优化通胆汤联合熊去氧胆酸治疗原发性胆汁性肝硬化临床观察  

Clinical observation of optimized “Tongdan Decoction ” and ursodesoxycholic acid for the treatment of primary biliary cirrhosis

作　　者：魏春山[1] 唐海鸿[1] 贺劲松[1] 郑颖俊[1] 周大桥[1] 童光东[1] 

机构地区：[1]广东省深圳市中医院肝病科,广东深圳518033

出　　处：《上海中医药杂志》2014年第8期37-39,共3页Shanghai Journal of Traditional Chinese Medicine

基　　金：广东省中医药局"建设中医药强省"科研项目(20132022)

摘　　要：目的观察优化通胆汤联合熊去氧胆酸治疗原发性胆汁性肝硬化的临床疗效。方法将66例原发性胆汁性肝硬化患者随机分为治疗组与对照组,每组33例。对照组予复方甘草酸苷片、熊去氧胆酸胶囊等治疗,治疗组同时加用优化通胆汤治疗。两组疗程均为1年,观察主要临床症状及体征的变化,比较肝功能(ALT、AST、GGT、ALP、TB、TBA)、免疫学指标(IgM、IgG、IgA、AMA及各亚型、ANA)、肝脏瞬时弹性成像硬度值的变化情况。结果 1治疗前后组内比较,两组皮肤瘙痒、乏力、黄疸、肝肿大、脾肿大等主要临床症状及体征的变化差异均有统计学意义(P<0.05);组间治疗后比较,皮肤瘙痒、乏力、黄疸、肝肿大、脾肿大等主要临床症状及体征的变化差异有统计学意义,治疗组优于对照组(P<0.05)。2治疗前后组内比较,两组ALT、AST、GGT、ALP、TB、TBA差异均有统计学意义(P<0.05);组间治疗后比较,ALT、AST、GGT、ALP、TB、TBA差异有统计学意义,治疗组优于对照组(P<0.05)。3治疗前后组内比较,治疗组IgG、IgA差异有统计学意义(P<0.05),而对照组IgM、IgG、IgA差异无统计学意义(P>0.05);组间治疗后比较,IgG、IgA差异有统计学意义,治疗组优于对照组(P<0.05)。治疗前后组内比较,两组AMA(总、M2、M4、M9)、ANA阳性率的差异均无统计学意义(P>0.05);组间治疗后比较,AMA(总、M2、M4、M9)、ANA阳性率的差异均无统计学意义(P>0.05)。4治疗前后组内比较,两组肝脏硬度值差异均有统计学意义(P<0.05);组间治疗后比较,肝脏硬度值差异有统计学意义,治疗组优于对照组(P<0.05)。结论优化通胆汤联合熊去氧胆酸治疗原发性胆汁性肝硬化,可明显缓解患者的临床主症,改善肝功能及肝脏硬度,降低肝纤维化程度。Objective To observe the clinical efficacy of optimized ＂Tongdan Decoction＂ and ursodesoxycholic acid for the treatment of primary biliary cirrhosis （PBC）. Methods Sixty-six cases with PBC were randomized into treatment group and control group, with 33 cases in each group. Control group was treated with Compound Glycyrrhizin Tablets and Ursodeoxycholic Acid Capsules, and treatment group was additionally treated with optimized ＂Tongdan Decoction＂, with the course of 1 year. We observed the clinical symptoms and signs. The liver function indicators of ALT, AST, GGT, ALP, TB, TBA and immunologic indicators of lgM, IgG, IgA, AMA, M2, M4, M9 and ANA were compared. The changes of liver transient elastography were observed. Results ① There were statistical differences of the improvements of the main signs and symptoms of the skin itching, fatigue, jaundice, hepatomegaly and splenomegaly between before and after treatment in both two groups （ P 〈 0. 05 ） ; after treatment, there were statistical differences of the improvements of the main signs and symptoms of the skin itching, fatigue, jaundice, hepatomegaly and splenomegaly between the two groups （ P 〈 0.05 ）. ② There were statistical differences in the indicators of liver function （ ALT, AST, GGT, ALP, TB, TBA） between before and after treatment in both two groups （ P 〈 0.05 ） ; and after treatment, there were statistical differences in the indicators of ALT, AST, GGT, ALP, TB, TBA between the two groups （P 〈 0.05）. ③ There were statistical differences in the levels of serum IgG and IgA in the treatment group （ P 〈 0.05 ） and no statistical difference was found in the serum IgM, IgG and IgA in the control group （ P 〉 0.05 ） ; after treatment, there were statistical differences in the levels of serum IgG and IgA between the two groups （ P 〈 0.05 ）. No statistical differences in positive rates of AMA and ANA between before and after treatment （ P 〉 0.05 ） ; after treatment, no statistical differences

关 键 词：原发性胆汁性肝硬化 优化通胆汤 熊去氧胆酸 肝脏瞬时弹性成像硬度值 

分 类 号：R575.2[医药卫生—消化系统]