利胆解瘀汤联合西药治疗妊娠期肝内胆汁淤积症随机平行对照研究

目的]观察利胆解瘀汤联合西药治疗妊娠期肝内胆汁淤积症疗效。方法]使用随机平行对照方法，将90例门诊患者按随机数字表法分为两组。对照组45例①基础治疗。②地塞米松，10mg／次，1次／d，静注，3d后停止应用地塞米松，给予S-腺苷蛋氨酸（思美泰）1．0g＋0．5％葡萄糖溶液500mL，1次／d，静滴。治疗组45利胆解瘀汤（茯苓、茵陈、丹参各20g，栀子15g，白芍、郁金、柴胡、黄芩、生大黄各10g，甘草6g），本院煎药室制备口服煎剂，2次／剂，1剂／d，水煎150mL，早晚口服。西医治疗同对照组。连续治疗10d为1疗程。观测临床症状、剖产率、早产率、胎儿窘迫发生率、瘙痒症状评分及TBA、ALT、AST比较、不良反应。治疗1疗程，判定疗效。结果]治疗组痊愈9例，显效21例，有效11例，无效4例，总有效率91．11％。对照组痊愈7例，显效18例，有效9例，无效11例，总有效率75．56％。治疗组疗效优于对照组（P〈0．05）。剖产率、早产率、胎儿窘迫发生率治疗组优于对照组（P〈0．05）。瘙痒症状评分及TBA、ALT、AST治疗组改善优于对照组（P〈0．05）。结论]利胆解瘀汤联合西药治疗妊娠期肝内胆汁淤积症效果显著，值得推广。

Gallbladder Stasis Decoction Combined with Western Medicine in lintrahepatic Cholestasis of Pregnancy A Randomized Controlled Trial of Treatment

Objective ] To observe the gallbladder stasis decoction combined with western medicine in the treatment of intrahepatic cholestasis of pregnancy outcome. Methods] Using randomized controlled methods, 90 patients were randomly divided into two groups. Control the basic treatment group of 45 cases. ② dexamethasone, 10mg/, 1 /d, intravenous injection, 3 days to stop the application of dexamethasone, S- S-adenosylmethionine （ Si Meitai ） 1.0g＋0.5% glucose solution 500mL, 1 /d, intravenous drip. The treatment group of 45 cases of gallbladder stasis Decoction （ Fuling, Yinchen, Danshen each 20g, Zhizi 15g, Baishao, Yujin, Chaihu, Huangqin, Shengdahuang each 10g, Gancao 6g）, the decocting room preparation oral decoction, 2 times / agent, agent 1 /d, water simmer in water 150mL, sooner or later oral. Western medicine treatment with the control group. Continuous treatment with 10d for 1 courses. Observation of clinical symptoms, the cesarean section rate, premature delivery rate, the incidence of fetal distress, itching symptoms score and TBA, ALT, AST, adverse reaction. 1 courses of treatment, the curative effect. Results ] The treatment group cured 9 cases, effective in 21 cases, effective 11 cases, invalid 4 cases, the total efficiency of 91.11%. The control group cured 7 cases, effective in 18 cases, effective 9 cases, invalid 11 cases, the total efficiency of 75.56%. The treatment group was better than control group （P〈 0.05 ） . The cesarean section rate, the rate of premature delivery, fetal distress rate in the treatment group than in control group （P〈 0.05 ） . Pruritus symptom score and TBA, ALT, AST of the treatment group was better than the control group （P〈 0.05 ） . Conclusion ] Gallbladder stasis soup combined with western medicine in treating intrahepatie cholestasis of pregnancy effect is significant, worthy of promotion.