中西医结合疗法对妊娠期肝内胆汁淤积症孕产妇妊娠结局的影响

Effect of Combined Traditional Chinese and Western Medicine Therapy on Pregnancy Outcome in Pregnant Women with Intrahepatic Cholestasis of Pregnancy

目的 探究中西医结合疗法对妊娠期肝内胆汁淤积症孕产妇妊娠结局的影响,为当前临床治疗提供参考意见。方法 方便2020年1—12月就诊于厦门莲花医院的84例妊娠期肝内胆汁淤积症孕产妇作为研究对象,分为对照组和观察组,每组42例。其中,对照组孕产妇接受常规西药治疗,观察组孕产妇则在此基础上给予中西医结合疗法进行治疗。比较两组孕产妇治疗前后的肝功能、瘙痒评分、妊娠结局及用药不良反应。结果观察组孕产妇ALT、AST、TB、CG指标分别为(69.45±13.51)U/L、(70.82±22.59)U/L、(12.25±5.28)μmol/L、(663.47±82.69)μg/L明显优于对照组的(77.27±14.35)U/L、(81.42±24.71)U/L、(15.17±5.56)μmol/L、(783.25±88.52)μg/L,差异有统计学意义(t=2.571、2.052、2.468、6.408,P<0.001);Ribalta评分(1.59±0.42)分低于对照组的(1.85±0.48)分,差异有统计学意义(P<0.05);分娩不良率11.90%明显低于对照组孕产妇的42.85%,差异有统计学意义(P<0.05);观察组不良反应率为23.81%与对照组的19.05%对比,差异无统计学意义(P>0.05)。结论 在妊娠期肝内胆汁淤积症孕产妇治疗中,中西医结合疗法能够改善孕产妇的肝功能,缓解临床症状,改善分娩结局,安全有效,值得推广应用。

Objective To investigate the effect of combined Chinese and Western medicine therapy on pregnancy outcome in pregnant women with intrahepatic cholestasis of pregnancy,and to provide reference opinions for current clinical treatment.Methods Conveniently select 84 pregnant women with intrahepatic cholestasis of pregnancy who were hospitalized in Xiamen Lotus Hospital from January to December 2020 were divided into a control group and an observation group,with 42 cases in each group.Among them,the pregnant women in the control group received conventional western medicine treatment,while the pregnant women in the observation group were treated with integrated traditional Chinese and Western medicine on this basis.The liver function,pruritus score,pregnancy outcome,and adverse drug reactions of the two groups of pregnant women before and after treatment were compared.Results The maternal ALT,AST,TB and CG indexes of the observation group were(69.45±13.51)U/L,(70.82±22.59)U/L,(12.25±5.28)μmol/L,(663.47±82.69)μg/L respectively,which were significantly better than those of the control group(77.27±14.35)U/L,(81.42±24.71)U/L,(15.17±5.56)μmol/L,(783.25±88.52)μg/L in the control group,the difference was statistically significant(t=2.571,2.052,2.468,6.408,P<0.001).The Ribalta score in the observation group(1.59±0.42)points was lower than that of the control group(1.85±0.48)points,the difference was statistically significant(P<0.05).The adverse delivery rate in the observation group was 11.90%significantly lower than that in the control group of 42.85%of mothers,and the difference was statistically significant(P<0.05).The difference was not statistically significant when comparing the adverse reaction rate of 23.81%in the observation group with 19.05%in the control group(P>0.05).Conclusion In the treatment of maternal intrahepatic cholestasis during pregnancy,combined traditional Chinese and Western medicine therapy can improve maternal liver function,alleviate clinical symptoms and improve delivery outcomes,which is safe and effective and worthy of promotion and application.