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目的探讨熊去氧胆酸联合不同药物治疗原发性胆汁性肝硬化的疗效及安全性。方法选择2013年1月至2014年12月我院收治的原发性胆汁性肝硬化患者120例为研究对象,随机分为三组:单用熊去氧胆酸治疗(A组);熊去氧胆酸+多烯磷胆碱胶囊治疗(B组);熊去氧胆酸+水飞蓟宾胶囊治疗(C组)。每组40例,疗程12个月,观察3种不同治疗方案的临床疗效,观察用药前、用药后1、3、6、12个月肝功、主要症状等指标变化,记录治疗过程中不良反应发生情况。结果三组患者治疗后各项症状均有改善,治疗前后比较均有统计学差异(P<0.05),治疗后6、12个月症状积分比较,B、C组优于A组(P<0.05),治疗后各时间点B、C组之间比较无统计学差异(P>0.05);治疗后12个月B、C组完全反应率优于A组(P<0.05),B、C组之间比较无统计学差异(P>0.05);治疗前三组血清ALT、AST、ALP、GGT、TBI组间比较无统计学差异(P>0.05),各指标治疗后与治疗前比较均显著降低(P<0.05),第一个月降低幅度最大,降低幅度B、C组优于A组(P<0.05),B、C组组间比较无统计学差异(P>0.05);不良反应发生率组间比较无统计学差异(P=0.89)。结论熊去氧胆酸联合多烯磷胆碱胶囊或水飞蓟宾胶囊治疗原发性胆汁性肝硬化安全有效,有助于改善患者肝功能及临床症状。
Objective To investigate the efficacy and safety of ursodeoxycholic acid combined with different drugs in the treatment of primary biliary cirrhosis. Methods A total of 120 patients with primary biliary cirrhosis admitted from January 2013 to December 2014 in our hospital were randomly divided into three groups: Ursodeoxycholic acid alone (A group), Bears Treatment with oxycholic acid + polyenephrine capsules (group B); Ursodeoxycholic acid + silybin capsules (group C). Each group of 40 cases, treatment of 12 months, observed the clinical efficacy of three different treatment options, observed before treatment, the liver function, the main symptoms and other indicators 1,3,6,12 months after treatment, record the adverse reactions in the course of treatment What happened? Results The symptoms of all three groups were improved after treatment, and there were significant differences between before and after treatment (P <0.05). After 6 and 12 months of treatment, symptom scores were better in group B and C than in group A (P <0.05) ). There was no significant difference between groups B and C after treatment (P> 0.05). The complete response rate of group B and C at 12 months after treatment was better than that of group A (P <0.05), and group B and C (P> 0.05). There was no significant difference in serum ALT, AST, ALP, GGT and TBI between the three groups before treatment (P> 0.05), and there was significant difference between before treatment and after treatment (P <0.05). The first month had the largest decrease and the decrease rate was lower in group B than in group A (P <0.05), but there was no significant difference between group B and group C (P> 0.05). Adverse reactions There was no significant difference in incidence between groups (P = 0.89). Conclusion Ursodeoxycholic acid combined with phorbol choline capsules or silybin capsules safe and effective treatment of primary biliary cirrhosis, help to improve liver function and clinical symptoms.