西药联合茵栀黄对妊娠肝内胆汁淤积症产后出血量及妊娠结局影响的Meta分析  

Effect of Western Medicine Combined with Yinzhihuang(茵栀黄)on Postpartum Hemorrhage and Pregnancy Outcome of Intrahepatic Cholestasis of Pregnancy:A Meta-Analysis

作　　者：卢佳南 焦波 吴俏坪 夏霁 王艳 LU Jianan;JIAO Bo;WU Qiaoping;XIA Ji;WANG Yan(Obstetrics Department,Hainan Branch,Shanghai Children's Medical Center,School of Medicine,Shanghai Jiao Tong University,Sanya 572000)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心海南医院产科,三亚572000

出　　处：《中药药理与临床》2024年第8期76-81,共6页Pharmacology and Clinics of Chinese Materia Medica

基　　金：三亚市高校及医疗机构专项科技计划项目课题(编号:2021GXYL36)。

摘　　要：目的:探讨常规西药联合茵栀黄对妊娠肝内胆汁淤积症患者的出血量及妊娠结局的影响,以期为相关疾病的早期治疗提供参考和依据。方法:采用复合逻辑检索方式,以“茵栀黄”、“妊娠期肝内胆汁淤积症”、“妊娠结局”、“Pregnancy-related cholestasis”、“intrahepatic cholestasis of pregnancy”等为检索词对中英文数据库(PubMed、Medline、知网、万方等)从建库至2022年12月31日的文献进行检索,并筛选以西药联合茵栀黄(包括茵栀黄颗粒、茵栀黄口服液、茵栀黄注射液及茵栀黄中药汤剂)用于妊娠肝内胆汁淤积症治疗的参考文献。Review Manager软件进行Meta分析。结果:共计纳入16项研究,与对照组比较,联合组产后出血量显著降低,血清ALT、AST水平显著降低,治疗有效率显著升高(P<0.01);妊娠结局中,剖宫产、胎儿窘迫、早产、羊水粪染发生率显著降低(P<0.01)。结论:西药联合茵栀黄用于妊娠肝内胆汁淤积症患者的治疗,有助于改善患者肝功能,降低产后出血量,并在一定程度上降低早产、胎儿窘迫、羊水粪染等不良妊娠结局的发生率。Objective:To investigate the effect of conventional western medicine combined with Yinzhihuang(茵栀黄)on postpartum hemorrhage and pregnancy outcome in patients with intrahepatic cholestasis of pregnancy(ICP),providing a reference for the early treatment of this condition.Methods:A comprehensive literature retrieval was conducted using a compound logic retrieval method.Search terms included"Yinzhihuang","intrahepatic cholestasis of pregnancy","pregnancy outcome",and"pregnancy-related cholestasis".The search covered both Chinese and English databases(PubMed,Medline,CNKI,Wanfang Data,etc.)from database inception to December 31,2022.Studies involving the use of western medicine combined with Yinzhihuang(including Yinzhihuang Granules,Yinzhihuang Oral Liquid,Yinzhihuang Injection and Yinzhihuang Decoction)for the treatment of ICP were selected.Meta-analysis was performed using Review Manager software.Results:Sixteen studies were included.Compered with the control group,postpartum hemorrhage was significant decreased in the combination group(P<0.01),the content of ALT and AST in serum were significantly decreased,and the effective rate was significantly increased.For pregnancy outcomes,the incidence of cesarean section,fetal distress,preterm birth,and meconium-stained amniotic fluid showed a significant decrease(P<0.01).Conclusion:The combination of western medicine and Yinzhihuang in the treatment of ICP is beneficial for improving liver function,reducing postpartum hemorrhage,and,to some extent,lowering the incidence of adverse pregnancy outcomes such as preterm birth,fetal distress,and meconium-stained amniotic fluid.

关 键 词：茵栀黄 妊娠肝内胆汁淤积症 妊娠结局 肝功能 早产 羊水粪染 胎儿窘迫 剖宫产 

分 类 号：R714.461[医药卫生—妇产科学]