张玉花

[摘要] 目的 探讨熊去氧胆酸联合茵栀黄口服液治疗妊娠期肝内胆汁淤积症临床效果评价。 方法 将我院产科治疗的124例妊娠期肝内胆汁淤积症患者随机分为两组，对照组单用熊去氧胆酸治疗，观察组采用熊去氧胆酸联合茵栀黄口服液治疗，比较两组患者的治疗效果、肝内胆汁淤积各指标、妊娠结局。 结果 观察组治疗有效率为96.77%，较对照组的75.81%明显提高，差异有统计学意义（P<0.05）；观察组治疗后TBA、ALT、AST、TB水平明显低于对照组，差异有统计学意义（P<0.05）；观察组早产、剖宫产、胎儿窘迫、产后24h出血量、新生儿体质量等均明显较对照组改善，差异有统计学意义（P<0.05）。 结论 熊去氧胆酸联合茵栀黄口服液治疗妊娠期肝内胆汁淤积症临床疗效显著，能够明显改善相关生化指标，缓解临床症状，改善妊娠结局，减少对母婴的不良影响，具有积极的临床意义。

[关键词] 妊娠期肝内胆汁淤积症；熊去氧胆酸；茵栀黄口服液

[中图分类号] R714.255 [文献标识码] A [文章编号] 2095-0616（2017）07-193-03

Evaluation of clinical effect of ursodeoxycholic acid combined with Yinzhihuang oral liquid in treatment of intrahepatic cholestasis of pregnancy

ZHANG Yuhua

Taiping Town Shengang Health Center，Conghua District，Guangzhou 510900，China

[Abstract] Objective To explore evaluation of clinical effect of ursodeoxycholic acid combined with Yinzhihuang oral liquid in treatment of intrahepatic cholestasis of pregnancy. Methods 124 patients with intrahepatic cholestasis of pregnancy who were treated in department of obstetrics of our hospital were randomly divided into two groups.The control group was treated with ursodeoxycholic acid while the observation group was treated by ursodeoxycholic acid combined with Yinzhihuang oral liquid.Curative effects，intrahepatic cholestasis indexes and pregnancy outcomes of patients in two groups were compared. Results Effective rate of treatment of the observation group was 96.77%，which was significantly improved compared with that of the control group 75.81%.The difference was statistically significant （P<0.05）.Levels of TBA，ALT，AST and TB after treatment of the observation group were significantly lower than those of the control group.The difference was statistically significant （P<0.05）.Premature delivery，caesarean section，fetal distress， blood volume of postpartum 24h，neonatal birth weight and so on were all significantly improved compared with those of the control group.The difference was statistically significant （P<0.05）. Conclusion Ursodeoxycholic acid combined with Yinzhihuang oral liquid in treatment of intrahepatic cholestasis of pregnancy has significant clinical curative effect，which can significantly improve related biochemical index，relieve clinical symptoms， improve pregnancy outcome and reduce harmful effects on mother and infant.It has positive clinical significance.

[Key words] Intrahepatic cholestasis of pregnancy；Ursodeoxycholic acid；Yinzhihuang oral liquid

妊娠期肝內胆汁淤积症（ICP）为妊娠期特有疾病，属于高危妊娠，发生于妊娠中、晚期，临床表现为皮肤瘙痒、母体血清胆汁酸明显升高，可伴有肝功能异常。本病对胎儿影响较大，可导致早产、胎儿窘迫，甚至发生死胎，对产妇的影响主要为产后出血，其各项症状和体征于分娩后自然消失，在

此妊娠时复发率高，且有遗传倾向[1]。因此，及时有效的干预治疗对改善胎兒预后，促进良好妊娠结局，减少产妇产后出血等，具有重要的临床意义。西医治疗多采用熊去氧胆酸降胆汁酸，但临床疗效不一，部分患者可因治疗无效而提前剖宫产。中医治疗本病有丰富的临床经验，且对母胎无明显毒副作用[2]。本研究采用熊去氧胆酸联合茵栀黄口服液治疗妊娠期肝内胆汁淤积症，观察其临床效果，现报道如下。

1 资料与方法

1.1 一般资料

将2016年1～12月在我院产科治疗的124例妊娠期肝内胆汁淤积症患者随机分为两组。……