中药治疗妊娠期肝内胆汁淤积症的临床疗效研究  

Efficacy of traditional Chinese medicine in the treatment of intrahepatic cholestasis of pregnancy

作　　者：李金艳[1] 曾敏[2] 

机构地区：[1]重庆市中医院妇产科,400021 [2]重庆市中医院病理科,400021

出　　处：《重庆医学》2015年第18期2518-2520,共3页Chongqing medicine

摘　　要：目的探讨中药治疗妊娠期肝内胆汁淤积症(ICP)的临床疗效。方法将60例ICP患者分为两组:观察组30例以中药茵陈利胆汤联合熊去氧胆酸治疗,对照组30例仅口服熊去氧胆酸药物,疗程均为20d。对比两组血清总胆汁酸(TBA)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)水平、胎盘组织中Caspase-3表达及围产儿结局。结果观察组胎盘组织中合体滋养细胞、细胞滋养细胞、蜕膜细胞及间质细胞Caspase-3表达分别为(10.58±2.62)%、(15.8±4.02)%、(10.17±3.58)%、(14.23±4.39)%明显低于对照组的(20.46±8.68)%、(33.89±7.05)%、(20.56±4.23)%、(28.29±5.58)%,差异有统计学意义(P<0.05);两组患者治疗后TBA及ALT、AST均有所下降,观察组疗效优于对照组,差异有统计学意义(P<0.05),观察组围产儿窒息发生率低于对照组,差异有统计学意义(P<0.05)。结论中药治疗可以明显降低ICP患者胎盘中Caspase-3表达及ICP患者的各项生化指标,改善围产儿结局。Objective To discuss the efficancy of traditional Chinese medicine in treatment of intrahepatic cholestasis of pregnancy .Methods A total of 60 patients who were admitted to our hospital for severe intrahepatic cholestasis of pregnancy（ICP） from January 2009 to December 2012 were randomly divided into two group using random number table .Patients in study group （n=30） took traditional Chinese medicine three times a day plusUDCA twice a day orally .Patients in control Group （n=30）were on‐ly given UDCA twice a day orally .Conventional treatment and care for ICP were given to both groups .Biochemical index （TBA , ALT ,and AST）level ,pregnancy outcome and Caspase‐3 of the two groups were recorded and compared and compared .Results The expressing of Caspase‐3 in placental cytotrophoblast ,syncytiotrophoblast .Decidual cells and interstitial cells of study group were （10 .58 ± 2 .62）% ,（15 .8 ± 4 .02）% ,（10 .17 ± 3 .58）% ,（14 .23 ± 4 .39）% ,respectively ,which were significantly lower than those in control group（P〈0 .05） ,which were （20 .46 ± 8 .68）% ,（33 .89 ± 7 .05）% ,（20 .56 ± 4 .23）% ,（28 .29 ± 5 .58）% .TBA ,ALT、AST in two groups were declined ,and ctedy group was better than in control group（P〈0 .05） .The index of liver function were all lower in study group than that of control group（P〈0 .05） .Incidence rate of neonatal asphyxia was lower in study group than that of con‐trol group （P〈0 .05） .Conclusion Traditonal Chinese medicine can reduce the expression of Caspase‐3 in study group .It is safe and eflfective in the treatment of ICP .

关 键 词：妊娠并发症 胆汁淤积  肝内 中药 治疗效果 半胱氨酸天冬氨酸蛋白酶3 CASPASE 3 

分 类 号：R271.9[医药卫生—中西医结合]