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中西医结合治疗轻、重度妊娠肝内胆汁淤积症临床分析
引用本文:张蔚,曹来英,曾洁,王毅军,洛若愚,王丽荣.中西医结合治疗轻、重度妊娠肝内胆汁淤积症临床分析[J].中国妇幼保健,2007,22(28):4026-4028.
作者姓名:张蔚  曹来英  曾洁  王毅军  洛若愚  王丽荣
作者单位:武汉大学人民医院妇产科,湖北,武汉,430060
摘    要:目的:评估中西医结合分度治疗妊娠肝内胆汁淤积症(ICP)的疗效。方法:240例ICP患者按我院自拟的分度诊断标准诊断为轻度ICP(170例)和重度ICP(70例),并随机分成两组。A组(120例)中轻度ICP(85例)给予茵陈汤加西药治疗(思泰美、地塞米松、能量合剂),重度ICP(35例)给予郁胆汤加西药治疗(同前),B组(120例)中轻度ICP(85例)和重度ICP(35例)均给予西药治疗(同前)。同时将60例因入院3天内即分娩而未给予治疗的ICP孕妇作为C组。观察三组患者治疗前后瘙痒评分、肝胆系B超声像图特征、血清生化指标和围生儿预后情况。结果:A组轻度和重度ICP患者治疗一个疗程后瘙痒评分和血清生化指标明显下降,肝胆系B超声像图特征明显改善,与B组相比有统计学差异。与B、C组相比,A组围生儿预后明显改善。结论:针对不同程度的ICP患者给予相应的中西医结合治疗是合理、有效的方法。

关 键 词:胆汁淤积  肝内  妊娠  预后
文章编号:1001-4411(2007)28-4026-03
修稿时间:2006-04-04

Analysis on the efficacy of the combination of TCM and Western Medicine in treating intrahepatic cholestasis of pregnancy with different degree
ZHANG Wei, CAO Lai - Ying , ZENG Jie,et al..Analysis on the efficacy of the combination of TCM and Western Medicine in treating intrahepatic cholestasis of pregnancy with different degree[J].Maternal and Child Health Care of China,2007,22(28):4026-4028.
Authors:ZHANG Wei  CAO Lai - Ying  ZENG Jie  
Institution:Department of Gynecology and Obstetrics, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China
Abstract:Objective:To study the efficacy of the combination of TCM and Western Medicine in treating intrahepatic cholestasis of pregnancy with different degree.Methods:240 patients were randomly divided into two groups: A group(n=120) and B group(n=120).In A group,TCM YCT and western medicine(Transmetic,Dexamethasone,and Energy Mixture) were together used for the mild ICP,while TCM YDT and Western Medicine were together used for the severe ICP.In B group only Western Medicine was used for whichever mild ICP or severe ICP.60 patients of non-treatment were C group because of delivering within 3 days after hospitalization.The itch score,type-B ultrasonic efficacy,serum biochemical indexes,including TBA,ALT,and TBIL were observed before the treatment and after 2 weeks treatment,and the prognosis of perinatal newborn babies between the three groups was compared after delivery.Results:(1)The itch score,serum biochemical indexes of group A decreased significantly lower than those of group B(P<0.05 or P<0.01).(2)According to the type-B ultrasonic sonogram,the total effective power of group A was 95.83%,which was significantly higher than that of group B(85.00%)(P<0.01).(3)The premature delivery rate,fetal distress rate and amniotic fluid pollution rate of mild ICP in group A were 16.5%,12.9%,and 12.9%,which were significantly lower than those of group B(23.5%,32.9%,17.6%) and group C(45.7%,50%,43.5%)(P<0.01),but the perinatal babies mortality was no-significant among three groups.The premature delivery rate,fetal distress rate amniotic fluid pollution rate and perinatal babies mortality of severe ICP in group A were 20%,28.6%,25.7% and 2.9%,which were significantly lower than those of group B(31.4%,45.7%,42.9%,5.7%) and group C(64.3%,42.9%,71.4%,28.6%)(P<0.05).Conclusion:The combination of TCM and Western Medicine for the different degree ICP is effective and reasonable treatment.
Keywords:Intrahepatic cholestasis  Pregnancy  Intrahepatic cholestasis of pregnancy(ICP)
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