还原型谷胱甘肽联合双歧杆菌三联活菌对妊娠期肝内胆汁淤积症的治疗效果OA
Therapeutic Effect of Reduced Glutathione Combined with Live Combined Bifidobacterium,Lactobacillus and Enterococcus on Intrahepatic Cholestasis of Pregnancy
目的:探讨还原型谷胱甘肽联合双歧杆菌三联活菌治疗妊娠期肝内胆汁淤积症(ICP)的临床疗效及对患者肝功能、妊娠结局的影响.方法:选取2021年5月～2025 年 6 月本院收治的126 例 ICP 患者,采用随机数字表法分为对照1组、对照 2 组和联合组,每组 42 例.所有患者均给予常规治疗,对照1组口服双歧杆菌三联活菌胶囊,对照2组静脉滴注注射用还原型谷胱甘肽,联合组给予注射用还原型谷胱甘肽联合双歧杆菌三联活菌胶囊治疗.比较3组临床疗效、瘙痒症状评分、肝功能指标[总胆红素(TBIL)、总胆汁酸(TBA)、直接胆红素(DBIL)]、肠道菌群数量(双歧杆菌、大肠埃希菌、乳酸杆菌数量)、沉默信息调节因子1(SIRT1)/核因子κB p65(NF-κB p65)信号通路相关mRNA表达量、炎症因子[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)]及不良妊娠结局.结果:治疗4周后,联合组临床治疗总有效率高于对照1组、对照2组(P＜0.05).治疗2周及4周后,联合组瘙痒症状评分、TBIL、TBA、DBIL、NF-κB p65 mRNA表达量、TNF-α和IL-6均低于对照1组、对照2组,SIRT1 mRNA表达量高于对照1组、对照2组(P＜0.05);联合组与对照1组双歧杆菌、乳酸杆菌数量均高于对照2组,大肠埃希菌数量均低于对照2组(P＜0.05).3组不良妊娠结局总发生率比较无统计学差异(P＞0.05).结论:还原型谷胱甘肽联合双歧杆菌三联活菌可有效提高ICP患者临床疗效,改善皮肤瘙痒状况,促进肝功能恢复,调节肠道菌群数量,改善SIRT1、NF-κB p65 mRNA表达量.
Objective:To investigate the clinical efficacy of reduced glutathione combined with live combined Bifidobacterium,Lactobacillus and Enterococcus in the treatment of intrahepatic cholestasis of pregnancy(ICP),and its impact on patients'liver function and pregnancy outcomes.Methods:A total of 126 patients with ICP admitted to our hospital from May 2021 to June 2025 were selected and divided into control group 1,control group 2 and combination group by random number table method,with 42 patients in each group.All patients received conventional treatment.Control group 1 was treated with oral live combined Bifidobacterium,Lactobacillus and Enterococcus capsules,control group 2 was treated with intravenous infusion of reduced glutathione for injection,and the combination group was treated with reduced glutathione for injection combined with live combined Bifidobacterium,Lactobacillus and Enterococcus capsules.Clinical efficacy,pruritus symptom score,liver function indexes[total bilirubin(TBIL),total bile acid(TBA),direct bilirubin(DBIL)],intestinal flora counts(Bifidobacterium,Escherichia coli,Lactobacillus),expression levels of mRNA related to silent information regulator 1(SIRT1)/nuclear factor-kappa B p65(NF-κB p65)signaling pathway,inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],and adverse pregnancy outcomes were compared among the three groups.Results:After 4 weeks of treatment,the total clinical effective rate of the combination group was higher than that of control group 1 and control group 2(P<0.05).After 2 and 4 weeks of treatment,the pruritus symptom score,TBIL,TBA,DBIL,NF-κB p65 mRNA expression level,TNF-α and IL-6 in the combination group were lower than those in control group 1 and control group 2,and the SIRT1 mRNA expression level was higher than that in control group 1 and control group 2(P<0.05).The counts of Bifidobacterium and Lactobacillus in the combination group and control group 1 were higher than those in control group 2,and the count of Escherichia coli was lower than that in control group 2(P<0.05).There was no statistically significant difference in the total incidence of adverse pregnancy outcomes among the three groups(P>0.05).Conclusion:Reduced glutathione combined with live combined Bifidobacterium,Lactobacillus and Enterococcus can effectively improve the clinical efficacy of patients with ICP,relieve skin pruritus,promote the recovery of liver function,regulate the number of intestinal flora,and optimize the mRNA expression levels of SIRT1 and NF-κB p65.
张丽丽;董枫;周晓丽
河南中医药大学第五临床医学院(郑州人民医院)产科,郑州 450003河南中医药大学第五临床医学院(郑州人民医院)产科,郑州 450003河南中医药大学第五临床医学院(郑州人民医院)产科,郑州 450003
医药卫生
妊娠期肝内胆汁淤积症肠道菌群数量沉默信息调节因子1还原型谷胱甘肽双歧杆菌三联活菌
intrahepatic cholestasis of pregnancyintestinal flora countsilent information regulator 1reduced glutathionelive combined Bifidobacterium,Lactobacillus and Enterococcus
《中国合理用药探索》 2026 (3)
88-96,9
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