The Curative Effect Observation Of Treating Primary Biliary Cholangitis Through The Combination Of Ursodeoxycholic Acid With Danshilitong

Purpose:Taking treating through the combination of compound glycyrrhizin glucoside tablet with UDCA as the control group to observe the clinical curative effect of treating primary biliary cholangitis through the combination of danshilitong with UDCA,to provide a new treatment program to patients who are intolerate for hormone similar drugs in clinic.Methods:Select 57 cases of patients who are clearly diagnosed with primary billiary cholangitis came from outpatient and inpatient of hepatobiliary and pancreatic department of the Second Hospital of Jilin University between January 2014 and March 2017,including 7 male cases and 50 female cases,the patients were divided into two groups.The control group contains 29 cases,they were given ursodeoxycholic acid capsules 15mg·kg^-1·d^-1,3 times a day oral,compound glycyrrhizin glucoside 3 tablets each time,3 times a day oral;and the experimental group contains 28 cases,they were given ursodeoxycholic acid capsules 15mg·kg^-1·d^-1,3 times a day oral,danshilitong 6 tablets each time,3 times a day oral.The clinical observation time was 48 weeks.To observe the improvement of clinical symptoms and signs（including fatigue,abdominal distension,loss of appetite,pruritus,jaundice）and liver function（involving TBIL,ALP,GGT,TBA）,and the change of blood pressure,blood glucose and serum potassium both before treatment and after treatment for 2,4 and 12 weeks.The changes of anti-mitochondrial antibody（AMA-M2）and the occurrence of adverse reactions were observed before treatment and 12,24 and 48 weeks after treatment.Results:1.The relief of clinical symptoms and signs:According to the clinical observation,the clinical manifestations of fatigue,abdominal distension,loss of appetite,pruritus,jaundice were improved in two groups after 2 weeks,4 weeks and 12 weeks of treatment,with significant difference between before and after treatment（P<0.05）,while two groups of patients had similar remission rate at different treatment time points,no significant difference（P>0.05）.After treatment,there was no significant difference between two groups in improving the clinical symptoms（P>0.05）.2.The improvement of liver function:After 2,4 and 12 weeks,the liver function of two groups improved compared with that before treatment（P<0.05）.At the end of the 12th week,most of the liver biochemical indexes recovered to normal in both groups,there was no significant difference between the two groups（P>0.05）.During the whole treatment,there was no significant difference between the two groups in the improvement of liver function at different treatment time ponits.（P>0.05）.3.The change of serum anti-mitochondrial antibody:After treatment for 12,24and 48 weeks,the anti-mitochondrial antibodies（AMA-M2）in a few patients in two groups were slightly better than those before treatment,but the overall variety is not obvious,the difference was not statistically significant（P>0.05）.4.The occurrence of adverse reactions:In the control group,there was one case of hypertension,three cases of hyperglycemia and two cases of hypokalemia occured at the 12th week of treatment.There was one case of hypertension,two cases of hyperglycemia and three cases of hypokalemia at the 24th week of treatment.In addition,one case of edema of both lower extremities,six cases of hypertension,three cases of hypokalemia and four cases of hyperglycemia appeard at the end of 48th weed.However,the experimental group did not occur adverse reactions as the above until the end of treatment.Except for the difference in hypertension between the control group and the treatment group after 48 weeks of treatment（P<0.05）,there was no significant difference in other adverse reactions between the two groups（P>0.05）.Concludions:For those primary billiary cholangitis patients who can not stand long-term use of glucocorticoid or hormone similar drugs and complicate with obvious complications can select ursodeoxycholic acid capsules combined with Danshilitong as the ideal treatment method.Through clinical observation,the combination of the two drugs may get same treatment effect to ursodeoxycholic acid combined with compound glycyrrhizin glucoside both in relieving clinical symptoms and improving liver function.It can delay the course of the disease,and no obvious adverse reactions have been found.However,due to the less clinical observation samples of this research,the curative effect still needed to be studied further.