新医学
新醫學
신의학
NEW CHINESE MEDICINE
2015年
5期
308-311
,共4页
王淑平%陈宝艳%刘志辉%李艳芳%李道成%孙晓峰
王淑平%陳寶豔%劉誌輝%李豔芳%李道成%孫曉峰
왕숙평%진보염%류지휘%리염방%리도성%손효봉
清热利胆法%妊娠期肝内胆汁淤积症%临床疗效%辅助性T细胞17%调节性T细胞
清熱利膽法%妊娠期肝內膽汁淤積癥%臨床療效%輔助性T細胞17%調節性T細胞
청열리담법%임신기간내담즙어적증%림상료효%보조성T세포17%조절성T세포
Antipyretic choleretic method%Intrahepatic cholestasis of pregnancy%Clinical efficacy%T helper cell 17%Regulatory cell
目的:探讨茵陈蒿汤联合丁二磺酸腺苷蛋氨酸治疗妊娠期肝内胆汁淤积症(ICP)的临床疗效及其对辅助性 T 细胞17(Th17)/调节性 T 细胞(Treg)平衡的影响。方法选择40例 ICP患者,随机分为中西医联合治疗组(A 组)和单纯西医治疗组(B 组)各20例,B 组单纯给予丁二磺酸腺苷蛋氨酸治疗,A 组在 B 组基础上联合茵陈蒿汤治疗,另选择20名健康孕妇作健康对照组(C 组)。观察 A、B 组 ICP 患者在治疗前、后的瘙痒评分、肝功能,比较 A、B、C 组 Th17/Treg 相关细胞因子 IL-17、TGF-β的变化及妊娠结局。结果治疗后,A 组 ICP 患者瘙痒评分、胆汁酸、ALT、AST 均低于 B 组(P 均<0.05);在妊娠结局方面,3组的早产率、新生儿窒息率及新生儿体质量比较差异均无统计学意义(P 均>0.05)。A、B 组 ICP 患者外周血 IL-17水平均明显高于健康对照组, TGF-β水平均低于健康对照组(P 均<0.05);与 B 组相比,治疗后 A 组 IL-17降低及 TGF-β升高更加明显(P 均<0.05)。结论茵陈蒿汤联合丁二磺酸腺苷蛋氨酸治疗 ICP 疗效显著,其机制可能与改善 Th17/Treg 失衡状态有关。
目的:探討茵陳蒿湯聯閤丁二磺痠腺苷蛋氨痠治療妊娠期肝內膽汁淤積癥(ICP)的臨床療效及其對輔助性 T 細胞17(Th17)/調節性 T 細胞(Treg)平衡的影響。方法選擇40例 ICP患者,隨機分為中西醫聯閤治療組(A 組)和單純西醫治療組(B 組)各20例,B 組單純給予丁二磺痠腺苷蛋氨痠治療,A 組在 B 組基礎上聯閤茵陳蒿湯治療,另選擇20名健康孕婦作健康對照組(C 組)。觀察 A、B 組 ICP 患者在治療前、後的瘙癢評分、肝功能,比較 A、B、C 組 Th17/Treg 相關細胞因子 IL-17、TGF-β的變化及妊娠結跼。結果治療後,A 組 ICP 患者瘙癢評分、膽汁痠、ALT、AST 均低于 B 組(P 均<0.05);在妊娠結跼方麵,3組的早產率、新生兒窒息率及新生兒體質量比較差異均無統計學意義(P 均>0.05)。A、B 組 ICP 患者外週血 IL-17水平均明顯高于健康對照組, TGF-β水平均低于健康對照組(P 均<0.05);與 B 組相比,治療後 A 組 IL-17降低及 TGF-β升高更加明顯(P 均<0.05)。結論茵陳蒿湯聯閤丁二磺痠腺苷蛋氨痠治療 ICP 療效顯著,其機製可能與改善 Th17/Treg 失衡狀態有關。
목적:탐토인진호탕연합정이광산선감단안산치료임신기간내담즙어적증(ICP)적림상료효급기대보조성 T 세포17(Th17)/조절성 T 세포(Treg)평형적영향。방법선택40례 ICP환자,수궤분위중서의연합치료조(A 조)화단순서의치료조(B 조)각20례,B 조단순급여정이광산선감단안산치료,A 조재 B 조기출상연합인진호탕치료,령선택20명건강잉부작건강대조조(C 조)。관찰 A、B 조 ICP 환자재치료전、후적소양평분、간공능,비교 A、B、C 조 Th17/Treg 상관세포인자 IL-17、TGF-β적변화급임신결국。결과치료후,A 조 ICP 환자소양평분、담즙산、ALT、AST 균저우 B 조(P 균<0.05);재임신결국방면,3조적조산솔、신생인질식솔급신생인체질량비교차이균무통계학의의(P 균>0.05)。A、B 조 ICP 환자외주혈 IL-17수평균명현고우건강대조조, TGF-β수평균저우건강대조조(P 균<0.05);여 B 조상비,치료후 A 조 IL-17강저급 TGF-β승고경가명현(P 균<0.05)。결론인진호탕연합정이광산선감단안산치료 ICP 료효현저,기궤제가능여개선 Th17/Treg 실형상태유관。
Objective To investigate the clinical efficacy of oriental virgate wormwood decoction in combination with S-adenosyl methionine in treating intrahepatic cholestasis of pregnancy (ICP)and evaluate the influence on Th17 /Treg balance.Methods Forty ICP patients were randomly divided into the integrated Western and Traditional Chinese medicine (group A,n =20)and the Western medicine groups (group B,n =20).In the group A,patients were treated with oriental virgate wormwood decoction plus S-adenosyl methio-nine and those in the group B received S-adenosyl methionine alone.Another 20 healthy pregnant women were chosen as normal controls (group C).The pruritus score and liver function before and after treatment were ob-served in the groups A and B.Changes in the levels of Th17 /Treg-related cytokines,such as IL-17 and TGF-βand pregnant outcomes were statistically compared among three groups.Results After treatment,the pruri-tus score,bile acid,ALT and AST in the group A were significantly lower than those in the group B (all P <0.05).With respect to pregnant outcomes,the premature birth rate,neonatal asphyxia rate and neonatal weight did not significantly differ among three groups (all P >0.05).In groups A and B,IL-17 of peripheral blood was significantly higher whereas the level of TGF-βwere considerably lower compared with those in the control group (both P <0.05).Compared with group B,more significant IL-17 decrease and TGF-βincrease were noted in the group A (both P <0.05).Conclusions Oriental virgate wormwood decoction combined with S-adenosyl methionine is highly efficacious in treating ICP,probably due to the mechanism by alleviating Th17 /Treg ratio imbalance.