思美泰联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症的疗效观察

目的观察思美泰（SAMe）联合熊去氧胆酸（UDCA）治疗妊娠期肝内胆汁淤积症（ICP）的临床疗效。方法选择90例ICP患者，随机分成三组：A组采用UDCA口服，300mg／次，2次／d；B组静脉滴注SAMe1000mg／次，1次／d；C组口服UDCA300mg，2次／d，同时加用静脉滴注SAMe 1000mg/次，1次／d，治疗7天为一疗程，间隔3周可以重复下一疗程直到分娩止。结果治疗后所有患者瘙痒症状改善，三组瘙痒评分差异有统计学意义（P〈0.05）；治疗后血清TBA、TB、ALT和AST的水平明显降低（P〈0.01），C组下降最为明显，差异有统计学意义（P〈0.05）。结论治疗妊娠期肝内胆汁淤积症，在缓解瘙痒症状方面，SAMe的疗效优于UDCA，而在降低胆汁酸等肝生化指标上，UDCA的疗效优于SAMe，UDCA和SAMe两者结合比单一疗法更有效。

Clinical observation of combining transmeil and ursodeoxycholic acid in the troatment of intrahepatie cholestasis of pregnce

Objective To observe the clinical effects of combined use of transmetil(SAMe) and ursodeoxycholic acid(UDCA)in the treatment for intrahepatic cholestasis of pregnancy(ICP).Methods 90 cases of ICP were randomly divided into three groups:A group UDCA oral,300mg /times,2 times /d;B Group intravenous SAMe 1000mg /times,1 times /d,C group oral UDCA 300mg,2 times /d,add simultaneously with intravenous SAMe 1000mg /times,1 times /d,the treatment for 7 days as one course of treatment which can be repeated with an interval of three weeks until the time to give birth.Results After treatment,itching symptom was improved in all patients,pruritus score between the three groups was significantly different(P<0.05);after the treatment,serum TBA,TB,ALT and AST levels decreased significantly(P<0.01),C group dropped most obviously,the difference was significant(P<0.05).Conclusion In the treatment of intrahepatic cholestasis during pregnancy to ease the itching on symptoms,SAMe is superior to the efficacy of UDCA,and in the reduction of bile acids and other biochemical markers on liver,UDCA is superior to the efficacy of SAMe,UDCA combined with SAMe is more effective.than each of single therapy.