CAJ | 학술논문

目的：观察熊去氧胆酸联合清瘀利胆汤治疗妊娠期肝内胆汁淤积症的方法、临床疗效以及安全性。方法116例妊娠期肝内胆汁淤积症患者随机分为两组。对照组56例给予熊去氧胆酸、地塞米松、苯巴比妥等常规治疗，治疗组60例在对照组治疗的基础上联合清瘀利胆汤治疗，两组均治疗14d。结果治疗后，治疗组的总有效率为91．67％，对照组总有效率为78．57％，两组比较差异有统计学意义（P＜0．05）；对照组的瘙痒评分以及血清总胆汁酸均有所降低，治疗组的瘙痒评分、血清总胆汁酸、谷丙转氨酶、谷草转氨酶均有所降低，且治疗组降低水平均明显低于对照组（P＜0．05）。治疗组分娩孕周长与对照组比较，差异有统计学意义（P＜0．05）；治疗组新生儿窒息、早产、宫内窘迫以及剖宫产率、产后出血率均低于对照组（P＜0．05）；两组均无不良反应发生。结论在治疗妊娠期肝内胆汁淤积症中，采用熊去氧胆酸结合清瘀利胆汤具有更良好的疗效，可有效消除患者的瘙痒，降低血清总胆汁酸、谷丙转氨酶、谷草转氨酶的水平，明显改善新生儿窒息、早产、宫内窘迫以及产后出血的发生率。
목적：관찰웅거양담산연합청어리담탕치료임신기간내담즙어적증적방법、림상료효이급안전성。방법116례임신기간내담즙어적증환자수궤분위량조。대조조56례급여웅거양담산、지새미송、분파비타등상규치료，치료조60례재대조조치료적기출상연합청어리담탕치료，량조균치료14d。결과치료후，치료조적총유효솔위91．67％，대조조총유효솔위78．57％，량조비교차이유통계학의의（P＜0．05）；대조조적소양평분이급혈청총담즙산균유소강저，치료조적소양평분、혈청총담즙산、곡병전안매、곡초전안매균유소강저，차치료조강저수평균명현저우대조조（P＜0．05）。치료조분면잉주장여대조조비교，차이유통계학의의（P＜0．05）；치료조신생인질식、조산、궁내군박이급부궁산솔、산후출혈솔균저우대조조（P＜0．05）；량조균무불량반응발생。결론재치료임신기간내담즙어적증중，채용웅거양담산결합청어리담탕구유경량호적료효，가유효소제환자적소양，강저혈청총담즙산、곡병전안매、곡초전안매적수평，명현개선신생인질식、조산、궁내군박이급산후출혈적발생솔。
s:Objective To observe the method, clinical efficacy and safety of Ursodeoxycholic acid combined with Qingyulidan decoction intreatmentofintrahepaticcholestasisofpregnancy.Methods 116casesofintrahepaticcholestasisofpregnancywererandomlydividedinto two groups.56 cases of control group were given Ursodeoxycholic acid, dexamethasone, phenobarbital and other conventional treatment, 60 cases of treatment group were treated with Qingyulidan decoction based on the control group.Both groups were treated with 14 days.Results After treatment, the total effective rate of treatment group was 91.67%and control group was 78.57%, there had significantly difference between two groups ( P<0.05);the control group of pruritus score and serum total bile acid were reduced, the treatment group of pruritus score, serum total bile acid, alanine aminotransferase, aspartate aminotransferase were lower,the levels in treatment group were significantly lower than control group (P<0.05);in the treatment group ,the neonatal asphyxia, premature delivery, intrauterine distress and the rates of cesarean section, postpartum hemorrhage were lower than those of control group (P<0.05); two groups had no adverse reaction occurred. Conclusion Ursodeoxycholic acid combined with Qingyulidan decoction in treatment of intrahepatic cholestasis of pregnancy has a good cur-ative effect, can effectively eliminate the itch of the patients, reduce serum total bile acid, alanine aminotransferase, aspartate aminotrans-ferase levels, improve neonatal asphyxia, premature delivery, intrauterine distress and the incidence of postpartum hemorrhage.