易善复注射液对妊娠晚期肝内胆汁淤积症联合用药治疗的影响

Effect of polyene phosphatidylcholine injection on combination therapy of intrahepatic cholestasis of pregnancy

目的观察易善复注射液对妊娠期肝内胆汁淤积症(ICP)联合用药治疗疗效的影响。方法将78例符合ICP诊断标准的患者随机分成两组,对照组采用思美泰及熊去氧胆酸联合用药治疗10 d,研究组在对照组联合用药的基础上加用易善复注射液治疗10 d。观察并比较两组患者治疗前后临床症状、血清生化指标的改善程度及妊娠转归。结果治疗后两组患者瘙痒症状均有改善(P<0.01),研究组改善更明显,两组间瘙痒评分差异有统计学意义(P<0.05)。两组治疗后血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TB)、直接胆红素(DB)、总胆汁酸(TBA)的水平明显降低(P<0.01),但观察组下降更明显,两组间的差异有统计学意义(P<0.05)。治疗后观察组胎儿窘迫、早产及产后出血的发生率较对照组低(P<0.05)。结论易善复注射液能进一步地提高思美泰及熊去氧胆酸联合用药治疗ICP的临床效果,并更好地改善妊娠结果。

Objective To evaluate the effect of polyene phosphatidylcholine injection on combination therapy of intrahepatic cholestasis of pregnancy（ ICP）. Methods Seventy-eight cases of ICP were enrolled and randomly divided into treatment and control group. The patients in treatment group were treated with sadenosyl methionine combinded with polyene phosphatidylcholine injection,and those in control group were treated with sadenosyl methionine for 10 days. The changes in itching symptom,liver function（ AST,ALT,TBA,TB,DB）,and pregnancy outcome were compared between the two groups. Results After treatment,the itching symptom relived significantly in both groups（ P〈0. 01）. The itching symptom relived more significantly in control group,there was significant difference in itching score between the two groups（ P〈0. 05）. The serum AST,ALT,TBA,TB and DB decreased significantly after treatment in both groups（ P〈0. 01）,and the decrease was more remarkable in treatment group（ P〈0. 05）. The incidences of contaminated amniotic fluid,premature and fetal distress,preterm labor in treatment group were all significantly lower than those in control group（ P〈0. 05）. Conclusion Polyene phosphatidylcholine injection can further improve the effects of combination therapy on ICP and better improve prengnancy outcomes.