中西医结合治疗妊娠期肝内胆汁淤积症初探

发布时间：2019-03-27 20:31

【摘要】：目的评估复方丹参注射液联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症的临床疗效及对新生儿预后的影响。方法选择妊娠期肝内胆汁淤积症患者128例,分成两组。治疗组72例采用复方丹参注射液(20mL加入10%葡萄糖注射液500mL静脉滴注,每天1次)和熊去氧胆酸[15mg/(kg.d),分3次口服]联合治疗;对照组56例采用熊去氧胆酸治疗;均以14天为1个疗程。观察两组治疗前后瘙痒评分、血清生化指标[甘胆酸(CG)、总胆红素(TBiL)、谷丙转氨酶(ALT)及谷草转氨酶(AST)]变化及分娩后比较两组围生儿情况。结果两组治疗后瘙痒评分均明显降低,治疗组由3.6分降至1.4分,对照组由3.4分降至1.6分,两组评分比较差异无统计学意义(P0.05),但起效时间治疗组(4～6天)较对照组(8～10天)更快;两组血清CG、TBiL、ALT及AST均较治疗前下降(P0.01),治疗组较对照组下降更明显,差异有统计学意义(P0.05)。治疗后两组间胎儿窘迫、羊水粪染和新生儿窒息发生率比较,差异均无统计学意义(P0.05);但新生儿体重治疗组[(3108±236)g]大于对照组[(2681±269)g],差异有统计学意义(P0.05)。结论复方丹参注射液联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症,疗效优于单用熊去氧胆酸治疗者。
[Abstract]:Objective to evaluate the clinical efficacy and prognosis of compound salvia miltiorrhiza injection combined with ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy. Methods 128 patients with intrahepatic cholestasis of pregnancy were divided into two groups. 72 cases in the treatment group were treated with compound salvia miltiorrhiza injection (20mL plus 10% glucose injection 500mL intravenous drip once a day) and ursodeoxycholic acid (15mg/ (kg.d) 3 times orally). 56 cases in the control group were treated with ursodeoxycholic acid for 14 days as a course of treatment. The changes of pruritus score, serum biochemical indexes [total bilirubin (TBiL), glutamic pyruvic transaminase (ALT) and glutamic oxaloacetic transaminase (AST)] in the two groups were observed before and after treatment, and the perinatal conditions of the two groups were compared after delivery. Results after treatment, the pruritus scores of the two groups decreased significantly, from 3.6 to 1.4 in the treatment group and from 3.4 to 1.6 in the control group. There was no significant difference in the scores between the two groups (P0.05). However, the onset time of the treatment group (4 days, 6 days) was faster than that of the control group (8 days, 10 days). The levels of serum CG,TBiL,ALT and AST in the two groups were significantly lower than those in the control group (P0.01), and the difference was statistically significant (P0.05). There was no significant difference in the incidence of fetal distress, amniotic fluid meconium staining and neonatal asphyxia between the two groups after treatment (P0.05). But the neonatal weight treatment group [(3108 卤236g)] was higher than the control group [(2681 卤269g)], the difference was statistically significant (P0.05). Conclusion compound salvia miltiorrhiza injection combined with ursodeoxycholic acid is more effective than ursodeoxycholic acid alone in the treatment of intrahepatic cholestasis of pregnancy.
【作者单位】：西安交通大学医学院第一附属医院妇产科;
【分类号】：R714.25

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