茵栀黄颗粒联合熊去氧胆酸片治疗妊娠期肝内胆汁淤积症临床研究

Clinical Study on Yinzhihuang Granules Combined with Ursodeoxycholic Acid Tablets for Intrahepatic Cholestasis of Pregnancy

目的:观察茵栀黄颗粒联合熊去氧胆酸片治疗妊娠期肝内胆汁淤积症(ICP)的临床疗效。方法:选取96例ICP患者,按照随机数字表法分为对照组和观察组各48例。对照组给予熊去氧胆酸片治疗,观察组在对照组基础上加用茵栀黄颗粒治疗,2组均治疗15 d,随访至妊娠结束。比较2组治疗前后肝功能、瘙痒症状评分;比较2组临床疗效、妊娠结局。结果:治疗后,2组天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆汁酸(TBA)、总胆红素(TBil)水平均较治疗前降低,观察组AST、ALT、TBA、TBil水平均低于对照组(P<0.05)。观察组总有效率为93.75%,高于对照组的79.17%(P<0.05)。治疗后,2组瘙痒症状评分均较治疗前降低(P<0.05),观察组瘙痒症状评分低于对照组(P<0.05)。观察组羊水污染、胎儿窘迫、早产发生率均低于对照组(P<0.05)。结论:茵栀黄颗粒联合熊去氧胆酸片治疗ICP可提高临床疗效,缓解患者的瘙痒症状,改善其肝功能和妊娠结局。

Objective:To observe the clinical effect of Yinzhihuang granules combined with ursodeoxycholic acid tablets for intrahepatic cholestasis of pregnancy(ICP).Methods:A total of 96 cases of ICP patients were selected and divided into the control group and the observation group according to the random number table method,48 cases in each group.The control group was treated with ursodeoxycholic acid tablets,and the observation group was additionally treated with Yinzhihuang granules based on the treatment of the control group.Both groups were treated for 15 days,follow up until delivery.The scores of liver function and pruritus symptom before and after treatment,clinical effects and pregnancy outcomes in the two groups were compared.Results:After treatment,the levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bile acid(TBA)and total bilirubin(TBil)in the two groups were decreased when compared with those before treatment,and the levels of AST,ALT,TBA and TBil in the observation group were lower than those in the control group(P<0.05).The total effective rate was 93.75%in the observation group,higher than that of 79.17%in the control group(P<0.05).After treatment,pruritus symptom score in the two groups were decreased when compared with those before treatment(P<0.05),and pruritus symptom score in the observation group was lower than that in the control group(P<0.05).The incidences of amniotic fluid contamination,fetal distress and premature delivery in the observation group were lower than those in the control group(P<0.05).Conclusion:The therapy of Yinzhihuang granules combined with ursodeoxycholic acid tablets for ICP can enhance the clinical effect,relieve the pruritus symptom of patients,and improve liver function and pregnancy outcome.