【摘要】 目的评估两种方法治疗妊娠肝内胆汁淤积症的效果。方法临床诊断为肝内胆汁淤积症患者45例,随机分为对照组(n=21)与治疗组(n=24),对照组仅用S-腺苷蛋氨酸静滴治疗,治疗组应用S-腺苷蛋氨酸静滴及针刺治疗(肝俞、胆俞、风市、百虫窝、太冲、曲泉)。两组治疗均以10天为1疗程。治疗10天后进行临床瘙痒症状、血中胆汁酸及转氨酶的评价,分娩后观察两组的早产率、新生儿体质量和新生儿窒息率。结果治疗组治疗后皮肤瘙痒评分,血中胆汁酸、天冬氨酸转氨酶和丙氨酸转氨酶降低数值分别为(1.07±0.69),(48.3±2.1)μmol/L,(3.96±0.26)U/L,(1.99±0.21)U/L;早产率、新生儿体质量和新生儿窒息率分别为8.33%、(3.6±0.4)kg、25.0%。对照组皮肤瘙痒评分,血中胆汁酸、天冬氨酸转氨酶和丙氨酸转氨酶降低数值分别为(2.56±0.57),(22.5±3.8)μmol/L,(0.94±0.15)U/L,(0.74±0.15)U/L;早产率、新生儿体质量和新生儿窒息率分别为:38.1%、(3.4±0.3)kg、33.33%。治疗组较对照组皮肤瘙痒评分、血中胆汁酸、转氨酶的浓度明显下降(P<0.05);早产率下降(P<0.05),但新生儿体质量和新生儿窒息率差异无统计学意义(P>0.05)。结论S-腺苷蛋氨酸联合针刺治疗妊娠肝内胆汁淤积症效果确切,可部分改善围产儿的预后。更多还原

【Abstract】 Objective: To observe the therapeutic effect of integrating Chinese and Western Medicine on intrahepatic cholestasis of pregnancy.Methods: Forty-five patients with intrahepatic cholestasis of pregnancy were randomly divided into the two groups: treated group and control group.The treated group was treaded by s-adenosyl methionine combined acupuncture(Ganshu Ganshu Fengshi Baichongwo Taichong Ququan),and the control group only by s-adenosyl methionine.After 10 days treatment,the liver function and itch score were observed.After parturition,the incidence of premature delivery,the weight of newboms and the incidence of neonatal asphyxia were studied.Results: In the treated group,the itch score was(1.07±0.69),and the decrease of TAB,AST and ALT were(48.3±2.1)μmol/L,(3.96±0.26)U/L,(1.99±0.21)U/L respectively.The incidence of premature delivery,the weight of newboms and the incidence of neonatal asphyxia were 8.33%,(3.6±0.4)kg,25.0%.In the control group,the itch score was(2.56±0.57),and the decrease of TAB,AST and ALT were(22.5±3.8)μmol/L,(0.94 ±0.15)U/L,(0.74 ±0.15)U/L.The incidence of premature delivery,the weight of newboms and the incidence of neonatal asphyxia were 38.1%,(3.4±0.3)kg、33.33%.Compared with the control group,the serum cholic acid,transom inase and score of itch were significantly decreased in the treated group(P<0.05).The incidence of premature delivery was also lowered(P<0.05) but the difference in the weight of newboms and the incidence of neonatal asphyxia was not significant(P>0.05).Conclusion: The Method of integratting Chinese and Western exerts definite therapeutic effect on patients with intrahepatic cholestasis of pregnancy.The prognosis of their fetus can somewhat be improved by this treatment.更多还原