中西医结合治疗原发性胆汁性肝硬化的临床观察

目的观察熊去氧胆酸（UDCA）联合中药愈肝方治疗原发性胆汁性肝硬化（PBC）的临床疗效。方法回顾性分析2007年1月～2012年4月在我院住院并符合纳入标准的PBC患者共63人，根据治疗方案不同，分为治疗组（UDCA联合愈肝方治疗）及对照组（UDCA治疗），比较两组的临床疗效。结果治疗12周后，治疗组有25例（83．3％）好转，对照组有17例好转（51．5％），治疗组的好转率优于对照组，两者比较差异有统计学意义（P〈0．05）。且治疗组在总胆红素（TBIL）、碱性磷酸酶（ALP）、γ-谷氨酰转肽酶（γ-GT）、丙氨酸氨基转氨酶（ALT）、天门冬氨酸氨基转氨酶（AST）几项主要生化指标方面均较对照组有显著下降（P〈0．05或P〈0．01）。结论UDCA联合中药愈肝方治疗原发性胆汁性肝硬化，较单用UDCA更有效。本研究中采用的愈肝方，不仅体现了中医辨证治疗的传统思想，而且综合考虑了单味药的现代药理研究结果，为中西医结合治疗PBC探索了一个新的治疗理念，充分体现了中西医结合治疗的特色。

Clinical Observation of Primary Biliary Cirrhosis Treated with Integrated Chinese and Western Medicine

Objective To observe the clinical efficacy on primary biliary cirrhosis （PBC）treated with ursodeoxycholic acid（UDCA） combined with Chinese medicine, yuganfang. Methods 63 cases of PBC in compliance with the inclusive criteria and admitted in the hospital from January 2007 to April 2012 were the subjects in the retrospective analysis. According to the different treatment programs, a treatment group （ UDCA ＋ yufanfang） and a control group（UDCA） were divided. The clinical efficacy was compared between two groups. Results In 12 weeks of treatment, 25 cases （ 83.3% ） in the treatment group and 17 cases （51.5%） in the control group were improved. The improvement rate in the treatment group was superior to the control group, presenting the statistical significant difference （ P 〈 0. 05 ）. In the treatment group, the main biochemical indexes such as TBIL, ALP, γ-GT, ALT and AST were reduced significantly as compared with the control group（P〈0.05 orP〈0.01）. Conclusion UDCA combined with Chinese medicine,yuganfang is more effective in the treatment of PBC as compared with the single medication of UDCA. In the research, yuganfang was adopted, which not only embodies the traditional idea of pattern/syndrome differentiation in traditional Chinese medicine,but also comprehensively considers the modern pharmaceutical research results of single herbal medicine. It explores a new therapeutic idea in the treatment of PBC with the integrated Chi- nese and western medicine and fully reflects the characteristics of the integration of Chinese and western med- icine in treatment.