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目的:观察茵陈蒿汤治疗妊娠期肝内胆汁淤积症的疗效及对雌激素水平的影响。方法:选择2012年1月~2014年12月我院产科收治就诊并住院分娩孕妇77例进行研究,随机分为观察组(n=39)与对照组(n=38)。对照组口服熊去氧胆酸,观察组在对照组基础上联用茵陈蒿汤,比较两组治疗前后雌激素水平、治疗有效率、胎儿妊娠结局及不良反应发生率。结果:两组治疗前雌二醇与雌三醇水平的比较均无统计学意义(P>0.05),治疗后两组均降低,组内前后差异有统计学意义(P<0.05),且观察组治疗后雌二醇与雌三醇水平均低于对照组,提示改善幅度更大。观察组治疗有效率为87.2%(34/39),高于对照组61.8%(26/38),差异有统计学意义(P<0.05)。两组早产、胎儿窘迫发生率的差异无统计学意义(P>0.05),但观察组产后出血、羊水污染发生率均明显低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为5.2%(2/39),对照组为10.5%(4/38),差异无统计学意义(P>0.05)。结论:茵陈蒿汤在妊娠期肝内胆汁淤积症中的应用可大幅降低雌激素水平并促进临床症状的消退,妊娠结局更佳,值得推广应用。
Objective: To observe the curative effect of Yinchenhao decoction on intrahepatic cholestasis of pregnancy and its effect on estrogen level. Methods: From January 2012 to December 2014, 77 pregnant women admitted to obstetrics department and hospitalized in our hospital were selected and randomly divided into observation group (n = 39) and control group (n = 38). The control group oral ursodeoxycholic acid, the observation group in the control group on the basis of Yinchenhao decoction, estrogen levels before and after treatment were compared, the treatment efficiency, fetal pregnancy outcomes and the incidence of adverse reactions. Results: There was no significant difference in the levels of estradiol and estriol between the two groups before treatment (P> 0.05). After treatment, the levels of estradiol and estriol decreased in both groups before and after treatment (P <0.05) After treatment, the estradiol and estriol levels were lower than the control group, suggesting a greater improvement. The effective rate of observation group was 87.2% (34/39), higher than that of control group (61.8%, 26/38), the difference was statistically significant (P <0.05). There was no significant difference in the incidence of preterm birth and fetal distress between the two groups (P> 0.05). However, the incidence of postpartum hemorrhage and amniotic fluid contamination in the observation group was significantly lower than that in the control group (P <0.05). Adverse reactions in the observation group were 5.2% (2/39) in the observation group and 10.5% (4/38) in the control group, with no significant difference (P> 0.05). Conclusion: The application of Yinchenhao Decoction in intrahepatic cholestasis of pregnancy can significantly reduce the level of estrogen and promote the regression of clinical symptoms. The pregnancy outcome is better and it is worth popularizing and applying.