麻黄连翘赤小豆-茵陈蒿汤联合西药治疗重度妊娠期肝内胆汁淤积症的临床研究  

The clinical study of Mahuang Lianqiao Chixiaodou-Yinchenhao Decoction in treating intrahepatic cholestasis of pregnancy

作　　者：郑慧 徐洲 赖丽 张瑞琪 扈晓宇[2] ZHENG Hui;XU Zhou;LAI Li(Department of Obstetrics,Sichuan Jinxin Xinan Women and Children's Hospital,Chengdu,Sichuan 610066,China)

机构地区：[1]四川锦欣西囡妇女儿童医院产科,四川成都610066 [2]成都中医药大学附属医院感染科,四川成都610072

出　　处：《四川中医》2025年第1期156-159,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：四川省医学会(青年创新)科研课题(编号:S21092)。

摘　　要：目的:探讨经方“麻黄连翘赤小豆-茵陈蒿汤”联合西药治疗重度妊娠期肝内胆汁淤积症(ICP)的临床效果。方法:选取我院2022年1月~2024年1月收治的重度ICP患者63例,随机分配入试验组和对照组。其中试验组30例,对照组33例。对照组采用熊去氧胆酸(UCDA)联合S-腺苷蛋氨酸(SAMe)治疗,试验组在对照组基础上加用麻黄连翘赤小豆-茵陈蒿汤治疗;比较两组患者治疗前后皮肤瘙痒程度、总胆汁酸(TBA)、丙氨酸转氨酶(ALT)、门冬氨酸转氨酶(AST)及母婴结局。结果:治疗后两组的瘙痒评分、血清TBA、ALT、AST水平均较治疗前下降;试验组TBA水平下降更明显,差异均有统计学意义(P<0.05);试验组剖宫产率、羊水粪染率、产后出血率均分别低于对照组,其中剖宫产率、羊水粪染率比较差异有统计学意义(P<0.05)。结论:经方“麻黄连翘赤小豆-茵陈蒿汤”联合西药的治疗方案可在一定程度上改善重度ICP的生化指标及母婴结局。Objective:To investigate the clinical efficacy of“Mahuang Lianqiao Chixiaodou-Yinchenhao decoction”combined with western medicine in treating severe Intrahepatic cholestasis of pregnancy(ICP).Methods:A total of 63 patients with severe intrahepatic cholestasis of pregnancy admitted to our hospital from January 2022 to January 2024 were randomly assigned to the experimental group and the control group.There were 30 cases in the experimental group and 33 cases in the control group.The control group was treated with Ursodeoxycholic acid(UDCA)combined with S-adenosylmethionine(SAMe),and the experimental group was treated with Mahuang Lianqiao Chixiaodou-Yinchenhao decoction on the basis of the control group.Before and after treatment,the pruritus score,TBA,alanine aminotransferase(ALT)and aspartate aminotransferase(AST)were detected in the two groups,maternal and neonatal outcomes were analyzed simultaneously.Results:The pruritus score,TBA,ALT and AST levels of the two groups after treatment were lower than before treatment,TBA in the experimental group decreased more significantly,the difference was statistically significant(P<0.05).The cesarean section rate,aminiotic fluid fecal staining rate,postpartum hemorrhage rate in the experimental group were lower than those in the control group,the cesarean section rate and aminiotic fluid fecal staining rate were statistically significant(P<0.05).Conclusion:Mahuang Lianqiao Chixiaodou-Yinchenhao decoction combined with western medicine can improve the biochemical indexes and maternal and neonatal outcomes of severe ICP to a certain extent.

关 键 词：妊娠期肝内胆汁淤积症 熊去氧胆酸 S-腺苷蛋氨酸 麻黄连翘赤小豆-茵陈蒿汤 母婴结局 

分 类 号：R271[医药卫生—中医妇科学]