加味茵陈蒿汤联合熊去氧胆酸治疗原发性胆汁性胆管炎的临床疗效及对FGF19的影响

Clinical efficacy of Modified Yinchenhao Decoction combined with ursodeoxycholic acid in the treatment of primary biliary cholangitis and effect on FGF19

目的评价加味茵陈蒿汤联合熊去氧胆酸治疗原发性胆汁性胆管炎的临床疗效及对血清FGF19的影响。方法将64例肝胆湿热兼瘀血阻络型原发性胆汁性胆管炎患者随机分为治疗组和对照组,每组32例。治疗组给予加味茵陈蒿汤联合熊去氧胆酸治疗,对照组给予熊去氧胆酸治疗。两组疗程均为12个月,观察中医证候积分、生化学应答率、肝脏生化指标、血清FGF19的变化情况。结果①治疗后,治疗组、对照组的生化学应答率分别为87.5%、62.5%,组间差异有统计学意义(P<0.05);②治疗后,治疗组血清ALT、AST、GGT、ALP水平均较对照组下降,差异有统计学意义(P<0.05);③治疗后,治疗组中医证候积分低于对照组,差异有统计学意义(P<0.05);④治疗后,治疗组血清FGF19水平较对照组升高,差异有统计学意义(P<0.05)。结论加味茵陈蒿汤联合熊去氧胆酸治疗肝胆湿热兼瘀血阻络型原发性胆汁性胆管炎,能够有效提高生化学应答率,可改善血清ALT、AST、GGT、ALP水平及中医证候积分,提高血清FGF19水平。

Objective To evaluate the clinical efficacy of Modified Yinchenhao Decoction combined with ursodeoxycholic acid(UDCA)in the treatment of primary biliary cholangitis(PBC)and the effect on serum fibroblast growth factor 19(FGF19).Methods Sixty-four cases of PBC with syndrome of dampness heat in liver and gallbladder and blood stasis blocking collaterals were randomly divided into the treatment group and control group,32 cases in each group.The treatment group was treated with modified Yinchenhao Decoction and UDCA,while the control group was treated with UDCA,with a course of 12 weeks.The changes of Chinese medical syndrome score,biochemical response rate,liver biochemical indexes and serum FGF19 were observed.Results①After treatment,the biochemical response rate of the treatment group was 87.5%and the biochemical response rate of the control group was 62.5%,and there was statistically significant difference(P<0.05).②After treatment,the levels of ALT,AST,GGT and ALP in the treatment group were lower than those in the control group,with statistically significant differences(P<0.05).③After treatment,the Chinese medical syndrome score in the treatment group was lower than that in the control group,with statistically significant difference(P<0.05).④After treatment,the level of serum FGF19 in the treatment group was higher than that in the control group,with statistically significant difference(P<0.05).Conclusion Modified Yinchenhao Decoction combined with UDCA can effectively enhance the biochemical response rate in the treatment of PBC with syndrome of dampness heat in liver and gallbladder and blood stasis blocking collaterals,improve the serum levels of ALT,AST,GGT,ALP and the Chinese medical syndrome score,and increase the level of serum FGF19.