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

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.