茵陈蒿汤治疗妊娠期肝内胆汁淤积症30例临床分析

Therapeutic Effect of Yinchenhao Decoction for Intrahepatic Cholestasis of Pregnancy:An Analysis of 30 Cases

目的:观察茵陈蒿汤治疗妊娠期肝内胆汁淤积症(ICP)的临床疗效。方法:将60例ICP患者随机分为2组各30例,基础组予西医基础治疗,茵陈蒿汤组在基础组治疗基础上加用茵陈蒿汤治疗,观察2组治疗前后瘙痒症状、胆汁酸的变化;并设正常妊娠孕妇30例作为正常对照组,比较3组新生儿状况及羊水污染的情况。结果:治疗后2组瘙痒症状评分均降低,与治疗前比较,差异均有显著性意义(P<0.05),2组间瘙痒症状评分比较,差异无显著性意义(P>0.05)。治疗后茵陈蒿汤组血清胆汁酸较治疗前降低(P<0.01);与基础组治疗后比较,差异有非常显著性意义(P<0.01)。治疗后基础组新生儿Apgar评分、出生体重均较茵陈蒿汤组、正常对照组低(P<0.01);茵陈蒿汤组新生儿Apgar评分、出生体重与正常对照组相当(P>0.05)。正常对照组羊水污染情况发生2例,基础组发生7例,茵陈蒿汤组发生5例。结论:茵陈蒿汤联合基础治疗干预ICP,有助于缓解瘙痒,降低血胆汁酸水平,改善新生儿出生情况,降低羊水污染率。

Objective： To investigate the therapeutic effect of Yinchenhao Decoction for intrahepatic cholestasis of pregnancy（ICP）. Methods： Sixty ICP patients were randomly divided into Chinese medicine treatment group and basic treatment group, 30 cases in each group. Both groups were given routine western medicine, and Chinese medicine treatment group was given Yinchenhao Decoction additionally. The changes of pruritus and bile acid before and after treatment were observed in both groups, and the neonatal condition and amniotic fluid pollution in both groups were compared to those of 30 healthy pregnant women （normal group）. Results： Pruritus score was decreased in both treatment groups after treatment （P 〈 0.05 compared to that before treatment）, but the difference between the two treatment groups was insignificant（P 〉 0.05）. Serum bile acid level in Chinese medicine treatment group was also decreased after treatment（P 〈 0.01 compared to that before treatment and to that in the basic treatment group after treatment）. The newborn infants of basic treatment group had lower Apgar score and body weight （P 〈 0.01）, while the Apgar score and body weight of newborn infants in Chinese medicine treatment group were similar to those of the normal group（P 〉 0.05）. Amniotic fluid pollution occurred in 2 cases of normal group, 7 of basic treatment group and 5 of Chinese medicine treatment group. Conclusion： Yinchenhao, Decoction is effective for the treatment of intrahepatic cholestasis of pregnancy based on routine western medicine, which has the effect of relieving pruritus, decreasing serum bile acid, promoting the neonatal condition and reducing amniotic fluid pollution.