茵陈柴胡汤对妊娠期肝内胆汁淤积症患者糖脂代谢及MRP表达的影响

Effects of Yinchen Chaihu Decoction on Glucose and Lipid Metabolism and MRP Expression of ICP Patients

目的:探究茵陈柴胡汤对妊娠期肝内胆汁淤积症(ICP)糖脂代谢及胎盘胆盐载体(MRP)表达影响性。方法:选取2016年12月至2018年12月山东省立第三医院收治的ICP患者112例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组56例。对照组常规治疗,观察组常规治疗基础上加用茵陈柴胡汤,均治疗2周。比较治疗前后肝功能、免疫功能、糖脂指标、胎盘组织MRP变化以及妊娠结局。结果:1)治疗后2组TBA、CG、ALT、AST、HbA1c、FPG、TG、TC、LDL-C、IL-12、TNF-α较治疗前均下降(P<0.05),HDL-C、IL-4较治疗前均升高(P<0.05),观察组优于对照组(P<0.05)。2)治疗后2组胎盘组织MRP1、MRP2较治疗前均显著升高(P<0.05),观察组优于对照组(P<0.05)。3)治疗后观察组早产、新生儿窘迫、羊水粪染、新生儿窒息、剖宫产发生率显著低于对照组,体质量高于对照组,比较差异有统计学意义(P<0.05)。结论:茵陈柴胡汤能通过改善ICP糖脂代谢及胎盘MRP,提高免疫功能和肝功能,从而改善母婴结局。

Objective:To investigate the influence of Yinchen Chaihu Decoction on glucose and lipid metabolism and placental bile salt carrier(MRP)expression in intrahepatic cholestasis of pregnancy(ICP).Methods:A total of 112 patients with ICP were included,and were randomly divided into a control group(56 cases)and a study group(56 cases),according to random number expression method.The control group was treated routinely,and the observation group was treated with Yinchen Chaihu Decoction on the basis of routine treatment,and both were treated for 2 weeks.Liver function,immune function,glucose and lipid indexes,placental tissue MRP changes and pregnancy outcome were compared before and after treatment.Results:1)After treatment,TBA,CG,ALT,AST,HbA1c,FPG,TG,TC,LDL-C,IL-12,TNF-αwere all lower than those before treatment(P<0.05),HDL-C,IL-4 were higher than those before treatment(P<0.05),and the study group was better than the control group(P<0.05).2)After treatment,placental tissue MRP1 and MRP2 in both groups were significantly higher than those before treatment(P<0.05),and the study group was better than the control group(P<0.05).3)After treatment,the incidences of premature delivery,neonatal distress,amniotic fluid,neonatal asphyxia,and cesarean delivery were significantly lower in the study group than in the control group,and their body weight was higher than that in the control group.Conclusion:Yinchen Chaihu Decoction can improve maternal and infant outcomes by improving ICP glucose and lipid metabolism and placental MRP,and improving immune function and liver function.