金茵化瘀方联合丁二磺酸腺苷蛋氨酸对妊娠期肝内胆汁淤积症肝酶指标及脂质过氧化物的影响

Effect of Jinying Huayu Decoction Combined with Adenosine Methionine Dibutyrate on Liver Enzymes and Lipid Peroxidation in Patients with Intrahepatic Cholestasis of Pregnancy

目的:观察金茵化瘀方联合丁二磺酸腺苷蛋氨酸治疗妊娠期肝内胆汁淤积症患者的临床疗效,及对肝酶指标及脂质过氧化物的影响。方法:将94例妊娠期肝内胆汁淤积症患者随机分为两组。对照组静脉滴注丁二磺酸腺苷蛋氨酸,1000 mg/次,1次/d;观察组在对照组治疗的基础上给予金茵化瘀方治疗,每日1剂,两组均连续治疗两周。比较治疗前后两组患者瘙痒症状改善情况、肝功能指标、脂质过氧化物指标;比较两组治疗后的临床疗效、妊娠结局及不良反应。结果:观察组的总有效率为91.5%,对照组的临床总有效率为76.6%,两组比较差异有统计学意义(P<0.05)。治疗后观察组的瘙痒评分明显低于对照组,两组比较有统计学差异(P<0.05)。两组治疗后ALT、AST、DBIL、TBA及TBIL水平显著降低,并且观察组的指标低于对照组(P<0.05);对照组治疗后MDA、SOD、GSH及NO水平没有明显变化,而观察组的指标治疗后显著降低(P<0.05),两组比较有统计学差异(P<0.05)。观察组的经阴分娩例数明显高于对照组(P<0.05),产妇并发症明显少于对照组(P<0.05),观察组的新生儿情况由于对照组(P<0.05)。观察组的不良反应发生率明显低于对照组,两组比较有统计学差异(P<0.05)。结论:金茵化瘀方联合丁二磺酸腺苷蛋氨酸治疗妊娠期肝内胆汁淤积症临床疗效确切,有效调节肝酶指标及脂质过氧化物水平,值得临床推广使用。

Objective: To observe the clinical efficacy of Jinying Huayu Decoction and adenosine methionine dimercaptosuccinate in the treatment of intrahepatic cholestasis of pregnancyand evaluate the effects of hepatic enzymes and lipid peroxides. Methods: Ninety-four patients with intrahepatic cholestasis during pregnancy were randomly divided into two groups. The patients in the control group were intravenously infused with adenosine methionine diniethylsulphate, 1000 mg/time, once a day. Patients in the observation group were treated with Jinyin Huayu Decoction on the basis of treatment in the control group, one dose per day. Both groups were continuouslvtreated for two weeks. The pruritus symptom, liver function index and lipid peroxide indexes were compared between the two groups before and after treatment. The clinical efficacy, pregnancy outcomes and adverse reactions were compared between the two groups after treatment. Results :The total effective rate was 91.5% in the observation group and 76. 6% in the control group. The difference between the two groups was statistically significant ( P < 0. 05). After treatment, the itch score of the observation group was significantly lower than that of the control group, and there was a statistically significant difference between the two groups (P <0. 05). The levels of ALT, AST, DBIL, IB A and TBIL were significantly lower in the two groups after treatment, and the indexes in the observation group were lower than those in the control group ( P < 0. 05 ). The levels of MDA, SOD, GSH and NO in the control group did not change significantly after treatment. The index of the group was significantly decreased after treatment( P < 0. 05 ), and there was a statistical difference between the two groups ( P < 0. 05 ). The number of cases of vaginal delivery in the observation group was significantly higher than that in the control group (P < 0. 05 ). The maternal complications were significantly less than that of the control group ( P < 0. 05 ), and the neonatal condition in the observation group was superior to that of the control group( P <0. 05 ). The incidence of adverse reactions in the observation group was significantly lower than that in the control groupand there was a statistically significant difference between the two groups( P <0. 05 ). Conclusion : Jinyin Huayu Decoction combined with adenosine methionine succinate is effective in the treatment of intrahepatic cholestasis of pregnancy and can effectively regulate liver enzymes and lipid peroxide levels, worthy of clinical application.