87 Cases Factors Influencing Primary Biliary Cholangitis With Poor Response To And TCM Syndrome Type Analysis

Purpose: A retrospective analysis of patients with PBC via UDCA therapy clinical,laboratory and immunological indexes before and after 1 year of change,before treatment of TCM syndrome type distribution,and to study the efficacy of PBC patients after treatment with UDCA in our poor response to the influence factors of and TCM syndrome type distribution,so as to improve the PBC efficacy response in patients with poor quality of life,prolong survival time.Methods:Between January 2009 and December 2017 in the fourth clinical medical college of xinjiang medical university hospital diagnosis of PBC,and UDCA enough hospital readmission information of patients 1 year after treatment,begin with general information collection(including age,gender,etc.),biochemical,immunologicalindexes,TCMsyndrome type and biochemical,immunological indexes,1 year after treatment.According to the Paris I and II standards,the subjects were divided into the response group and the suboptimal response group.Results:(1)87patients met the eligibility criteria,including 12 males and 65 females.There were 9 cases(10.34%)with gastrointestinal hemorrhage,2 cases(2.29%)with hepatic encephalopathy,26 cases(29.88%)with ascites,and 7 cases(8.04%)with spontaneous peritonitis.One case of hepatopulmonary/hepatorenal syndrome(1.15%).(2)ALT,AST and GGT all decreased after 1 year of UDCA treatment(P<0.05).(3)Paris I and II standards were used to evaluate the therapeutic response,among which 28 patients responded to the therapeutic effect and 59 patients responded poorly.There were statistical differences in PLT,RBC,AST,ALP,TBIL,ALB and PT between the two groups(P<0.05).Five of the patients died in the process.There was no significant difference in TCM syndromes between the two groups.(4)The symptoms of TCM in the response group were significantly different from those of the suboptimal response group in jaundice,edema,anorexia and dry mouth or bitter taste(P<0.05).There was a significant difference between the two groups(P=0.001).(5)Univariate Logistic regression showed that low levels of PLT,RBC,ALB and CHE were risk factors for UDCA response in PBC patients,while high levels of PT,AST,ALP,GGT,TB,TCM syndrome score and ascites were adverse factors for poor response.(6)Multivariate Logistic regression showed that RBC and CHE were independent adverse factors for poor response to UDCA in PBC patients(P<0.05).Conclusion:The efficacy of PBC patients in our hospital was evaluated 1 year after UDCA treatment.PLT,RBC,ALB,CHE,PT,AST,ALP,GGT,TBIL,Child-pugh score,MELD score,ascites were the influencing factors,while RBC and CHE were the independent influencing factors for efficacy response.There was no statistically significant difference in TCM syndrome types between the two groups(P= 0.455),and TCM syndrome score was a disadvantageous factor for response to efficacy(P=0.002).These factors are associatedwith PBC diagnosis and are cause-and-effect with response to efficacy.