金茵化瘀方联合丁二磺酸腺苷蛋氨酸对妊娠期肝内胆汁淤积症肝酶指标及脂质过氧化物的影响
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摘要
目的:观察金茵化瘀方联合丁二磺酸腺苷蛋氨酸治疗妊娠期肝内胆汁淤积症患者的临床疗效,及对肝酶指标及脂质过氧化物的影响。方法:将94例妊娠期肝内胆汁淤积症患者随机分为两组。对照组静脉滴注丁二磺酸腺苷蛋氨酸,1000 mg/次,1次/d;观察组在对照组治疗的基础上给予金茵化瘀方治疗,每日1剂,两组均连续治疗两周。比较治疗前后两组患者瘙痒症状改善情况、肝功能指标、脂质过氧化物指标;比较两组治疗后的临床疗效、妊娠结局及不良反应。结果:观察组的总有效率为91.5%,对照组的临床总有效率为76.6%,两组比较差异有统计学意义(P<0.05)。治疗后观察组的瘙痒评分明显低于对照组,两组比较有统计学差异(P<0.05)。两组治疗后ALT、AST、DBIL、TBA及TBIL水平显著降低,并且观察组的指标低于对照组(P<0.05);对照组治疗后MDA、SOD、GSH及NO水平没有明显变化,而观察组的指标治疗后显著降低(P<0.05),两组比较有统计学差异(P<0.05)。观察组的经阴分娩例数明显高于对照组(P<0.05),产妇并发症明显少于对照组(P<0.05),观察组的新生儿情况由于对照组(P<0.05)。观察组的不良反应发生率明显低于对照组,两组比较有统计学差异(P<0.05)。结论:金茵化瘀方联合丁二磺酸腺苷蛋氨酸治疗妊娠期肝内胆汁淤积症临床疗效确切,有效调节肝酶指标及脂质过氧化物水平,值得临床推广使用。
Objective: To observe the clinical efficacy of Jinying Huayu Decoction and adenosine methionine dimercaptosuccinate in the treatment of intrahepatic cholestasis of pregnancyand evaluate the effects of hepatic enzymes and lipid peroxides. Methods:Ninety-four patients with intrahepatic cholestasis during pregnancy were randomly divided into two groups. The patients in the control group were intravenously infused with adenosine methionine dimethylsulphate, 1000 mg/time, once a day. Patients in the observation group were treated with Jinyin Huayu Decoction on the basis of treatment in the control group, one dose per day. Both groups were continuouslytreated for two weeks. The pruritus symptom, liver function index and lipid peroxide indexes were compared between the two groups before and after treatment. The clinical efficacy, pregnancy outcomes and adverse reactions were compared between the two groups after treatment. Results: The total effective rate was 91.5% in the observation group and 76.6% in the control group. The difference between the two groups was statistically significant(P<0.05). After treatment, the itch score of the observation group was significantly lower than that of the control group, and there was a statistically significant difference between the two groups(P<0.05). The levels of ALT, AST, DBIL, TBA and TBIL were significantly lower in the two groups after treatment, and the indexes in the observation group were lower than those in the control group(P<0.05). The levels of MDA, SOD, GSH and NO in the control group did not change significantly after treatment. The index of the group was significantly decreased after treatment(P<0.05), and there was a statistical difference between the two groups(P<0.05). The number of cases of vaginal delivery in the observation group was significantly higher than that in the control group(P<0.05). The maternal complications were significantly less than that of the control group(P<0.05), and the neonatal condition in the observation group was superior to that of the control group(P<0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control groupand there was a statistically significant difference between the two groups(P<0.05). Conclusion: Jinyin Huayu Decoction combined with adenosine methionine succinate is effective in the treatment of intrahepatic cholestasis of pregnancy and can effectively regulate liver enzymes and lipid peroxide levels,worthy of clinical application.
