熊去氧胆酸联合甘草酸二铵治疗原发性胆汁性胆管炎的效果观察

张玉果; 赵素贤; 李文聪; 任伟光; 南月敏

doi:10.3969/j.issn.1001-5256.2019.06.028

熊去氧胆酸联合甘草酸二铵治疗原发性胆汁性胆管炎的效果观察

DOI: 10.3969/j.issn.1001-5256.2019.06.028

基金项目:

中国肝炎防治基金会-天晴肝病研究基金(TQGB20140203)；河北省中医药管理局课题(2014143)；

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中图分类号: R575.7
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出版历程
- 收稿日期: 2019-02-14
- 出版日期: 2019-06-20

Clinical effect of ursodeoxycholic acid combined with diammonium glycyrrhizinate in treatment of primary biliary cholangitis

Research funding:

摘要

摘要:
目的对比熊去氧胆酸（UDCA）联合甘草酸二铵与单用UDCA治疗原发性胆汁性胆管炎（PBC）的生化学应答和肝脏硬度变化情况。方法选取2014年1月-2016年3月就诊于河北医科大学第三医院中西医结合肝病科的PBC患者66例,均行FibroTouch检测,以肝脏硬度值表示肝纤维化程度,对比分析UDCA联合甘草酸二铵与单用UDCA治疗PBC患者4、12、24和48周的肝生化学应答和治疗24、48周后肝脏硬度值变化情况。两组间计量资料比较采用两独立样本t检验,治疗前后生化学指标及肝脏硬度值比较采用配对t检验。结果 UDCA联合甘草酸二铵治疗组与单用UDCA对照组比较,联合治疗组AST水平在治疗后4周[（38. 4±15. 4） U/L vs （61. 6±28. 8） U/L,t=2. 684,P=0. 012]、12周[（36. 4±12. 6） U/L vs （58. 1±24. 8） U/L,t=2. 953,P=0. 006)]、24周[（37. 0±8. 5） U/L vs （52. 9±17. 2） U/L,t=3. 134,P=0. 004]、48周[（34. 9±7. 9） U...
- 原发性胆汁性胆管炎 /
- 熊去氧胆酸 /
- 甘草酸二铵
Abstract:
Objective To investigate the clinical effect of ursodeoxycholic acid (UDCA) alone or in combination with diammonium glycyrrhizinate on biochemical response and liver stiffness measurement (LSM) in the treatment of primary biliary cholangitis (PBC) . Methods A total of 66 patients with PBC who visited Department of Traditional and Western Medical Hepatology, Third Hospital of Hebei Medical University, from January 2014 to March 2016 were enrolled. The FibroTouch test was performed, and LSM was used to indicate the degree of liver fibrosis. The patients treated with UDCA and diammonium glycyrrhizinate (treatment group) and those treated with UDCA alone (control group) were compared in terms of liver biochemical response at 4, 12, 24, and 48 weeks of treatment and LSM at 24 and 48 weeks of treatment. The independent samples t-test was used for comparison of continuous data between two groups, and the paired t-test was used for comparison of biochemical parameters and LSM before and after treatment. Results Compared with the control group, the treatment group had a significantly lower level of aspartate aminotransferase at 4, 12, 24, and 48 weeks of treatment (4 weeks: 38. 4 ± 15. 4 U/L vs61. 6 ± 28. 8 U/L, t = 2. 684, P = 0. 012; 12 weeks: 36. 4 ± 12. 6 U/L vs 58. 1 ± 24. 8 U/L, t = 2. 953, P = 0. 006; 24 weeks: 37. 0 ± 8. 5 U/L vs 52. 9 ± 17. 2 U/L, t = 3. 134, P = 0. 004; 48 weeks: 34. 9 ± 7. 9 U/L vs 48. 6 ± 12. 7 U/L, t = 3. 463, P = 0. 002) , as well as a significantly lower level of alkaline phosphatase at 24 and 48 weeks of treatment (24 weeks: 91. 6 ± 15. 1 U/L vs 137. 3 ± 55. 6 U/L, t =2. 970, P = 0. 006; 48 weeks: 71. 3 ± 14. 7 U/L vs 128. 7 ± 45. 5 U/L, t = 4. 503, P < 0. 001) . There was a significant reduction in LSM at 24 and 48 weeks of treatment in the control group (24 weeks: 12. 9 ± 6. 8 kPa vs 13. 9 ± 7. 6 k Pa, t = 4. 814, P < 0. 001; 48 weeks:12. 6 ± 6. 4 kPa vs 13. 9 ± 7. 6 kPa, t = 3. 928, P = 0. 010) and the treatment group (24 weeks: 13. 4 ± 7. 0 kPa vs 15. 8 ± 9. 7 k Pa, t =3. 031, P = 0. 010; 48 weeks: 12. 0 ± 5. 7 kPa vs 15. 8 ± 9. 7 kPa, t = 3. 044, P = 0. 010) ; however, there was no significant difference in LSM between the control group and the treatment group at 24 and 48 weeks of treatment (all P > 0. 05) . Conclusion In patients with PBC, UDCA combined with diammonium glycyrrhizinate can improve serum biochemical response and has a better clinical effect than UDCA alone.Both groups have a significant reduction in LSM at 24 and 48 weeks of treatment, suggesting that UDCA combined with diammonium glycyrrhizinate can help to maintain disease stability.
- primary biliary cholangitis /
- ursodeoxycholic acid /
- diammonium glycyrrhizinate

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