Clinical Study of Ursodeoxycholic Acid Combined with Adenosylmethionine in the Treatment of Intrahepatic Cholestasis of Pregnancy / 医学研究杂志

ABSTRACT

Objective To study the clinical efficacy of ursodeoxycholic acid combined with adenosylmethionine in the treatment of intrahepatic cholestasis of pregnancy (ICP) and its effect on pregnancy outcomes.Methods One hundred and four patients with ICP were divided into study group (52 cases) and control group (52 cases) according to the random number table.The patients in the control group were treated with ursodeoxycholic acid on the basis of routine treatment.While ursodeoxycholic acid combined with adenosylmethionine in the study group.The levels of serum IL-17 and TGF-β were measured before and after treatment,and the serum levels of IL-17 and TGF-β were measured before and after the treatment in both groups.The clinical efficacy,pregnancy outcome and also the levels of serum IL-17 and TGF-β were measured and compared before and after treatment in both groups.Results The treatment efficiency (88.46％) of the study group was significantly higher than that of the control group (71.15％),the difference was statistically significant (P ＜ 0.05).The clinical efficacy of mild ICP patients in the control group was better than that the severe ICP patients (P ＜ 0.05),but the clinical efficacy of the study group was not significantly related to the severity of ICP.The score of pruritus in the ICP group was significantly higher than that in the mild ICP group (P ＜ 0.05),and the score of itching in the study group was significantly lower than that in the control group (P ＜ 0.05).The pregnancy outcome of the study group was significantly better than that of the control group (P ＜0.05).The pregnancy outcome of severe ICP patients was significantly better than that of the mild ICP patients (P ＜ 0.05).The improvement of liver function in study group was better than that in control group,and the improvement of liver function in severe ICP patients was less than that in mild ICP group (P ＜ 0.05).The improvement of IL-17 and TGF-β levels in the study group was better than that in the control group,and the levels of IL-17 and TGF-β in patients with severe ICP were lower than those in patients with mild ICP (P ＜ 0.05).Conclusion Ursodeoxycholic acid combined with adenosylmethionine can significantly improve the outcome of pregnancy and the liver function in patients with intrahepatic cholestasis of pregnancy.The mechanism of which may be to improve the patient's Th1T/Treg imbalance,the efficacy is related to the severity of ICP.