加味茵陈蒿汤联合熊去氧胆酸治疗原发性胆汁性肝硬化的临床研究

目的:观察加味茵陈蒿汤联合熊去氧胆酸治疗30例原发性胆汁性肝硬化临床分期为早中期患者的临床疗效。方法:60例患者随机分为对照组和治疗组各30例。两组均给予基础治疗,对照组患者同时口服熊去氧胆酸胶囊15～20mg.kg-1.d-1;治疗组患者在对照组基础上加服加味茵陈蒿汤,1剂/d,疗程均为24周。观察治疗前后两组患者的临床疗效、肝功能(γ-GT、ALP、ALT、AST、TBil)、免疫指标(IgM、IgG及IgA)的变化。结果:治疗结束时,治疗组26例(86.7%)患者得到完全反应,与对照组19例(63.3%)比较差异有显著性意义(P<0.05);两组患者治疗后肝功能(γ-GT、ALP、ALT、AST、TBil)均较治疗前明显下降(P<0.05),治疗组治疗后肝功能下降明显优于对照组(P<0.05或P<0.01);治疗后两组患者免疫指标IgM、IgG、IgA均较前有所下降,经比较差异无统计学意义(P>0.05)。结论:加味茵陈蒿汤联合熊去氧胆酸治疗原发性胆汁性肝硬化,较单用熊去氧胆酸疗效更好,并能明显改善患者的肝功能。

Clinical efficacy of ursodeoxycholic acid combined with modified Artemisiae Scopariae decoction for treating 30 cases of primary biliary cirrhosis

Objective:To observe the efficacy of ursodeoxycholic acid(UDCA) combined with modified Artemisiae Scopariae decoction for treating the patients with primary biliary cirrhosis(PBC) in Ⅱor Ⅲ clinical stage.Methods: Sixty PBC patients were assigned randomly and equally to the control group and the treatment group,the control group was given basic treatment plus UDCA 15～20mg·kg-1·d-1,besides the treatment of the control group,the patients in the treatment group took modified herbae artemisiae capillariae decoction,the treatment course was 24 wk.The clinical effect,biochemistry indicators(γ-GT,ALP,ALT,AST and TBil)and immunoglobulin levels(IgM,IgG and IgA)were compared before and after treatment.Results:After 24wk-treatment,in the treatment group 86.7%(26/30 cases) patients had CR,while in the control group,the ratio was 63.3%(19/30 cases),showing a significantly better effect in the treatment group than in the control group(P<0.05);In both control and treatment group,compared with before treatment,the levels of γ-GT,ALP,ALT,AST and TBil were decreased significantly(P<0.05),but in control group,the level was still which were markedly higher than that those in the treatment group at the same(P<0.05,P<0.01).In all patients,the levels of IgA,IgG and IgM decreased,but there was no significant difference(P>0.05).Conclusion:Combined therapy of modified herbae artemisiae capillariae decoction and UDCA has better therapeutic effect than UDCA monotherapy to PBC,especially on improving liver function.