Efficacy of Ursodeoxycholic Acid Combined with Tongdan Decoction(通胆汤) on Immunological Indices and Histopathological Changes in Primary Biliary Cirrhosis Patients

<正>Objective:To observe the efficacy of ursodeoxycholic acid(UDCA) combined with Tongdan Decoction(通胆汤) on immunological indices and histopathological changes in patients with primary biliary cirrhosis(PBC) ofⅡorⅢhistological stage.Methods:Sixty PBC patients were assigned randomly and equally to the control group treated with UDCA alone and the treatment group treated with UDCA combined with Tongdan Decoction.The immunological indices and histopathological changes were detected before and after 24-week treatment,and the follow-up lasted for 1-3 years.Results:After 24-week treatment,CD4~+CD28~- in the peripheral blood was lowered and CD4~+CD25~+ was increased in both groups,and better effect was shown in the treatment group(P0.01).The levels of IgM,IgG,and IgA decreased markedly after 96-week treatment in the treatment group(P0.05,P0.01),while in the control group,only the latter two showed significant decrease after 148 week(all P0.05).At the end of the 3-year follow-up,the medians of histopathological inflammation grading and fibrosis staging declined to a lower rank,and the effect on inflammation was superior in the treatment group to the control group shown by non-parameters Wilcoxon paired symbols test(Z = 2.761, P=0.006).Conclusion:Combined therapy of Tongdan Decoction and UDCA showed a better therapeutic effect than UDCA monotherapy on PBC,especially in improving immunological indices and histopathological hepatic changes.