利胆汤联合西药治疗妊娠期肝内胆汁淤积综合征临床观察  

Clinical observation of Lidan decoction combined with western medicine in the treatment of intrahepatic cholestasis syndrome during pregnancy

作　　者：郑丽春[1] Zheng Lichun

机构地区：[1]沈丘县人民医院

出　　处：《中医临床研究》2019年第18期135-137,共3页Clinical Journal Of Chinese Medicine

摘　　要：目的:探究妊娠期肝内胆汁淤积综合征应用利胆汤联合西药治疗的临床疗效。方法:选取本院于2016年6月-2018年6月本院收治的84例ICP患者为研究对象,在患者及其家属知情同意前提下按临床随机分组为对照组与研究组,每组42例;其中对照组给予熊去氧胆酸片10 mg/kg+取苯巴比妥片5~8 mg/kg,每日3次+注射用丁二磺酸腺苷蛋氨酸1000 mg与500 mL浓度为5%的葡萄糖溶液混合行静脉滴注,1次/d等西药治疗;而研究组则在对照组患者治疗基础上,取黄芩15 g,泽泻15 g,金钱草15 g,茯苓15 g,车前草15 g,茵陈12 g,栀子12 g,蝉蜕10 g等中药组成利胆汤基本方,并按照患者实际情况随症加减治疗;对比观察两组临床治疗效果、临床症状与肝功能改善情况,统计患者不良妊娠结局发生率。结果:治疗后对两组患者治疗情况进行对比,研究组总有效率(95.24%)高于对照组(76.19%),患者瘙痒程度评分与血清总胆汁酸水平均低于对照组,且患者TBIL、IBIL、DBIL、ALT、AST等指标均优于对照组;而不良妊娠结局发生率(4.76%)则低于对照组(19.05%)(P<0.05)。结论:利胆汤联合西药治疗ICP,有助于促进临床疗效提升,改善妊娠结局,应用价值较高。Objective:To explore the clinical efficacy of Lidan decoction(利胆汤)combined with western medicine in the treatment of intrahepatic cholestasis syndrome(ICP)during pregnancy.Methods:84 ICP patients admitted to our hospital from June,2016 to June,2018 were selected as the study subjects.Under the premise of informed consent of patients and their family members,they were randomly divided into the control group and the study group,with 42 patients in each group.In the control group,ursodeoxycholic acid tablets(10 mg/kg)+phenobarbital tablets(5~8 mg/kg)were given,3 times/d+infusions were mixed with 1,000 mg adenosine methionine butanedisulfonate(5 mg/kg)and 5%glucose solution(500 mL)for injection.In the study group,the basic prescription of Lidan decoction was composed of 15 g of scutellaria,15 g of alisma sinensis,15 g of lazicao,15 g of poria cocos,15 g of plantain sinensis,12 g of wormwood,12 g of gardenia and 10 g of cicada,and the treatment was added or reduced according to the actual conditions of the patients.The clinical therapeutic effect,clinical symptoms and improvement of liver function were compared between the two groups,and the incidence of adverse pregnancy outcomes was statistically analyzed.Results:After treatment,the total effective rate of the study group(95.24%)was higher than that of the control group(76.19%),and the pruritus degree score and serum total bile acid level of the patients were lower than those of the control group.The incidence of adverse pregnancy outcomes(4.76%)of the study group was lower than that of the control group(19.05%)(P<0.05).Conclusion:Lidan decoction(利胆汤)combined with western medicine in the treatment of ICP could promote the improvement of clinical efficacy,improve the pregnancy outcome,and had high application value.

关 键 词：妊娠期肝内胆汁淤积综合征 利胆汤 中西联合治疗 临床疗效 

分 类 号：R271.9[医药卫生—中西医结合]