Objective: To observe the clinical efficacy of Jinying Huayu Decoction and adenosine methionine dimercaptosuccinate in the treatment of intrahepatic cholestasis of pregnancyand evaluate the effects of hepatic enzymes and lipid peroxides. Methods:Ninety-four patients with intrahepatic cholestasis during pregnancy were randomly divided into two groups. The patients in the control group were intravenously infused with adenosine methionine dimethylsulphate, 1000 mg/time, once a day. Patients in the observation group were treated with Jinyin Huayu Decoction on the basis of treatment in the control group, one dose per day. Both groups were continuouslytreated for two weeks. The pruritus symptom, liver function index and lipid peroxide indexes were compared between the two groups before and after treatment. The clinical efficacy, pregnancy outcomes and adverse reactions were compared between the two groups after treatment. Results: The total effective rate was 91.5% in the observation group and 76.6% in the control group. The difference between the two groups was statistically significant(P<0.05). After treatment, the itch score of the observation group was significantly lower than that of the control group, and there was a statistically significant difference between the two groups(P<0.05). The levels of ALT, AST, DBIL, TBA and TBIL were significantly lower in the two groups after treatment, and the indexes in the observation group were lower than those in the control group(P<0.05). The levels of MDA, SOD, GSH and NO in the control group did not change significantly after treatment. The index of the group was significantly decreased after treatment(P<0.05), and there was a statistical difference between the two groups(P<0.05). The number of cases of vaginal delivery in the observation group was significantly higher than that in the control group(P<0.05). The maternal complications were significantly less than that of the control group(P<0.05), and the neonatal condition in the observation group was superior to that of the control group(P<0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control groupand there was a statistically significant difference between the two groups(P<0.05). Conclusion: Jinyin Huayu Decoction combined with adenosine methionine succinate is effective in the treatment of intrahepatic cholestasis of pregnancy and can effectively regulate liver enzymes and lipid peroxide levels,worthy of clinical application.
引文
[1] 潘方利,梁权芳,周银燕. 妊娠期肝内胆汁淤积症不良母婴结局的临床分析[J]. 中国当代医药,2017,24(5):61-63.
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[7] 刘娟,魏忠诚. 茵黄汤加减辅助治疗妊娠期肝内胆汁淤积症48例临床疗效观察[J]. 四川中医,2017,35(10):123-125.
[8] 樊阳阳,张京京,王影. S-腺苷蛋氨酸联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症的临床疗效及对肝功能、炎症因子的影响[J]. 药物评价研究,2018,41(2):267-271.
[9] 李珺. 丁二磺酸腺苷蛋氨酸与地塞米松联合对妊娠期肝内胆汁淤积患者疗效观察及对患者炎症因子和肝功能影响[J]. 中国中西医结合消化杂志,2018,26(1):58-61.
[10] 杨德红,邵庆华. 丁二磺酸腺苷蛋氨酸联合多烯磷脂酰胆碱治疗妊娠期肝内胆汁淤积症的疗效观察[J]. 肝脏,2018(4):357-359.
[11] 张振琪,瞿晓青,高羽迪. 茵陈丹芍汤治疗妊娠期肝内胆汁淤积症的临床疗效及其对Th1/Th2平衡的影响[J]. 浙江中医杂志,2017,52(9):634-635.
[12] 陈展,余晓晓,梁海娜,等. 莲黄汤治疗妊娠肝内胆汁淤积症30 例疗效观察[J]. 浙江中医杂志,2016,51(11):839.
[13] 符慧慧. 茵陈蒿汤治疗妊娠期肝内胆汁淤积症价值分析[J]. 实用中西医结合临床,2017,17(10):45-47.
[14] 赵爱荣.妊娠期肝内胆汁淤积症的研究[J].医疗装备,2018,31(6):194-195.
[15] 刘慧,周昌菊. 脂质过氧化对妊娠肝内胆汁淤积症患者母儿红细胞ATP酶的影响[J]. 实用预防医学,2011,18(2):286-288.
[16] 李亚男. 妊娠期肝内胆汁淤积症患者脂质过氧化物及雌激素水平改变及临床意义[J]. 中国妇幼保健,2013,28(23):3758-3760.
[17] 程春燕,潘颖,田彩霞. 妊娠期肝内胆汁淤积症患者体内氧化还原系统的变化与胎儿窘迫的关系[J]. 中国妇幼保健,2015,30(35):6191-6192.
[18] 谢萍,王莹,尹燕平. S-腺苷甲硫氨酸联合还原型谷胱甘肽治疗妊娠期肝内胆汁淤积症[J]. 国际妇产科学杂志,2017,44(2):222-224,240.
