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目的:探讨西宁高原缺氧环境下对于妊娠期合并肝内胆汁瘀积症(ICP)患者采用中药茵栀黄颗粒联合熊去氧胆酸治疗的临床效果。方法:采用随机数字表法将该院2011年10月~2013年12月收治的85例ICP患者分为联合组(43例)和对照组(42例),对照组采用常规对症支持治疗结合熊去氧胆酸治疗,联合组在对照组基础上加用茵栀黄颗粒治疗,比较两组患者治疗2个疗程(14天1个疗程)后的临床疗效差异。结果:治疗前联合组和对照组的TBA、TB、TBIL、ALT、AST、ALP差异无统计学意义(P>0.05);治疗后联合组的TBA(21.5±3.6)mol/L、TB(15.9±4.2)mol/L、TBIL(18.5±4.6)μmol/L、ALT(52.7±16.2)U/L、AST(46.5±11.3)U/L、ALP(105.4±19.3)U/L均显著低于对照组(P<0.05)。治疗前两组患者的瘙痒评分差异无统计学意义(P>0.05),治疗后联合组的瘙痒评分分别为(1.26±0.22)分、(0.54±0.18)分均低于同期对照组患者,差异有统计学意义(P<0.05)。联合组和对照组的分娩孕周、羊水Ⅲ度污染率、剖宫产率、术中出血量差异无统计学意义(P>0.05),联合组的新生儿体重(3 418.9±105.3)g、5 min Apgar(9.67±0.21)分均显著高于对照组(P<0.05)。结论:高原缺氧环境下对于妊娠期合并肝内胆汁瘀积症患者采用中药茵栀黄颗粒联合熊去氧胆酸治疗对于改善患者的肝功能、瘙痒症状、妊娠结局有积极意义。
Objective: To investigate the clinical efficacy of Yinzhihuang granule combined with ursodeoxycholic acid in patients with intrahepatic cholestasis (ICP) during pregnancy under hypoxia in Xining Plateau. Methods: Eighty-five ICP patients admitted to our hospital from October 2011 to December 2013 were divided into two groups: the combined group (43 cases) and the control group (42 cases) by random number table. The control group received conventional symptomatic supportive therapy combined with the bear Deoxycholic acid treatment, the combined group in the control group plus Yinzhihuang granules treatment, two groups of patients treated two courses (14 days after a course of treatment) after the difference in clinical efficacy. Results: There was no significant difference of TBA, TB, TBIL, ALT, AST and ALP between the combined group and the control group before treatment (TBA 21.5 ± 3.6mol / L, TB 15.9 ± 4.2 mol / L, TBIL 18.5 ± 4.6 μmol / L, ALT 52.7 ± 16.2 U / L, AST 46.5 ± 11.3 U / L and ALP 105.4 ± 19.3 U / L respectively Control group (P <0.05). The pruritus scores of the two groups before treatment were not significantly different (P> 0.05). The pruritus scores of the combined group after treatment were (1.26 ± 0.22) points and (0.54 ± 0.18) points lower than those of the control group There was statistical significance (P <0.05). There was no significant difference in gestational weeks, amniotic fluid Ⅲ degree of contamination, cesarean section rate and intraoperative blood loss between the combined group and the control group (P <0.05). The newborn weight (3 418.9 ± 105.3) g, 5 min Apgar (9.67 ± 0.21) points were significantly higher than the control group (P <0.05). Conclusion: The treatment of Yinzhihuang granules combined with ursodeoxycholic acid in patients with intrahepatic cholestasis of pregnancy in the plateau hypoxia environment is of positive significance to improve the liver function, pruritus symptoms and pregnancy outcome in patients with intrahepatic cholestasis of pregnancy.