复方阿托莫兰合剂在治疗妊娠肝内胆汁淤积症中的应用  

Application of Compound Reduced Glutathione Mixture in treatment of intrahepatic cholestasis of pregnancy

作　　者：张科荣[1] 陶建华[2] 范波[1] 蒋静[1] 夏智勇[1] 王文平[1] 黄锦[1] 

机构地区：[1]川北医学院附属医院妇产科,四川南充637000 [2]川北医学院病原生物学中心,四川南充637000

出　　处：《现代医药卫生》2013年第11期1601-1603,共3页Journal of Modern Medicine & Health

基　　金：四川省教委重点课题资助项目(2004A080)

摘　　要：目的探讨复方阿托莫兰（还原型谷胱甘肽）合剂联合熊去氧胆酸（UDCA）治疗妊娠肝内胆汁淤积症（ICP）的临床疗效。方法将56例ICP孕妇随机分为两组：治疗组30例和对照组26例。治疗组给予10%葡萄糖注射液（GS）250 mL、阿托莫兰0.6 g,5%GS 250 mL、思美泰（腺苷甲硫氨酸）1.0 g,10%GS 250 mL、潘兰金（门冬氨酸钾镁）20 mL、维生素（Vit）K1 20 mg,10%GS 500 mL、10%氯化钾10 mL、VitC 3.0 g、10%葡萄糖酸钙10 mL,10%GS 250 mL、50%GS 40 mL、10%氯化钾7 mL,丹参250 mL,均静脉滴注,每天1次;UDCA 250 mg,口服,每天2次。对照组给予UDCA 250 mg,口服,每天2次。两组均以10~14 d为1个疗程。比较两组患者治疗前后瘙痒评分、血胆汁酸（TBA）、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、总胆红素（TB）的变化、妊娠结局及围产儿情况等,对结果进行统计分析。结果两组孕妇治疗后瘙痒评分、TBA、转氨酶均较治疗前明显下降（P〈0.05或0.01）,TB无变化（P〉0.05）;治疗组治疗后瘙痒评分、TBA、ALT、AST的差值均高于对照组（P〈0.05）,分娩孕周较对照组延长（P〈0.05）,胎儿窘迫、羊水污染程度均优于对照组（P〈0.01）,两组新生儿Apgar评分（≤7分）比较,差异无统计学意义（P〉0.05）。结论复方阿托莫兰合剂联合UDCA治疗ICP效果更明显,安全。Objective To explore the clinical effect of Compound Reduced Glutathione Mixture combined with ur- sodeoxycholic acid （UDCA） in treating intrahepatic cholestasis of pregnancy （ICP）. Methods 56 cases oflCP pregnant women were divided into two groups：30 cases in the treatment group and 26 cases in the control group. The treatment group was given 10% glucose injection （GS） 250 mL＋Compound Reduced Glutathione Mixture 0.6 g, 5% GS 250 mL＋adenosylmethioninel.0 g, 10% GS 250 mL＋potassium magnesium aspartate20 mL＋Vit K120 rag, 10% GS 500 mL＋ 10% potassium chloride 10 mL＋VitC 3.0 g＋ 10% calcium glneonate 10 mL, 10% GS 250 mL＋50% GS 40 mL＋ 10% potassium chloride7 mL, Salvia Mihiorrhiza Injection 250 mL by intravenous drip,once daily and oral UDCA 250 rag,twice daily. The control group took oral UDCA250 rag,twice daily. The two groups all took 10-14 d as a course of treatment. The itchy symptom, changes of blood total bile acid （TBA）, alanine amino- transferase （ALT）, aspartate aminotransferase （AST） and total bilirubin （TB）, pregnancy outcome and perinatal infants situation before and ＇after treatment were compared between the two groups. The results were statistically analyzed. Results ： The pruritus score ,TBA ,transminases levels after treatment in the two groups were decreased obviously compared with before treatment （P〈0.05 or 0.01 ）, but there was no change in TB （P〉0.05）. The difference values of the pruritus score,TBA, ALT, AST before and after treat ment in the treatment group were higher than those in the control group （P〈0.05）. The delivery gestational weeks in the treatment was prolonged compared with the control group（P〈0.05 ）. Fetal distress and the amniotic fluid pollution degree in the treatment group were better than those in the control group （P〈0.01）. There was no statistical difference in the Apgar scores （ ≤ 7 points） between the two groups （P〉0.05）. Conclusion The effect of Compound Reduced Glutathione Mixtur

关 键 词：胆汁淤积 药物疗法 妊娠并发症 药物疗法 谷胱甘肽 治疗应用 复方阿托莫兰合剂 

分 类 号：R714.255[医药卫生—妇产科学]