护肝利胆汤加减联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症的效果及对MMP-9、MMP-2水平及妊娠结局的影响

Effect of modified Hugan Lidan decoction combined with ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy and its influences on MMP-9,MMP-2 levels and pregnancy outcome

目的探讨护肝利胆汤加减联合熊去氧胆酸(UDCA)治疗妊娠期肝内胆汁淤积症(ICP)的效果及对基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶-2(MMP-2)水平、妊娠结局的影响。方法选择2018年5月至2020年10月收治的86例ICP患者为研究对象,根据随机数字表法将其分为对照组与观察组,各43例。对照组采用常规治疗+UDCA,观察组在对照组基础上给予护肝利胆汤加减治疗。比较两组的治疗效果。结果治疗后,两组的总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)水平均降低,且观察组低于对照组(P<0.05)。治疗后,两组的MMP-9、MMP-2水平均降低,且观察组低于对照组(P<0.05)。治疗后,两组的微小RNA-3614-5p(miR-3614-5p)、微小RNA-21(miR-21)表达水平均降低,胰岛素样生长因子结合蛋白-3(IGFBP-3)表达水平均升高,且观察组优于对照组(P<0.05)。观察组的不良妊娠结局发生率为11.63%,低于对照组的30.23%(P<0.05)。结论护肝利胆汤加减联合UDCA治疗ICP的效果满意,不仅能够有效改善患者的肝功能指标,还能减少不良妊娠结局的发生,值得推广。

Objective To investigate the effect of modified Hugan Lidan decoction combined with ursodeoxycholic acid(UDCA)in the treatment of intrahepatic cholestasis of pregnancy(ICP)and its influences on matrix metalloproteinase-9(MMP-9),matrix metalloproteinase-2(MMP-2)levels and pregnancy outcome.Methods A total of 86 ICP patients admitted from May 2018 to October 2020 were selected as the research objects.According to the random number table method,the patients were divided into control group and observation group,with 43 cases in each group.The control group was treated with conventional therapy+UDCA,and the observation group was treated with modified Hugan Lidan decoction on the basis of the control group.The therapeutic effects of the two groups were compared.Results After treatment,the levels of total bilirubin(TBIL),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in the two groups decreased,and those in the observation group were lower than the control group(P<0.05).After treatment,the levels of MMP-9 and MMP-2 in the two groups decreased,and those in the observation group were lower than the control group(P<0.05).After treatment,the expression levels of microRNA-3614-5p(miR-3614-5p)and microRNA-21(miR-21)in the two groups decreased,and the expression level of insulin-like growth factor binding protein-3(IGFBP-3)increased,and those in the observation group were better than the control group(P<0.05).The incidence of adverse pregnancy outcomes in the observation group was 11.63%,which was lower than 30.23%in the control group(P<0.05).Conclusion Modified Hugan Lidan decoction combined with UDCA in the treatment of ICP has satisfactic effect.It can not only effectively improve the liver function indexes of patients,but also reduce the occurrence of adverse pregnancy outcomes,which is worth promoting.