摘要
Abstract
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.关键词
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Key words
intrahepatic cholestasis of pregnancy/intestinal flora count/silent information regulator 1/reduced glutathione/live combined Bifidobacterium,Lactobacillus and Enterococcus分类
医药卫生
