胆瘀方结合熊去氧胆酸片及丁二磺酸腺苷蛋氨酸治疗妊娠期肝内胆汁淤积症的临床分析

Clinical analysis of cholestasis of intrahepatic cholestasis in gestation with ursodeoxycholic acid tablets and adenosylmethionine disulfonic acid two in the treatment of pregnancy

目的探讨胆瘀方结合熊去氧胆酸片及丁二磺酸腺苷蛋氨酸治疗妊娠期肝内胆汁淤积症对患者疗效、血清促甲状腺激素(thyroid stimulating hormone,TSH)、甲状腺过氧酶抗体(thyroid peroxisase antibody,TPOAb)、白细胞介素18(interleukin-18,IL-18)及血清肿瘤坏死因子α(tumor necrosis factor,TNF-α)水平及母婴结局的影响分析。方法收集在邢台市第九医院就诊的126例妊娠期肝内胆汁淤积症患者,随机分为研究组与对照组,每组63例,对照组采用熊去氧胆酸片及丁二磺酸腺苷蛋氨酸进行治疗,研究组则在此基础上联合使用中药胆瘀方进行治疗。同期收集体检健康的100例妊娠孕妇作为健康组,检测2组患者及健康志愿者的血清TSH、TPOAb、IL-18及TNF-α水平,观察2组患者的疗效及不良妊娠结局情况。结果对照组和研究组患者治疗前血清TSH、TPOAb、IL-18和TNF-α差异无统计学意义(P>0.05),且均高于健康组(P<0.05);治疗后,2组患者血清TSH、TPOAb、IL-18和TNF-α值均有明显改善,但研究组较对照组改善更为显著(P<0.05)。研究组患者的总有效率显著高于对照组(P<0.05),研究组患者的不良妊娠结局发生率显著低于对照组(P<0.05)。结论采用中西医结合治疗妊娠期肝内胆汁淤积症,可有效改善患者血清TSH、TPOAb、IL-18及TNF-α水平,提高患者疗效,对母婴结局具有良好的保障作用。

To investigate the effect of bile stasis combined with ursodeoxycholic acid tablets and ademetionine1,4-butanedisulfonate on the treatment of intrahepatic cholestasis of pregnancy,serum TSH,TPOAb,IL-18and TNF-alpha levels,and maternal and child outcomes.Methods One hundred and twenty-six cases of intrahepatic cholestasis of pregnancy treated in our hospital were equally and randomly divided into the study group and control group.The control group was treated with ursodeoxycholic acid tablets and ademetionine1,4-butanedisulfonate,while the study group was additionally given bile stasis,a traditional Chinese medicine.Another100healthy pregnant women served as the healthy group.The serum levels of TSH,TPOAb,IL-18and TNF-alpha of the three groups were tested to observe the curative effect in the first two groups of patients and pregnancy outcomes.Results The serum TSH,TPOAb,IL-18and TNF-alpha levels in the two groups of patients were not significantly different(P>0.05),but were higher than those in the healthy group(P<0.05).After treatment,serum TSH,TPOAb,IL-18and TNF-alpha levels of the two groups of patients were significantly improved,especially in the study group(P<0.05).The total effective rate in the study group was significantly higher than that in the control group(P<0.05),and the incidence of adverse pregnancy outcomes in the study group was significantly lower than that in the control group(P<0.05).Conclusion The treatment of intrahepatic cholestasis of pregnancy with traditional Chinese medicine and Western medicine can effectively improve the serum levels of TSH,TPOAb,IL-18and TNF-alpha,improve the curative effect,and help ensure good maternal and child outcomes.