丹参川芎嗪注射液对孕晚期肝内胆汁淤积症孕妇的治疗作用

doi:10.12092/j.issn.1009-2501.2018.04.014

中国临床药理学与治疗学 ›› 2018, Vol. 23 ›› Issue (4): 446-450.doi: 10.12092/j.issn.1009-2501.2018.04.014

丹参川芎嗪注射液对孕晚期肝内胆汁淤积症孕妇的治疗作用

应佳微¹，吴亮²，盛少琴¹

¹浙江中医药大学附属第二医院妇产科，杭州 310005，浙江； ²浙江中医药大学附属第一医院ICU，杭州 310006，浙江

收稿日期:2017-09-18 修回日期:2017-10-19 出版日期:2018-04-26 发布日期:2018-04-13
通讯作者: 盛少琴，女，硕士，主任医师，硕士生导师，主要从事妇产科学研究工作。 Tel:13819195728 E-mail：shshaoqin@sina.com
作者简介:应佳微，女，硕士，主要从事妇产科学研究工作。 Tel:18257345948 E-mail:1525261358@qq.com
基金资助:
浙江省中医药科技计划资助项目（2017ZA059）

Clinical study on the treatment of salvia ligustrazine injection on pregnant women with ICP in late pregnancy

YING Jiawei¹，WU Liang²，SHENG Shaoqin¹

¹ Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, Zhejiang, China;² Department of Critical Care Medicine, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang, China

Received:2017-09-18 Revised:2017-10-19 Online:2018-04-26 Published:2018-04-13

摘要/Abstract

摘要：

目的:探讨丹参川芎嗪注射液对孕晚期肝内胆汁淤积症（ICP）孕妇的治疗作用。方法:按照ICP诊疗指南（2015）分别筛选出ICP孕妇轻度289例，重度157例，利用随机数表法，分为治疗组和对照组。轻度对照组：予熊去氧胆酸250 mg，口服，每日3次治疗；重度对照组：予熊去氧胆酸250 mg，口服，每日3次+S腺苷蛋氨酸1.0 g，静滴，每日1次治疗。治疗组在对照组基础上加用5%葡萄糖注射液500 mL+丹参川芎嗪注射液10 mL，静滴，每日1次。以7 d为一个疗程，治疗前后分别检测各组血清总胆汁酸（TBA）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、人绒毛膜促性腺激素（hCG），脐动脉血流S/D值及评估各组瘙痒分值。结果:轻度ICP的两组孕妇TBA、ALT、AST、hCG、S/D值及瘙痒评分均较治疗前降低，治疗前后差异具有统计学意义（P＜0.05），治疗组与对照组组间变化相近（P＞0.05）；重度ICP的两组孕妇TBA、ALT、AST、hCG、S/D值及瘙痒评分均较治疗前降低，治疗前后差异具有统计学意义（P＜0.05），治疗组与对照组组间比较差异亦有统计学意义（P＜0.05）；血清hCG与脐动脉血流S/D值呈正相关关系（轻度组r=0.498，0.479，P＜0.01；重度组r=0.491，0.475，P＜0.01）。结论:丹参川芎嗪注射液能降低重度ICP孕妇生化指标、S/D值及hCG水平，改善瘙痒症状，但对轻度ICP孕妇无明显疗效。

关键词: 丹参川芎嗪注射液, ICP, hCG水平, S/D值, 瘙痒评分

Abstract:

AIM: To investigate the clinical study on the effect of salvia ligustrazine injection on pregnant women with ICP in late pregnancy. METHODS: Two hundred and eighty-nine mild cases and one hundred and fifty-seven severe cases of pregnant women with ICP selected by ICP diagnosis and treatment guidelines (2015) were randomly divided into treatment group and control group. Mild control group received ursodeoxycholic acid 250 mg, oral, 3 times a day; severe control group received ursodeoxycholic acid 250 mg, oral, 3 times a day and S-adenosy-L-methionine 1.0 g, ivgtt, once a day. The treatment group was added with 5% glucose injection 500 mL+salvia ligustrazine injection 10 mL, ivgtt, once a day on the basis of the control group. Seven days counts for a course of treatment, the serum total bile acids (TBA), alanine aminotransferase (ALT), aspartate aminotransferase (AST), human chorionic gonadotropin (hCG), S/D ratio of umbilical artery blood flow and pruritus scores were measured before and after treatment. RESULTS: After treatment, the levels of TBA, ALT, AST, hCG, S/D ratio and pruritus score in mild ICP were lower than those before treatment, there was statistically significant difference before and after treatment in both groups (P＜0.05),and there was no significant difference between the treatment group and the control group (P>0.05). After treatment, the levels of TBA, ALT, AST, hCG, S/D ratio and pruritus score in severe ICP were lower than those before treatment, there was statistically significant difference before and after treatment in both groups (P＜0.05), and there were significant differences between the treatment group and the control group (P＜0.05); there was a positive correlation between serum hCG and S/D ratio (in mild group r=0.498,0.479, P＜0.01;in severe group r=0.491,0.475, P＜0.01). CONCLUSION: Salvia miltiorrhiza injection can reduce the biochemical indexes, S/D ratio and hCG level of severe ICP pregnant women, and improve the symptoms of pruritus, but no obvious treatment effect on mild ICP pregnant women was observed.

Key words: salvia ligustrazine injection, intrahepatic cholestasis of pregnancy, human chorionic gonadotropin level, systolic/diastolic ratio, pruritus score

中图分类号:

R714

应佳微，吴亮，盛少琴. 丹参川芎嗪注射液对孕晚期肝内胆汁淤积症孕妇的治疗作用[J]. 中国临床药理学与治疗学, 2018, 23(4): 446-450.

YING Jiawei，WU Liang，SHENG Shaoqin. Clinical study on the treatment of salvia ligustrazine injection on pregnant women with ICP in late pregnancy[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2018, 23(4): 446-450.

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丹参川芎嗪注射液对孕晚期肝内胆汁淤积症孕妇的治疗作用

Clinical study on the treatment of salvia ligustrazine injection on pregnant women with ICP in late pregnancy

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