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目的:观察利胆汤联合西药治疗妊娠期肝内胆汁淤积综合征(ICP)的临床疗效。方法:选取80例ICP患者,按照入院先后顺序分为西药组与联合组各40例。西药组给予西药治疗,联合组在西药组用药基础上加用利胆汤。治疗后比较2组临床疗效,观察2组血清总胆汁酸水平、瘙痒程度评分及肝功能指标的变化,记录2组不良妊娠结局发生情况。结果:联合组治疗总有效率95.0%,西药组治疗总有效率75.0%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组血清总胆汁酸水平及瘙痒程度评分均较治疗前降低(P<0.05);联合组的血清总胆汁酸水平和瘙痒程度评分均低于西药组(P<0.05)。治疗后,2组血清谷草转氨酶(AST)、谷丙转氨酶(ALT)、直接胆红素(DBil)、间接胆红素(IBil)及总胆红素(TBil)水平均较治疗前降低,差异均有统计学意义(P<0.05);联合组5项肝功能指标水平均较西药组降低更显著,差异均有统计学意义(P<0.05)。联合组不良妊娠结局发生率7.5%,西药组不良妊娠结局发生率25.0%,2组比较,差异有统计学意义(P<0.05)。结论:利胆汤联合西药治疗可改善ICP患者的总胆汁酸水平,降低对肝脏的损伤,改善妊娠结局,缓解瘙痒症状,效果显著。
Objective: To observe the clinical effect of combined Lizhen Decoction and western medicine in the treatment of intrahepatic cholestasis syndrome (ICP) during pregnancy. Methods: Eighty patients with ICP were selected and divided into western medicine group and combination group according to the order of admission. Western medicine group treated with western medicine, the combined group in the Western medicine group based on the use of add gallbladder soup. After treatment, the clinical curative effect of the two groups were compared. The changes of serum total bile acid level, pruritus score and liver function index were observed in two groups. The incidence of adverse pregnancy outcome was recorded. Results: The total effective rate was 95.0% in the combination group and 75.0% in the western medicine group. There was significant difference between the two groups (P <0.05). After treatment, the levels of total serum bile acid and pruritus in both groups were lower than those before treatment (P <0.05). The serum total bile acid level and pruritus score in the combined group were lower than those in western medicine group (P <0.05). After treatment, the levels of AST, ALT, DBil, IBil and total bilirubin in two groups were lower than those before treatment, the difference was statistically significant (P <0.05). The five indexes of hepatic function in the combined group were significantly lower than those in the western medicine group (P <0.05). The incidence of adverse pregnancy outcomes in the combination group was 7.5%, and the incidence of adverse pregnancy outcomes in the western medicine group was 25.0%. There was significant difference between the two groups (P <0.05). Conclusion: The combination of Lilingdan decoction and western medicine can improve the total bile acid level of ICP patients, reduce the damage to the liver, improve the pregnancy outcome and relieve itching symptoms.