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目的观察妊娠期肝内胆汁淤积症患者应用熊去氧胆酸联合茵栀黄口服液治疗的效果和安全性。方法妊娠期肝内胆汁淤积症患者60例,依据治疗方法分为治疗组与对照组各30例,治疗组给予熊去氧胆酸250mg/次,4次/d,口服;茵栀黄口服液10mL/次,3次/d,口服;对照组仅给予熊去氧胆酸,用法、用量同治疗组。2组均连续治疗20d。比较2组治疗前、后瘙痒症状评分,血清总胆汁酸、总胆红素、直接胆红素、谷草转氨酶,谷丙转氨酶水平,记录妊娠结局。结果治疗组治疗后瘙痒症状评分、总胆汁酸、总胆红素、直接胆红素、谷丙转氨酶((0.57±0.68)分、(12.37±2.81)μmol/L、(13.74±2.84)μmol/L、(7.51±1.35)μmol/L、(68.78±12.85)u/L)较对照组((0.93±0.70)分、(14.60±4.79)μmol/L、(16.30±4.16)μmol/L、(9.91±2.39)μmol/L、(78.26±11.46)u/L)明显降低(P<0.05);谷草转氨酶水平及以上指标2组治疗后均较治疗前下降(P<0.05);治疗组新生儿出生体质量(2 845.00±341.93)g高于对照组(2 545.00±274.63)g(P<0.05),剖宫产率和早产率(83.33%、20.00%)与对照组(79.31%、24.14%)比较差异无统计学意义(P>0.05)。结论茵栀黄口服液联合熊去氧胆酸治疗肝内胆汁淤积症疗效优于单用熊去氧胆酸治疗。
Objective To observe the effect and safety of ursodeoxycholic acid combined with Yinzhihuang oral liquid in patients with intrahepatic cholestasis of pregnancy. Methods Sixty patients with intrahepatic cholestasis of pregnancy were divided into treatment group (30 cases) and control group (30 cases). The treatment group was given ursodeoxycholic acid (250 mg / time, 4 times daily), and Yinzhihuang Oral Liquid 10mL / time, 3 times / d, orally; control group was given only ursodeoxycholic acid, usage, dosage the same treatment group. 2 groups were treated for 20 days. The scores of pruritus symptoms, total bile acid, total bilirubin, direct bilirubin, aspartate aminotransferase, and alanine aminotransferase were compared between the two groups before and after treatment to record the pregnancy outcome. Results The scores of pruritus symptoms, total bile acid, total bilirubin, direct bilirubin, alanine aminotransferase (0.57 ± 0.68), (12.37 ± 2.81) μmol / L and (13.74 ± 2.84) μmol / L, (7.51 ± 1.35) μmol / L and (68.78 ± 12.85) u / L, respectively, were significantly higher than those in the control group (0.93 ± 0.70, 14.60 ± 4.79 and 16.30 ± 4.16 μmol / 9.91 ± 2.39) μmol / L and (78.26 ± 11.46) u / L, respectively (P <0.05). The level of aspartate aminotransferase and the above indexes in both groups were significantly lower than those before treatment (P <0.05) The body mass at birth (2845.00 ± 341.93) g was significantly higher than that of the control group (2 545.00 ± 274.63) g (83.33%, 20.00% vs 79.31%, 24.14% ) Was no significant difference (P> 0.05). Conclusion Yinzhihuang oral ursodeoxycholic acid treatment of intrahepatic cholestasis is superior to the treatment of ursodeoxycholic acid alone.