[19] 周学梅. 还原型谷胱甘肽治疗妊娠期肝内胆汁淤积症的效果观察[J]. 中国妇幼保健,2017,32(9):1885-1887.
[20] 金海. 妊娠期肝内胆汁淤积症患者血脂和雌激素水平变化及其意义[J]. 泰山医学院学报,2018,39(3):338-339.
[2] 范晓艳. 妊娠期肝内胆汁淤积症的辨治经验——莲黄汤的异病同治运用[J]. 中国妇幼健康研究, 2017,28(4):500.
[3] 刘滢瑜,尤子善,任贤勤. 妊娠期肝内胆汁淤积症161例临床分析[J]. 中国妇产科临床杂志,2017,18(5):452-453.
[4] 胡小玲,李美琴. 中西医结合治疗妊娠期肝内胆汁淤积症的疗效和对妊娠结局的影响[J]. 肝脏,2016,21(11):1008-1009.
[5] 贺晶,杨慧霞,段涛,等.妊娠期肝内胆汁淤积症诊疗指南[S].临床肝胆病杂志,2015,31(10):1575-1578.
[6] 田辉,雷莹娟,葛静. 熊去氧胆酸联合抗胆瘀汤治疗妊娠期肝内胆汁淤积症的临床疗效及对妊娠结局的影响[J]. 中医药导报,2016,22(5):86-89.
[7] 刘娟,魏忠诚. 茵黄汤加减辅助治疗妊娠期肝内胆汁淤积症48例临床疗效观察[J]. 四川中医,2017,35(10):123-125.
[8] 樊阳阳,张京京,王影. S-腺苷蛋氨酸联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症的临床疗效及对肝功能、炎症因子的影响[J]. 药物评价研究,2018,41(2):267-271.
[9] 李珺. 丁二磺酸腺苷蛋氨酸与地塞米松联合对妊娠期肝内胆汁淤积患者疗效观察及对患者炎症因子和肝功能影响[J]. 中国中西医结合消化杂志,2018,26(1):58-61.
[10] 杨德红,邵庆华. 丁二磺酸腺苷蛋氨酸联合多烯磷脂酰胆碱治疗妊娠期肝内胆汁淤积症的疗效观察[J]. 肝脏,2018(4):357-359.
[11] 张振琪,瞿晓青,高羽迪. 茵陈丹芍汤治疗妊娠期肝内胆汁淤积症的临床疗效及其对Th1/Th2平衡的影响[J]. 浙江中医杂志,2017,52(9):634-635.
[12] 陈展,余晓晓,梁海娜,等. 莲黄汤治疗妊娠肝内胆汁淤积症30 例疗效观察[J]. 浙江中医杂志,2016,51(11):839.
[13] 符慧慧. 茵陈蒿汤治疗妊娠期肝内胆汁淤积症价值分析[J]. 实用中西医结合临床,2017,17(10):45-47.
[14] 赵爱荣.妊娠期肝内胆汁淤积症的研究[J].医疗装备,2018,31(6):194-195.
[15] 刘慧,周昌菊. 脂质过氧化对妊娠肝内胆汁淤积症患者母儿红细胞ATP酶的影响[J]. 实用预防医学,2011,18(2):286-288.
[16] 李亚男. 妊娠期肝内胆汁淤积症患者脂质过氧化物及雌激素水平改变及临床意义[J]. 中国妇幼保健,2013,28(23):3758-3760.
[17] 程春燕,潘颖,田彩霞. 妊娠期肝内胆汁淤积症患者体内氧化还原系统的变化与胎儿窘迫的关系[J]. 中国妇幼保健,2015,30(35):6191-6192.
[18] 谢萍,王莹,尹燕平. S-腺苷甲硫氨酸联合还原型谷胱甘肽治疗妊娠期肝内胆汁淤积症[J]. 国际妇产科学杂志,2017,44(2):222-224,240.
[19] 周学梅. 还原型谷胱甘肽治疗妊娠期肝内胆汁淤积症的效果观察[J]. 中国妇幼保健,2017,32(9):1885-1887.
[20] 金海. 妊娠期肝内胆汁淤积症患者血脂和雌激素水平变化及其意义[J]. 泰山医学院学报,2018,39(3):338-339.