly compromised the health of mothers and infants. Currently in treatment of patients with early-onset severe preeclampsia is still less than ideal, so scholars at home and abroad began to focus on the study of early detection and early treatment of HDCP. Until now there is no single reliable, cost-effective screening test for early-onset preeclampsia, and there are no well-established measures for primary prevention. Terminating the pregnancy is the most effective treatment for these patients.We studied the application of eucommia particles in treating gravid with gestational hypertension and mild preeclampsia developped before32gestational weeks, observing the efficacy and safety of eucommia particles in the treatment of HDCP and possible mechanisms in the process.MethodsInclusion criteria:all objects were be diagnosed with gestational hypertension or mild preeclampsia, whose gestational age were less than32weeks and treatment time were no less than4weeks, could finish the examination on this experiment requires, and without diabetes, without the history of cardiovascular diseases, cerebrovascular disease, liver disease and nephropathy, without complication such as such as premature rupture of membranes, placenta praevia, placental abruption. Agree taking eucommia particles and signed informed consent form.The80cases were enrolled who treated in the Second Clinical College of Zhengzhou University obstetrics from August2010to January2012with hypertensive disorder complicating pregnancy,.They were divided into treatment group (40cases) and control group (40cases). Each group,patients with gestational hypertension and mild preeclampsia were20cases,respectively.The control group used conventional treatment. The treatment group took eucommia particles5g orally,2times per day,until delivery. Closely monitored maternal and fetal status during the treatment process, made routine urianlysis each two-day. Before the therapy and four weeks later, took hemodynamic test and the24-hour ambulatory blood pressure monitoring, used ELISA to determination the serum eNOS、ET-1level in the patients.At last, evaluated the outcomes of mother and infant after termination of pregnancy.Statistical analysesAll statistical analyses were performed by SPSS version17.0statistical software.Measurement data were compared by t test, while numeration data were compared by χ-test. P<0.05was considered statistically significant.Results1the serum eNOS、ET-1level(1) Before treatment, the serum eNOS level in patients with gestational hypertension and mild preeclampsia in the treatment group compared with the control group, respectively, the difference was not statistically significant (P>0.05).After four weeks’ therapy, the serum eNOS level in patients with gestational hypertension and mild preeclampsia of treatment group were significantly higher than the control group, the difference was statistically significant (P<0.05).(2) Before treatment, the serum ET-1level in patients with gestational hypertension and mild preeclampsia in the treatment group compared with the control group, respectively, the difference was not statistically significant (P>0.05).After four weeks’ therapy, the serum ET-1level in patients with gestational hypertension and mild preeclampsia of treatment group were significantly lower than the control group, the difference was statistically significant (P<0.05).2Clinical examination index comparison(1) After two weeks’ therapy:the results showed positive rates for qualitative urinary protein(±and more) of22.5%for treatment group and55%for control group, the difference was statistically significant (P<0.05).(2) After four weeks’ therapy:with the total effective rate of cardiac function improvement, the treatment group surpass the control group, the difference was statistically significant (P<0.05).(3) The24-hour ambulatory blood pressure monitoring results:after four weeks’ therapy, the mean of day and night systolic blood pressure(SBP) and diastolic blood pressure (DBP) of the treatment group were lower than the control group, the difference was statistically significant (P<0.05). The nocturnal reduction rate (NRR) of SBP and DBP in the treatment group compared with the control group, the difference was not statistically significant (P>0.05).3The pregnancy outcomeAfter the end of treatment, extending the time of gestational age, mother complications, birth weight,1-minute Apgar scores and newborn turn to department of paediatrics in the treatment group compared with the control group differences were statistically significant (P<0.05).4Adverse reactions(1) All pregnant women in the process of taking Eucommia particles did not appear headache, nausea, heart palpitations, allergic reaction, et al.(2) All the subjects newborn were not found abnormalities.Conclusions1Eucommia particles can adjust the serum eNOS, ET-1level of the HDCP patients, suggesting that it had the function of protect endothelial cells.2Eucommia particles can be significantly improved cardiac function,reduce blood pressure and proteinuria in patients with HDCP. 3Eucommia particles can obviously improve maternal and fetal outcomes in patients with HDCP, with little side effects, which provides a new way for the therapy in patients with HDCP whose gestational age were less than32weeks.