熊去氧胆酸联合茵栀黄口服液治疗妊娠期肝内胆汁淤积症的疗效观察

Observation on Therapeutic Effect of Ursodeoxycholic Acid Combined with Yinzhihuang Oral liquid on Intrahepatic Cholestasis of Pregnancy

目的:探讨熊去氧胆酸与茵栀黄口服液对妊娠期肝内胆汁淤积症患者肝功能指标以及妊娠结局的影响。方法:将2016年6月—2018年6月我院收治的100例妊娠期肝内胆汁淤积症患者纳为研究对象,按随机数字表法分为两组,各50例。对照组单一采用熊去氧胆酸(20 mg/次,qid)治疗,观察组采用熊去氧胆酸与茵栀黄口服液(10 mL,tid)联合治疗,比较两组肝功能指标以及妊娠结局。结果:治疗前,两组肝功能指标比较,差异无统计学意义(P> 0.05);治疗后,观察组总胆汁酸(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)水平均低于对照组,差异有统计学意义(P <0.05);观察组胎儿窘迫、羊水污染、剖宫产、早产发生率均低于对照组,差异有统计学意义(P <0.05);观察组新生儿出生体质量高于对照组,差异有统计学意义(P <0.05)。结论:熊去氧胆酸与茵栀黄口服液联合治疗妊娠期肝内胆汁淤积症,可有效缓解患者肝脏损伤,改善妊娠结局。

Objective:To investigate the effect of ursodeoxycholic acid and yinzhihuang oral liquid on liver function indexes and pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy.Methods:100 patients with intrahepatic cholestasis of pregnancy who were admitted to our hospital from June 2016 to June 2018 were enrolled as subjects investigated,and they were randomly divided into two groups,50 cases each.The patients in the control group were treated with ursodeoxycholic acid(20 mg/time,qid),and the patients in the observation group were treated with ursodeoxycholic acid and yinzhihuang oral liquid(10 mL,tid).The liver function indexes and pregnancy outcomes were compared between the two groups.Results:There were no statistically significant differences in liver function indexes before treatment between the two groups(P>0.05).After treatment,the levels of total bile acid(TBA),aspartate aminotransferase(AST),alanine aminotransferase(ALT)and total bilirubin(TBIL)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidences of fetal distress,amniotic fluid contamination,cesarean section and premature delivery in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The birth weight of the newborns in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Ursodeoxycholic acid combined with yinzhihuang oral liquid can effectively alleviate liver injury and improve pregnancy outcomes in the treatment of intrahepatic cholestasis of pregnancy.