中医药治疗妊娠期肝内胆汁淤积症临床观察

目的:探讨中医药治疗妊娠期肝内胆汁淤积症的效果。方法:选择2010年5月—2012年8月本院收治的84例妊娠期肝内胆汁淤积症患者为观察对象,随机分为治疗组和对照组,每组各42例,治疗组采用疏肝利胆中药汤剂口服,对照组采用熊去氧胆酸片口服。比较治疗后两组肝功能指标(ALT、AST、TBA、TBIL、DBIL)水平,Ribalta评分(瘙痒评分)及妊娠预后。结果:治疗组总有效率为85.7%,高于对照组的66.7%,但差异无统计学意义(P>0.05);治疗后,两组肝功能及瘙痒症状评分均较治疗前明显改善,但治疗组改善情况有显著性优于对照组,差异具有统计学意义(P<0.05);治疗组的新生儿体重明显重于对照组新生儿体重,差异有统计学意义(P<0.05)。结论:中医药治疗妊娠肝内胆汁淤积症是安全、有效的,特别是对于缓解皮肤瘙痒和改善妊娠结局效果显著,值得临床推广应用。

Observation on Effect of Chinese Medicine in Treatment of Intrahepatic Cholestasis of Pregnancy

Objective ： To explore the effect of Chinese medicine in the treatment of intrahepatic cholestasis of pregnancy. Methods：84 intrahepatic cholestasis of pregnancy patients from May 2010 to August 2012 in our hospital were selected,and were ran- domly divided into treatment group and control group,42 cases in each group. The treatment group used Shugan Lidan Decoction orally and control group used Ursodeoxycholic Acid Tablets orally. Two groups indexes of liver function （ALT, AST, TBA, TBIL, DBIL levels）, Ribaha score （pruritus score）and the prognosis of pregnancy after treatment were compared. Results：The total effective rate of treatment group was 85. 7%, higher than 66. 7% in control group, but the difference was not significant （P 〉 0. 05）. After treatment, two groups liver function and pruritus symptom score were significantly improved, but treatment group was significantly better than control group, and the difference had statistical significance （ P 〈 0.05 ）. The neonatal weight in treatment group was significantly heavier than that of the control group and there was a significant difference （P 〈 O. 05 ）. Conclusion ： Chinese medicine in the treatment of intrahepatic cholestasis of pregnancy is safe and effective, especially for the relief of pruritus and significantly improves the outcome of pregnancy effect, and it is worthy of clinical application.