利胆汤联合西药治疗妊娠期肝内胆汁淤积综合征临床观察

Clinical Observation of Lidan Tang Combined with Western Medicine for Intrahepatic Cholestasis in Pregnancy

目的:观察利胆汤联合西药治疗妊娠期肝内胆汁淤积综合征(ICP)的临床疗效。方法:选取80例ICP患者,按照入院先后顺序分为西药组与联合组各40例。西药组给予西药治疗,联合组在西药组用药基础上加用利胆汤。治疗后比较2组临床疗效,观察2组血清总胆汁酸水平、瘙痒程度评分及肝功能指标的变化,记录2组不良妊娠结局发生情况。结果:联合组治疗总有效率95.0%,西药组治疗总有效率75.0%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组血清总胆汁酸水平及瘙痒程度评分均较治疗前降低(P<0.05);联合组的血清总胆汁酸水平和瘙痒程度评分均低于西药组(P<0.05)。治疗后,2组血清谷草转氨酶(AST)、谷丙转氨酶(ALT)、直接胆红素(DBil)、间接胆红素(IBil)及总胆红素(TBil)水平均较治疗前降低,差异均有统计学意义(P<0.05);联合组5项肝功能指标水平均较西药组降低更显著,差异均有统计学意义(P<0.05)。联合组不良妊娠结局发生率7.5%,西药组不良妊娠结局发生率25.0%,2组比较,差异有统计学意义(P<0.05)。结论:利胆汤联合西药治疗可改善ICP患者的总胆汁酸水平,降低对肝脏的损伤,改善妊娠结局,缓解瘙痒症状,效果显著。

Objective：To observe the clinical effect of Lidan tang combined with western medicinein in treating intrahepatic cholestasis in pregnancy（ICP）. Methods：Selected 80 cases of ICP patients,then according to the sequence of hospitalization,divided them into the western medicine group and the combination group randomly,40 cases in each group.Both groups received western medicine for treatment, while the combination group additionally received Lidan tang for treatment. Compared the clinical effect in the two groups after treatment. Observed changes of serum total bile acid level,pruritus score and liver function index in both groups. Recorded adverse pregnancy outcomes in both groups. Results：The total effective rate was 95.0% in the combination group and 75.0% in western medicine group, the difference being significant（P〈0.05）. After treatment, serum total bile acid levels and pruritus scores in both groups were declined when compared with those before treatment（P〈0.05）,and serum total bile acid levels and pruritus scores in the combination group were both lower than those in western medicine group（P〈0.05）. After treatment,serum levels of aspartate aminotransferase（AST）,alanine aminotransferase（ALT）,direct bilirubin（DBil）,indirect bilirubin（IBil） and total bilirubin（TBil） in both groups were both decreased,comparing with those before treatment,differences being significant（P〈0.05）. The decrease of the levels of liver function indexes in the combination group was more obvious than that in western medicine group（P〈0.05）. The incidence of adverse pregnancy outcome was 7.5% in the combination group and 25.0% in western medicine group, the difference being significant（P〈0.05）. Conclusion：The therapy of Lidan tang combined with western medicine for intrahepatic cholestasis in pregnancy（ICP） can improve the total bile acid levels of patients, reduce the damage degree of liver, improve the pregnancy outcomes,and relieve pruritus symptoms,which has significant effect.