中药外用内服治疗妊娠期肝内胆汁淤积症的疗效观察

The observation of curative effect of external application and oral administration of Chinese herbs on intrahepatic cholestasis of pregnancy

目的探讨妊娠期肝内胆汁淤积症的中药外洗内服治疗效果。方法选取2014年9月至2015年9月本院收治的妊娠期肝内胆汁淤积孕妇共60例，随机分为治疗组和对照组，治疗组孕妇采用中药内服外洗方法治疗，而对照组孕妇给予思美泰针静脉注射。结果治疗后治疗组孕妇血清谷草转氨酶[（28．32±6．95）U／L比（40．30±7．51）U/L]、血清谷丙转氨酶[（29．71±5．57）U／L比（45．78±7．80）U／L]、总胆汁酸[（0．99±0．20）μmol／L比（2．39±0．42）μmol/L]、血清胆红素[（15．25±3．93）μmol／L比（27．56±6．20）μmol／L]及直接胆红素[（5．90±1．30）μmol，L比（8．92±2．06）μmol／L]水平均明显低于对照组孕妇（P〈0．05）；治疗后治疗组孕妇的瘙痒症状明显低于对照组孕妇低[（0．86±0．85）比（1．43±0．52）]；治疗组发生早产（10．00％比30．00％）、剖宫产（23．30％比63．33％）、羊水污染（10．00％比33．33％）、胎儿窘迫（6．67％比26．67％）、新生儿窒息（3．33％比20．00％）的情况均明显比对照组少（P〈0．05）。结论中药外洗内服治疗妊娠期肝内胆汁淤积症的疗效明显，能够有效地降低孕产妇的生化指标水平，改善妊娠结局，因此值得在临床上推广。

Objective To explore the curative effect of external washing and oral administration of Chinese herbs on intrahepatic cholestasis of pregnancy. Methods 60 cases of intrahepatic cholestasis of pregnancy in our hospital from September 2014 to September 2015 were randomly divided into treatment group and control group. The treatment group was treated with external washing and oral administration of Chinese herbs, while the control group was treated with transmetil intravenous injection. Results After treatment, the levels of serum aspartate aminotransferase, alanine aminotransferase, total bile acid, serum total bilirubin, and direct bilirubin in the treatment group were significantly higher than those in the control group [（28.32 ± 6.95） U/L vs.（40.30 ± 7.51）U/L, （29.71± 5.57）U/L vs.（45.78 ±7.80）U/L, （0.99 ± 0.20）μmol/L vs.（2.39 ± 0.42）μmol/L, （15.25±3.93） μmol/L vs.（27.56 ± 6.20） μmol/L, （5.90 ±1.30） -tmol/L vs.（8.92 ± 2.06） μmol/L; P〈0.05]. After treatment, the score of itching in the treatment group was lower than that in the control group [（0.86±0.85） vs.（1.43± 0.52）, P〈0.05]. The rates of preterm birth, cesarean delivery, meconium stained amniotic fluid, fetal distress, and neonatal asphyxia in the treatment group were significantly lower than those in the control group （10.00% vs.30.00%, 23.30% vs.63.33%, 10.00% vs.33.33%, 6.67% vs.26.67%, 3.33% vs.20.00%; P〈0.05）. Conclusions External washing and oral administration of Chinese herbs in the treatment of intrahepatic cholestasis of pregnancy has significant curative effect, can effectively reduce the levels of the biochemical indexes of pregnant women, improve the pregnancy outcome, worth promoting in clinical practice.