Analysis of Chinese Traditional Medicine in the Treatment of Intrahepatic Cholestasis of Pregnancy

doi:10.3877/cma.j.issn.1673-5250.2012.06.020

Objective

To evaluate clinical efficacy and safety of Chinese traditional medicine in the treatment of intrahepatic cholestasis of pregnancy (ICP).

Methods

The following databases were researched, including, Medline (Ovid, January 1902 to December 2011), EM base (January 1984 to December 2011), CBM (January 1978 to December 2010), Chinese Journal Full-text Database (CNKI, January 1979 to December 2011), Chinese Science and Technology Journals Full-text Database (VIP, January 1989 to December 2010), Wanfang Database (January 1977 to December 2010). The studies were screened, and the qualities were evaluated according to predefined inclusion and exclusion criteria, and then analysis was conducted by using RevMan 4.2.10 software.

Results

A total of 3 RCTs involving 249 patients were included. The results showed that Chinese traditional medicine group was superior to control group in remission rate of pruritus, rate of jaundice resolution, small for gestational age, premature delivery, birth weight, systolic/diastolic ratio (S/D) value and resistance index (RI). In addition, compared with Chinese traditional medicine group, control group was greatly superior in total clinical effects, postpartum hemorrhage and neonatal mortality rate.

Conclusions

Because of the low methodological quality and small sample, this conclusion needs to be proved by more high-quality, large-scale and multicenter randomized controlled trials in the future. There is no evidence that Chinese traditional medicine is ineffective or harmful, and the cost is generally not high. Clinicians can be based on individual circumstances selective use, especially during research and careful observation of its efficacy.

Key words: Chinese traditional medicine, intrahepatic cholestasis of pregnancy, randomized controlled trial

表1 3篇文献分析比较

Table 1 The analysis of three studies

纳入文献	n	治疗措施		疗程(个)	不良反应
纳入文献	n	治疗组	对照组	疗程(个)	不良反应
夏卫红等^[9]	40	抗淤胆汤药方：当归15 g，茵陈15 g，白芍10 g，首乌10 g，山栀10 g，黄芩10 g，柴胡10 g，川芎6 g，炙甘草9 g，每日1剂，水煎服，每剂服用2次，3次/d，100 mL/次，每15剂为1个疗程	地塞米松(口服，3 mg，3次/d，10 d后减量，每2 d减至原药量1/3)	不详	未发现
赵淑英^[10]	81	抗淤胆汤药方：龙胆草10 g，茵陈30 g，栀子10 g，黄柏15 g，川穹10 g，丹参30 g，黄芪15 g，党参15 g，黄芩15 g，白术10 g，浮萍10 g)，每日1剂，分早、晚水煎服用，7 d为1个疗程，抗淤胆汤＋考来烯胺(消胆胺)(4 g/次，3次/d，7 d为1个疗程)	消胆胺(口服，4 g/次，3次/d，7 d为1个疗程)	3	未提及
徐明娟等^[11]	128	川芎注射液(30 mL)＋10%葡萄糖注射液(500 mL)＋维生素C(2 g)＋维生素K1 (10 mg)，静脉滴注，7 d为1个疗程	10%葡萄糖注射液(500 mL)＋维生素C(2 g)＋维生素K1 (10 mg)，静脉滴注，7 d为1个疗程	1～2	头痛、心悸、面色潮红

表1 3篇文献分析比较

Table 1 The analysis of three studies

纳入文献	n	治疗措施		疗程(个)	不良反应
纳入文献	n	治疗组	对照组	疗程(个)	不良反应
夏卫红等^[9]	40	抗淤胆汤药方：当归15 g，茵陈15 g，白芍10 g，首乌10 g，山栀10 g，黄芩10 g，柴胡10 g，川芎6 g，炙甘草9 g，每日1剂，水煎服，每剂服用2次，3次/d，100 mL/次，每15剂为1个疗程	地塞米松(口服，3 mg，3次/d，10 d后减量，每2 d减至原药量1/3)	不详	未发现
赵淑英^[10]	81	抗淤胆汤药方：龙胆草10 g，茵陈30 g，栀子10 g，黄柏15 g，川穹10 g，丹参30 g，黄芪15 g，党参15 g，黄芩15 g，白术10 g，浮萍10 g)，每日1剂，分早、晚水煎服用，7 d为1个疗程，抗淤胆汤＋考来烯胺(消胆胺)(4 g/次，3次/d，7 d为1个疗程)	消胆胺(口服，4 g/次，3次/d，7 d为1个疗程)	3	未提及
徐明娟等^[11]	128	川芎注射液(30 mL)＋10%葡萄糖注射液(500 mL)＋维生素C(2 g)＋维生素K1 (10 mg)，静脉滴注，7 d为1个疗程	10%葡萄糖注射液(500 mL)＋维生素C(2 g)＋维生素K1 (10 mg)，静脉滴注，7 d为1个疗程	1～2	头痛、心悸、面色潮红

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