The Clinical Features Of Autoimmune Hepatitis And Chinese Medicine Therapy Were Retrospectively Analyzed

Objective:Through research on106patients with autoimmune hepatitis, we summarized the clinical manifestation, biochemical characteristics, histo-pathological manifestations and treatment of traditional Chinese medicine.The aim was to strengthen the understanding of the disease, evaluation of traditional Chinese medicine treatment of the disease, so that it was conducive to improve the level of clinical diagnosis and treatment of the disease.Methods:1. With the method of case retrospective analysis, we analyzed106patients diagnosed as autoimmune hepatitis from September2011to Augest2013in Beijing DiTan hospital affiliated to the Capital Medical University. The data composition was as follows:64cases still in the phase of autoimmune hepatitis patients;27cases in the progress of autoimmune cirrhosis of the liver stages;15cases in the degree of autoimmune hepatitis and primary biliary cirrhosis overlap (overlap syndrome).2. Collecting patients’clinical information:we referred to the medical records of106patients with AM, and collected the characteristics of history, common symptoms and signs, merge disease, laboratory examination indexes, liver biopsy histologic examination.3. Statistical analysis:SPSS17.0statistical software was used to describe statistical analysis, summarize its clinical characteristics.4. Evaluation of curative effect of traditional Chinese medicine:11cases of64patients with autoimmune hepatitis patients after oral Chinese medicine treatment was as traditional Chinese medicine group; out of26cases of patients treated by hormone, the remaining27cases not taking medicine and without hormone therapy was as the control group. By comparing two groups of patients, we analyzed the function of traditional Chinese medicine in improving symptoms, liver function, the function of autoantibodies, etc.Results:1. Cases characteristics:the clinical trial included106cases, there were27cases in liver cirrhosis group and64cases in no cirrhotic group, hepatic cirrhosis overlap Syndrome group contained15cases. There were no statistically significant differences on gender among groups, while the sex ratio is1:6.57, the patients’age of cirrhosis group was older than the other two groups.2. The symptoms and signs:AIH’s most common symptom was fatigue, which counted for69.8%. The other common symptoms followed by decreased appetite, dark urine, bloating, nausea, while the most common symptom was jaundice and most patients were mild jaundice, who accounted for more than half of all patients with jaundice. 3. Combined diseases:5cases had Sjogren’s syndrome.5cases had rheumatoid arthritis and10cases had diabetes. The others patients had eczema, urticaria, hyperthyroidism, thyroiditis, Vitiligo, tuberous and so on.4. Biochemical parameters:most patients had varying degrees of abnormal liver function, characterized by ALT, AST, TBIL, DBIL, GGT, ALP etc. rising. The non-liver cirrhosis group’s ALT, AST, GGT level is significantly higher than liver cirrhosis group. The Transaminase elevated degree of most patients is within10times ULN. Compared with non-cirrhosis group, cirrhosis group patients’AST, TBIL, DBIL, and ALP level elevated in1-2times ULN, and twice times ULN within respectively, and the2-5times, and1-2times patients were more than non-cirrhosis group. In non-cirrhosis group, the ALT, AST, DBIL, and GGT level elevated in3times above, and3times above, and10times above respectively, and the over5times of patients were more than cirrhosis group.5. Immune indices:this study found16types of autoantibodies, the much common’s own antibodies include ANA, AMA, AMA-M2, SMA, and87.5%SMA-positive patients with ANA positive.84.8%patients had ANA, their titers were between59.5%in1:1000, and fluorescent types accounted for a high proportion of the karyotype, they are nuclear-coal-, nuclear-particle, cytoplasmic granules.6. Histopathological characteristics:there were46cases of patients undergoing liver biopsy; typical pathological changes in patients were82.6%, performance for the meeting zone to varying degrees interface inflammation, most have more lymphomas, plasma cell infiltration.3cases had both AIH and PBC overlap syndrome, characterized by bile duct proliferation, interlobular bile ducts disappear.7. The therapeutic effects of traditional Chinese medicine:TCM group patients’ALT, AST, TBIL, DBIL level wrer better than the control group. Two groups patients’ALP, GGT, IgG, and antibody titer of indicators were lower after treatment, but the difference was not statistically significant.Conclusions:1. AIH is common in middle aged women, gender representation is1:6.57, age of cirrhosis group is older than the other two groups. Fatigue, decreased appetite, dark urine, bloating, jaundice are the main clinical manifestation, which often combined with other autoimmune diseases.2. Most of patients had liver inflammation, with ALT, AST, TBIL, DBIL increased.The increasing degrees of biochemical markers were defferent between non-cirrhosis group and cirrhosis group The increasing of gamma globulin was dominated by IgG elevated, y-globulin. The most common autoantibodies we found was ANA, with84.8%. More than60%patients with titers of1:100to1:1000and there was8kinds of fluorescent karyotype in these study. The most common of fluorescent karyotype were:nuclear-coal, nuclear-particle, cytoplasmic granules.3. Most of patients performed typical histologic, which were inflammatory cell infiltration and lymph slurry interface.4. Through small cases study we found that Traditional Chinese medicine had the ability to decrease serum ALT, AST, TBIL, DBIL, which was worth to be forth reaserching.