학술논문
Combination of silymarin and choline bitartrate in pregnancy induced pruritus
Document Type
Report
Source
Journal of Evolution of Medical and Dental Sciences. March 11, 2013, Vol. 2 Issue 10, p1559, 8 p.
Subject
Language
English
ISSN
2278-4748
Abstract
INTRODUCTION: Milk thistle has been used medicinally since the fourth century BCE. Its use in treating hepatobiliary diseases dates back to the 1700s, and its use as a liver protectant [...]
Intrahepatic cholestasis of pregnancy also known as Prurigo Gravidarum, often presents with symptoms mainly pruritus, severe enough to demand therapy and is of greater relevance due to its consequent fetal complications. Many drugs have been evaluated in its management, silymarin, a Milk Thistle extract being a promising modality. Considering that the bioavailability of Silymarin can be enhanced in combination with choline bitartrate, this study was conducted with the intention to establish that it can be a more safe and effective option for relieving pruritus and reducing complications. MATERIAL AND METHODS: A prospective randomized open labeled study was conducted on 20 antenatal patients second trimester onwards attending the Antenatal clinic, Medical College Kolkata from September 2009 to February 2010, suffering from pruritus and fulfilling both inclusion and exclusion criteriae. Apart from routine medications, they were prescribed 140 mg silymarin and 450 mg choline bitartrate thrice daily for 4 weeks and reassessment of parameters considered were done 7-10 days of therapeutic completion. Principal parameters evaluated included Itching area by rule of 5, duration and severity of itching (objectively scored) and laboratory investigations especially liver function assessment. RESULTS: Itching score, area and duration were reduced in all patients. Serum SGOT and SGPT levels were reduced in 45% and 35% cases respectively. CONCLUSION: Therefore, the fixed drug regime comprising of silymarin and choline bitartrate evaluated in the trial definitely provided both symptomatic as well as biochemical relief to the patients. Perinatal and neonatal outcome were uneventful. KEY WORDS: pregnancy pruritus, intrahepatic cholestasis, silymarin, choline bitartrate
Intrahepatic cholestasis of pregnancy also known as Prurigo Gravidarum, often presents with symptoms mainly pruritus, severe enough to demand therapy and is of greater relevance due to its consequent fetal complications. Many drugs have been evaluated in its management, silymarin, a Milk Thistle extract being a promising modality. Considering that the bioavailability of Silymarin can be enhanced in combination with choline bitartrate, this study was conducted with the intention to establish that it can be a more safe and effective option for relieving pruritus and reducing complications. MATERIAL AND METHODS: A prospective randomized open labeled study was conducted on 20 antenatal patients second trimester onwards attending the Antenatal clinic, Medical College Kolkata from September 2009 to February 2010, suffering from pruritus and fulfilling both inclusion and exclusion criteriae. Apart from routine medications, they were prescribed 140 mg silymarin and 450 mg choline bitartrate thrice daily for 4 weeks and reassessment of parameters considered were done 7-10 days of therapeutic completion. Principal parameters evaluated included Itching area by rule of 5, duration and severity of itching (objectively scored) and laboratory investigations especially liver function assessment. RESULTS: Itching score, area and duration were reduced in all patients. Serum SGOT and SGPT levels were reduced in 45% and 35% cases respectively. CONCLUSION: Therefore, the fixed drug regime comprising of silymarin and choline bitartrate evaluated in the trial definitely provided both symptomatic as well as biochemical relief to the patients. Perinatal and neonatal outcome were uneventful. KEY WORDS: pregnancy pruritus, intrahepatic cholestasis, silymarin, choline bitartrate