复方鳖甲软肝片联合丁二磺酸腺苷蛋氨酸和熊去氧胆酸治疗PBC患者疗效及其对血清肝纤维化指标的影响  

Efficacy of Fufangbiejia Ruanganpian and ursodeoxycholic acid combination in the treatm ent of patients with primary biliary cirrhosis

作　　者：刘进国 王暴魁[2] Liu Jinguo;Wang Baokui(Department of Internal Medicine of Traditional ChineseMedicine, People＇s Hospital, Zhaoling District, Luohe 462300, Henan Province, Chin)

机构地区：[1]河南省漯河市召陵区人民医院中医内科,462300 [2]北京中医药大学附属东方医院消化科

出　　处：《实用肝脏病杂志》2018年第3期340-343,共4页Journal of Practical Hepatology

基　　金：漯河市科技局医药科技计划项目(编号:201504377)

摘　　要：目的探讨复方鳖甲软肝片联合丁二磺酸腺苷蛋氨酸肠溶片和熊去氧胆酸胶囊治疗原发性胆汁性肝硬化(PBC)患者的疗效及对血清肝纤维化指标的影响。方法 2012年9月～2016年9月我院诊治的64例PBC患者,采用随机数字表法将其分为观察组32例和对照组32例。给予对照组丁二磺酸腺苷蛋氨酸和熊去氧胆酸胶囊治疗,观察组在对照组治疗的基础上给予复方鳖甲软肝片治疗,两组均治疗24 w。采用放射免疫法检测血清透明质酸(HA)、三型前胶原N端肽(PC-Ⅲ)、四型胶原(IV-C)和层粘连蛋白(LN)水平,采用GQOL-74生活质量评分量表行生活质量评价。结果在治疗24 w末,观察组血清ALT、AST和TBIL水平分别为(54.4±15.0)U/L、(61.3±16.4)U/L和(23.7±9.5)μmol/L,明显低于对照组[分别为(70.3±16.1)U/L、(75.5±16.5)U/L和(36.8±9.7)μmol/L,P<0.05];观察组血清HA、LN、PC-Ⅲ和IV-C水平分别为(116.9±12.5)μg/L、(103.4±11.4)μg/L、(123.6±22.8)μg/L和(80.4±9.8)μg/L,明显低于对照组[(156.5±12.7)μg/L、(126.9±11.2)μg/L、(155.5±22.4)μg/L和(97.6±9.9)μg/L,P<0.05];观察组躯体功能、心理功能、社会功能和物质生活评分分别为(78.9±8.6)分、(80.8±7.5)分、(89.7±9.7)分和(83.7±9.3)分,明显高于对照组[(69.7±8.3)分、(71.9±7.6)分、(79.7±9.5)分和(75.2±9.2)分,P<0.05]。结论复方鳖甲软肝片联合丁二磺酸腺苷蛋氨酸肠溶片和熊去氧胆酸胶囊治疗PBC患者效果显著,可有效改善患者肝功能,降低血清HA、LN、PC-Ⅲ和IV-C水平,提高患者生活质量。Objective To investigate the efficacy of Fufangbiejia Ruanganpian, a herbal compound,andursodeoxycholic acid （UDCA） combination in the treatment of patients with primary biliary cirrhosis （PBC） .Methods 64 patients with PBC were recruited in this study between September 2012 and September 2016, andthey were randomly divided into two groups by computer-generated numbers. The patients in observation groupreceived Fufangbiejia Ruanganpian, succinic acid adenosine methionine, and UDCA, and the patients in the controlreceived all but the herbal compound medicines. Serum hyaluronic acid （HA）, laminin （LN）, procollagen Nterminal peptide （PC-III） and type fore collagen （IV -C） levels were detected routinely and life quality wasestimated by GQOL-74. Results At the end of observation, serum ALT, AST and TBIL levels in the combinationgroup were （54.4±15.）U/L,（61.3±16.4）U/L and（23.7±9.5）μmol/L, significantly lower than（70.3±16.1）U/L,（75.5±16.5）U/L and（36.8±9.7）μmol/L in the control（P〈0.05）; serum HA, LN, PC-III and IV-C levels were （116.9±12.5）μg/L,（103.4±11.4）μg/L,（123.6±22.8）μg/L and（80.4±9.8） μg/L, significantly lower than（156.5±12.7） μg/L,（126.9 ±11.2） μg/L,（155.5 ±22.4） μg/L and （97.6 ±9.9） μg/L in the control （P〈0.05）; the physical function,psychological function, social function and material life scores were （78.9±8.6） ,（80.8±7.5） ,（89.7±9.7）and（83.7±9.3） , significantly higher than （69.7 ±8.3） ,（71.9 ±7.6） ,（79.7 ±9.5） and （75.2 ±9.2） in the control （P〈0.05） .Conclusion The combination of the Chinese herbal compound and adenosine methionine as well as UDCA intreatment of patients with PBC is effective, which might improve the liver functions, reduce serum HA, LN, PC-IIIand IV-C levels and improve the quality of life.

关 键 词：原发性胆汁性肝硬化 复方鳖甲软肝片 丁二磺酸腺苷蛋氨酸 熊去氧胆酸 治疗 

分 类 号：R575.22[医药卫生—消化系统]