中西医结合治疗对妊娠期肝内胆汁淤积症患者血清sICAM-1、SULT2A1水平及肝功能的影响

Effects of Integrated Traditional Chinese and Western Medicine on Serum sICAM-1,SULT2A1 Levels and Liver Function in Patients with Intrahepatic Cholestasis of Pregnancy

目的:探讨中西医结合治疗妊娠期肝内胆汁淤积症(ICP)的临床效果。方法:选取2020年1月-2021年1月于江西省妇幼保健院接受治疗的60例ICP患者,采用随机数字表法将其分为研究组(n=30)及对照组(n=30)。对照组服用熊去氧胆酸片,研究组在对照组的基础上联合自拟利胆汤。比较两组临床疗效、中医症候积分、肝功能指标[谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素(TB)]、血清可溶性细胞间黏附分子-1(sICAM-1)、硫酸基转移酶2A1(SULT2A1)、妊娠结局及不良反应。结果:研究组治疗总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05)。研究组治疗后中医症候积分、AST、ALT、TB、sICAM-1水平均低于对照组,SULT2A1水平高于对照组,差异均有统计学意义(P<0.05)。研究组胎儿窘迫、新生儿窒息、羊水污染发生率分别为10.00%、3.33%、13.33%,均低于对照组的33.33%、26.67%、43.33%,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:中西医结合在ICP治疗中获得较好效果,可促进各临床症状好转及肝功能恢复,改善妊娠结局,安全性高,值得推广。

Objective:To investigate the clinical effect of integrated traditional Chinese and western medicine in the treatment of intrahepatic cholestasis of pregnancy(ICP).Method:A total of 60 ICP patients who were treated in Jiangxi Maternal and Child Health Hospital from January 2020 to January 2021 were selected,they were divided into study group(n=30)and control group(n=30)according to random number table method.The control group was treated with Ursodeoxycholic Acid Tablets,and the study group was treated with self-made Lidan Decoction on the basis of the control group.The clinical efficacy,traditional Chinese medicine syndrome scores,liver function indexes[aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bilirubin(TB)]and serum soluble intercellular adhesion molecule-1(sICAM-1),sulfotransferase 2A1(SULT2A1),pregnancy outcomes and adverse reactions were compared between two groups.Result:The total effective rate in the study group was 93.33%,which was higher than 73.33%in the control group,the difference was statistically significant(P<0.05).After treatment,the traditional Chinese medicine syndrome scores,AST,ALT,TB,and sICAM-1 levels in the study group were lower than those in the control group,and the SULT2A1 level in the study group was higher than that in the control group,the differences were statistically significant(P<0.05).The incidence of fetal distress,neonatal asphyxia and amniotic fluid pollution in the study group were 10.00%,3.33%,and 13.33%,respectively,which were lower than 33.33%,26.67%and 43.33%in the control group,the differences were statistically significant(P<0.05).There was no significant difference in adverse reactions between two groups(P>0.05).Conclusion:Integrative traditional Chinese and western medicine has achieved good results in the treatment of ICP,which can promote the improvement of various clinical symptoms,the recovery of liver function,and the improvement of pregnancy outcomes,it is safe and worthy of promotion.