茵陈丹芍汤治疗妊娠中期轻度妊娠期肝内胆汁淤积症的临床观察

THE CLINICAL OBSERVATION ABOUT TREATMENT ON LOW GRADE INTRAHEPATIC CHOLESTASIS IN THE MID TRIMESTER OF PREGNANCY WITH YINCHEN - DANSHAO DECOCTION

目的观察茵陈丹芍汤治疗妊娠中期轻度妊娠期肝内胆汁淤积症(ICP)的临床疗效,探讨其作用机理。方法孕25～28周轻度ICP患者30例,口服茵陈丹芍汤治疗2周,观察治疗前后的瘙痒评分并用速率法检测血清胆汁酸(TBA)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)和尿液总胆汁酸的浓度。结果治疗后与治疗前比较瘙痒评分和血清TBA、ALT显著下降(p<0.01,p<0.05),血清TBA与尿液TBA浓度的比值显著下降(p<0.01)。结论茵陈丹芍汤能有效治疗ICP,其疗效机理可能与增加尿液中总胆汁酸的排泄有关。

Objective To observe the clinical therapeutic effect of treatment on low grade intrahepatic cholestasis of pregnancy in the mid trimester of pregnancy with Yinchen-Danshao（YCDS） decoction and to explore its mechanism of action.Methods 30 women whose gestational age was from 25 weeks to 28 weeks diagnosed as ICP were treated with YCDS decoction for 2 weeks.We observed their pruritus score,detected concentrations of serum total bile acid（TBA）,serum alanine aminotransferase（ALT）,serum aspartate transaminase（AST） and urine TBA by velocimetry respectively.Results Pruritus score and concentrations of serum TBA and serum AST of 30 women diagnosed as ICP treated with YCDS decoction were significantly descend compared with those of pretherapy（p〈0.01,p〈0.05）,meanwhile the relative value were also significantly descend（p〈0.01）.Conclusion YCDS decoction can treat ICP validly and its mechanism of action may be concerned with increase excretion of urine TBA.