苯扎贝特联合熊去氧胆酸治疗原发性胆汁性肝硬化的效果观察

摘要

目的:探讨苯扎贝特联合熊去氧胆酸治疗原发性胆汁性肝硬化的临床疗效.方法:选择2013年5月至2017年5月在本院就诊的90例原发性胆汁性肝硬化作为研究对象,采用随机数字表法将患者分为观察组和对照组,每组45例.在基础治疗上,对照组使用熊去氧胆酸治疗,观察组在对照组的基础上联合苯扎贝特治疗,两组均连续治疗3个月.比较两组临床疗效、治疗前后肝功能、免疫球蛋白(IgM)、肝脏弹力硬度值和临床症状体征的变化及不良反应.结果:治疗后,观察组临床疗效总有效率明显高于对照组(P＜0.05);两组碱性磷酸酶(ALP)、谷氨酰转肽酶(GGT)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBil)均较治疗前降低(P＜0.05),观察组ALP、GGT、ALT、AST、TBil均低于对照组,差异均有统计意义(均P＜0.05);两组IgM、肝脏弹力硬度值较治疗前均显著降低(P＜0.05),观察组IgM、肝脏弹力硬度值明显低于对照组(P＜0.05);观察组乏力、瘙痒、黄疸人数均明显少于对照组(P＜0.05);观察组和对照组治疗期间不良反应总发生率比较差异无统计学意义(P＞0.05).结论:苯扎贝特联合熊去氧胆酸治疗原发性胆汁性肝硬化效果显著,可有效改善患者肝功能、肝脏弹力硬度值等指标,显著缓解乏力、瘙痒等临床症状,且联合用药并未增加药物不良反应,临床应用价值高.%Objective:To study the efficacy of bezafibrate combined with ursodeoxycholic acid in the treatment of primary biliary cirrhosis (PBC).Methods:90 PBC patients treated in our hospital from May 2013 to May 2017 were selected,and randomly assigned into receiving either ursodeoxycholic acid (observation group,n=45) or bezafibrate combined with ursodeoxycholic acid (control group,n =45).All patients were continuously treated for 3 months.The clinical effect,liver function,immunoglobulin (IgM),liver elastic hardness,clinical symptoms and adverse reactions were compared.Results:After treatment,the total responserate in the observation group was significantly higher than that in the control group (P＜0.05).After treatment,the levels of alkaline phosphatase (ALP),glutamyl transferase (GGT),alanine aminotransferase (ALT),aspartate aminotransferase (AST) and total bilirubin (TBil) were decreased in both groups (P＜0.05),and the decrease was more significant in the observation group (P＜0.05).IgM,liver elastic hardness,and the prevalence of fatigue,itching and jaundice in the observation group were markedly lower than those in the control group (P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P ＞0.05).Conclusion:Bezafibrate combined with ursodeoxycholic acid was effective in the treatment of PBC.This combination could improve liver function,attenuate clinical symptoms such as asthenia,itching etc.,and did not increase adverse reactions.