茵栀黄口服液联合丁二磺酸腺苷蛋氨酸及熊去氧胆酸治疗妊娠期肝内胆汁淤积症临床观察

Clinical Observation on Yinzhihuang Oral Liquid Combined with Ademetionine Butanedisulfonate and Ursodeoxycholic Acid in the Treatment of Intrahepatic Cholestasis of Pregnancy

目的探讨茵栀黄口服液联合丁二磺酸腺苷蛋氨酸及熊去氧胆酸治疗妊娠期肝内胆汁淤积症(ICP)的临床疗效。方法选取医院2012年5月至2018年4月收治的ICP患者95例,按随机数字表法分为对照组(47例)和研究组(48例)。两组患者均予注射用丁二磺酸腺苷蛋氨酸及口服熊去氧胆酸胶囊治疗,研究组患者加服茵栀黄口服液,两组均治疗14 d。结果研究组总有效率为95.83%,明显高于对照组的68.09%(P<0.01);治疗7,14 d后,两组患者的皮肤瘙痒症状评分均明显降低,且研究组明显低于对照组(P<0.05);治疗后,两组患者血清总胆汁酸(TBA)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBiL)水平均明显下降,且研究组明显低于对照组(P<0.05);治疗期间,研究组与对照组不良反应发生率相当(4.17%比2.13%,P>0.05)。结论茵栀黄口服液联合熊去氧胆酸、丁二磺酸腺苷蛋氨酸治疗ICP,可显著改善皮肤瘙痒症状,降低血清学指标水平。

Objective To investigate the clinical efficacy of Yinzhihuang Oral Liquid combined with ademetionine butanedisulfonate and ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy(ICP).Methods Totally 95 patients with ICP admitted to our hospital from May 2012 to April 2018 were selected and divided into the control group(n=47) and the study group(n=48)according to the random number table method.The patients in the two groups were treated with ademetionine butanedisulfonate and ursodeoxycholic acid,on this basis,the patients in the study group were treated with Yinzhihuang Oral Liquid.Both groups were treated for 14 d.Results The total effective rate of the study group was 95.83%,which was significantly higher than 68.09% of the control group(P<0.01).After 7 d and 14 d of treatment,the scores of pruritus symptom in the two groups were significantly decreased,and those in the study group were significantly lower than those in the control group(P<0.05).After treatment,the levels of serum total bile acid(TBA),aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bilirubin(TBiL) in the two groups were significantly decreased,and those in the study group were significantly lower than those in the control group(P<0.05).During the treatment,the incidence of adverse reactions in the study group was similar to that in the control group(4.17% vs.2.13%,P>0.05).Conclusion Yinzhihuang Oral Liquid combined with ursodeoxycholic acid and ademetionine butanedisulfonate in the treatment of ICP can significantly improve the symptoms of pruritus and reduce the levels of serological indicators.