茵栀黄口服液联合熊去氧胆酸和思美泰治疗妊娠期肝内胆汁淤积症的疗效观察

目的 观察茵栀黄和熊去氧胆酸、思美泰中西医联合治疗妊娠期肝内胆汁淤积症（ICP）的临床疗效。方法 将80例妊娠期肝内胆汁淤积症患者分成观察组和对照组各40例，观察组用中药茵栀黄和熊去氧胆酸、思美泰治疗，对照组仅用熊去氧胆酸和思美泰治疗，比较2组孕妇的临床症状、血清总胆汁酸（TBA）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TB）水平变化情况、临床疗效和分娩结局。结果 治疗后2组血清TBA、ALT、AST、TB较治疗前均明显下降(P<0.05~0.01)，且观察组患者各项指标均明显低于对照组(P<0.05~0.01)，总有效率高于对照组(P<0.05)，早产、胎儿窘迫的发生率、剖宫产率、产后出血显著低于对照组，观察组新生儿体质量高于对照组，差异均具有统计学意义（P<0.05~0.01）。结论 采用中西医结合方式治疗妊娠期肝内胆汁淤积症具有较好的临床效果，围产儿预后情况较好。 

Curative Effect Observation of Yinzhihuang Combined with Ursodesoxycholic Acid and Transmetil in Treating Intrahepatic Cholestasis During Gestation Period

OBJECTIVE To investigate the clinical effects of combined treatment of Chinese and western medicine including Yinzhihuang， ursodeoxycholic acid and transmetil in the treatment of intrahepatic cholestasis of pregnancy. METHODS 80 cases with intrahepatic cholestasis of pregnancy were divided into observation group and control group， with 40 cases in each group. Patients in the observation group were administrated with traditional Chinese medicine Yinzhihuang and western medicine transmetil and ursodeoxycholic acid， while those in the control group were only given ursodeoxycholic acid and transmetil. Then clinical symptoms， changes of serum total bile acid(TBA)， alanine aminotransferase(ALT)， aspartate aminotransferase (AST)， total bilirubin (TB)， clinical effects and delivery outcomes were compared between the two groups. RESULTS Serum total bile acid， total bilirubin alanine aminotransferase and aspartate aminotransferase in the two groups decreased significantly after treatment and all these indicators in the observation group were significantly lower than those in the control group. The total efficiency of the observation group was much higher than that of the control group. There existed statistical significance in premature delivery， incidence of fetal distress， cesarean section， postpartum hemorrhage when comparison was made between the two groups(P<0.05). CONCLUSION Combining traditional Chinese medicine with western medicine for the treatment of the intrahepatic cholestasis of pregnancy exhibits excellent clinical effects and good perinatal prognosis， which deserves further clinical promotion.