熊去氧胆酸+苯扎贝特治疗原发性胆汁性胆管炎的临床效果

Clinical effect of ursodeoxycholic acid combined with bezafibrate in the treatment of primary biliary cholangitis

目的探讨熊去氧胆酸+苯扎贝特治疗原发性胆汁性胆管炎(PBC)的临床效果。方法将我院2017年1月至2018年4月收治的80例PBC患者随机分为观察组和对照组,各40例。对照组常规予以熊去氧胆酸治疗,观察组在熊去氧胆酸的基础上加用苯扎贝特治疗。比较两组患者治疗前、后肝功能指标、纤维化血清学指标、血清细胞因子水平,并观察主要临床症状缓解情况及不良反应发生情况。结果治疗后,两组血清TBIL、ALT、ALP、GGT及AST水平均显著降低,且观察组ALP及AST水平明显低于对照组(P<0.05)。治疗后,两组血清HA、TIMP-1、LN、PCⅢ水平均明显降低,且观察组明显低于对照组(P<0.05)。治疗后,两组的血清IL-1、IL-6、IL-22、TNF-α水平均明显降低,且观察组低于对照组(P<0.05)。治疗后,两组乏力、瘙痒阳性率均明显降低(P<0.05),但组间比较,差异无统计学意义(P>0.05)。观察组不良反应总发生率为10.00%,对照组无任何不良反应发生,组间比较,差异无统计学意义(P>0.05)。结论苯扎贝特治疗PBC,可改善肝功能,改善肝纤维化,抑制炎性细胞因子水平,具有良好的应用前景。

Objective To explore the clinical effect of ursodeoxycholic acid combined with bezafibrate in the treatment of primary biliary cholangitis(PBC). Methods Eighty patients with PBC admitted in our hospital from January 2017 to April2018 were randomly divided into observation group and control group, with 40 cases in each group. The control group was treated with ursodeoxycholic acid routinely, while the observation group was treated with bezafibrate on the basis of ursodeoxycholic acid. The liver function indexes, fibrosis serological indexes and serum cytokine levels were compared between the two groups before and after treatment, and the main clinical symptoms and adverse reactions were observed.Results After treatment, the levels of serum TBIL, ALT, ALP, GGT and AST in the two groups significantly decreased,while the levels of ALP and AST in the observation group were significantly lower than those in the control group(P<0.05).After treatment, the levels of serum HA, TIMP-1, LN and PC Ⅲ in both groups significantly decreased, and those of the observation group were significantly lower than the control group(P<0.05). After treatment, the levels of serum IL-1, IL-6,IL-22 and TNF-α in the two groups significantly decreased, and those of the observation group were lower than the control group(P<0.05). After treatment, the positive rate of fatigue and pruritus in both groups significantly decreased(P<0.05), but there were no significant differences between the two groups(P >0.05). The total incidence of adverse reactions in the observation group was 10.00%;no adverse reactions occurred in the control group, and there were no significant differences between the two groups(P>0.05). Conclusion Benzafibrate can improve liver function, improve liver fibrosis and inhibit the levels of inflammatory cytokines in the treatment of PBC, which has a good application prospect.