水飞蓟宾联合熊去氧胆酸对原发性胆汁性肝硬化患者临床疗效及肝功能的影响  

Clinical Efficacy of Silymarin Combined with Ursodeoxycholic Acid in the Treatment of Patients with Primary Biliary Cirrhosis and Its Effect on Liver Function

作　　者：张贺媛 王芳[1] 吴璇 刘雪姣 黄春洋[1] 王璇[1] ZHANG Heyuan;WANG Fang;WU Xuan;LIU Xuejiao;HUANG Chunyang;WANG Xuan(Beijing You′an Hospital,Capital Medical University,Beijing,China 100069)

机构地区：[1]首都医科大学附属北京佑安医院,北京100069

出　　处：《中国药业》2024年第5期105-108,共4页China Pharmaceuticals

基　　金：北京市属医院科研培育计划项目[PX2019062]。

摘　　要：目的探讨水飞蓟宾(SIL)联合熊去氧胆酸(UDCA)治疗原发性胆汁性肝硬化(PBC)的临床疗效,以及对患者肝功能的影响。方法选取医院2020年5月至2022年8月收治的PBC患者118例,按用药方案的不同分为单药组(57例)和联合组(61例)。单药组患者口服UDCA,联合组患者在单药组治疗基础上加用SIL,两组患者均治疗24周。结果联合组总有效率为95.08%,显著高于单药组的71.93%(P<0.05)。治疗后,两组患者的总胆红素、丙氨酸氨基转移酶、碱性磷酸酶、γ-谷氨酰转移酶,以及Ⅲ型前胶原、Ⅳ型胶原、层粘连蛋白、透明质酸酶水平均显著降低(P<0.05),且联合组均显著低于单药组(P<0.05)。单药组和联合组不良反应发生率相当(14.04%比21.31%,P>0.05)。结论SIL联合UDCA治疗PBC的临床疗效良好,可改善患者的肝功能指标及肝纤维化指标,且安全性良好。Objective To investigate the clinical efficacy of Silymarin Capsules combined with ursodeoxycholic acid in the treatment of patients with primary biliary cirrhosis(PBC)and its effect on liver function.Methods A total of 118 patients with PBC admitted to the hospital from May 2020 to August 2022 were selected and divided into the monotherapy group(57 cases)and the combined group(61 cases)according to different medication regimens.The patients in the monotherapy group were orally treated with ursodeoxycholic acid,on this basis,the patients in the combined group were treated with Silymarin Capsules.Both groups were treated for 24 weeks.Results The total effective rate in the combined group was 95.08%,which was significantly higher than 71.93%in the monotherapy group(P<0.05).After treatment,the levels of total bilirubin(TBiL),alanine aminotransferase(ALT),alkaline phosphatase(ALP)andγ-glutamyltransferase(GGT),and the levels of typeⅢprocollagen(PCⅢ),typeⅣcollagen(Ⅳ-C),laminin(LN),and hyaluronidase(HA)in the two groups significantly reduced(P<0.05),and those in the combined group were significantly lower than those in the monotherapy group(P<0.05).The incidence of adverse reactions in the monotherapy group was comparable to that in the combined group(14.04%vs.21.31%,P>0.05).Conclusion Silymarin Capsules combined with ursodeoxycholic acid in the treatment of patients with PBC have good clinical efficacy and safety,which can improve patients'liver function indexes and liver fibrosis indexes.

关 键 词：水飞蓟宾 熊去氧胆酸 原发性胆汁性肝硬化 肝功能 肝纤维化 临床疗效 

分 类 号：R969.4[医药卫生—药理学] R975.5[医药卫生—药学]