抗淤胆汤治疗妊娠合并胆汁酸淤积疗效及对前列环素、血栓素水平的影响

Study on Influence of Anti-cholestasis Decoction in Treatment of Pregnancy Complicated with Cholestasis on Clinical Curative Effect, Prostaglandin and Thromboxane Levels

目的探讨抗淤胆汤对妊娠合并胆汁酸淤积的临床疗效、前列环素及血栓素水平的影响。方法将妊娠合并胆汁酸淤积患者72例,随机分两组,分别36例,对照组采用熊去氧胆酸和腺苷蛋氨酸治疗,观察组采用熊去氧胆酸和腺苷蛋氨酸治疗联合抗淤胆汤治疗,每日1剂,治疗2周为1个疗程。比较两组患者临床疗效、直观模拟尺评分(Visualanaloguescale,VAS)及血总胆汁酸(total bile acids,TBA)、丙氨酸氨基转移酶(Alanine aminotransferase,ALT)、血栓素B2(Thromboxane B2,TXB2)、6酮-前列腺素Flα(6-keto-prostaglandin Flalpha,6-keto-PGF1α)的水平,随访评价母婴结局。结果对照组有效率77.78%(24/36)低于观察组94.44%(34/36),差异具有统计学意义(P<0.05)。两组孕妇治疗前VAS评分及血TBA、ALT、TXB2、6-keto-PGF1α比较,差异无统计学意义(P>0.05)。治疗后对照组和观察组VAS评分为(2.12±1.24)、(1.10±0.67),血TBA为(18.56±6.27)μmol/L、(13.75±5.30)μmol/L,血ALT为(102.33±24.67)U/L、(76.94±22.58)U/L,血TXB2为(161.72±25.94)ng/L、(140.53±24.51)ng/L,血6-keto-PGF1α为(38.64±12.47)ng/L、(56.91±14.55)ng/L,对照组和观察组上述指标比较,差异具有统计学意义(P<0.05)。两组孕妇母婴结局指标比较,差异无统计学意义(P>0.05)。结论抗淤胆汤对妊娠合并胆汁酸淤积的临床疗效显著,改善肝功能,降低总胆汁酸,纠正高凝状态,且母婴预后好。

Objective To investigate the effect of Anti-cholestasis Decoction in the treatment of pregnancy complicated with cholestasis on clinical curative effect,prostaglandin and thromboxane levels.Methods Seventy-two cases of pregnancy complicated with cholestasis in our hospitalwere randomly divided into two groups,36 cases in each group.The control group was treated with ursodeoxycholic acid and adenosylmethionine and the observation group was additionally treated with Anti-cholestasis Decoction,one dose a day,two weeks as a course of treatment.The clinical efficacy,visual analogue scale(VAS),levels of total bile acids(TBA),alanine aminotransferase(ALT),thromboxane B2(TXB2),6-keto-prostaglandFlalpha(6-keto-prostaglandin Flalpha,6-keto-PGF1 a)were compared between the two groups,and the maternal and infant outcomes were evaluated.Results The effective rate of the control group(77.78%,24/36)was lower thanthat of the observation group(94.44%,34/36)(P<0.05).There was no significant difference in VAS score,TBA,ALT,TXB2 or 6-keto-PGF1 alpha between the two groups before treatment(P>0.05).After treatment,the VAS scores of the control group and observation group were 2.12±1.24 and 1.10±0.67,respectively.The levels of TBAin blood of the control group and observation groupwere(18.56±6.27)μmol/L and(13.75±5.30)μmol/L,respectively.The levels of ALT in blood of the control group and observation group were(102.33±24.67)U/L and(76.94±22.58)U/L,respectively.The levels of TXB2 in blood of the control group and observation group were(161.72±25.94)ng/L and(140.53±24.51)ng/L,respectively.The level of 6-keto-PGF1αin blood of the control group and observation group were(38.64±12.47)ng/L and(56.91±14.55)ng/L,respectively.And there were significant differences in the above indexes between the two groups(P<0.05).There was no significant difference in maternal or infant outcomes between the two groups(P>0.05).Conclusion Anti-cholestasis Decoction has remarkable clinical effect on pregnancy complicated with cholestasis.It can improve liver function,reduce total bile acid,correct hypercoagulable state,and has good prognosis of mother and infant.