Analysis Of Risk Syndromes Of Primary Biliary Cholangitis With Poor Response To Ursodeoxycholic Acid Based On Logistic Regression Analysis

Objective: through observation the patient population biology index,the characteristics of biochemical indexes,blood routine indexes,etc,of primary bilious cholangitis(primary biliary cholangitis,PBC) and a preliminary explore TCM syndrome type distribution of the PBC patients which response poorly to UDCA(ursodesoxycholic acid),and find out the core card type and related risk factors,to provide the treatment based on syndrome differentiation of TCM,and to provide the reference.Methods: to choose the inpatient and outpatient clinic,301 cases of patients with PBC from shuguang hospital affiliated to Shanghai university of traditional Chinese medicine,infectious disease hospital of pudong area,Shanghai public health center,putuo district central hospital,longhua hospital and etc.According to the PBC diagnosis standard,patients are setting into and exclusion criteria.Formulated by reference to the state administration of traditional Chinese medicine key specialty cooperative jaundice(primary biliary cirrhosis)in TCM diagnosis and treatment program(try out)".It respectively diagnosed with liver and gallbladder damp heat syndrome,blood stasis heat alternating knot syndrome,phlegm and blood stasis resistance syndrome,cold dampness in stop,liver and kidney Yin deficiency syndrome,qi and Yin deficiency syndrome.According to the UDCA response standard which defined by institute of British Society of Gastroenterology in 2018,we divided the patients into UDCA response group(201 cases)and poor response group(100 cases).We record the patient population biology index,serological data,TCM syndrome type and so on.Then we collected data,and compared respectively UDCA response differences between the two groups to further explore the risk factors of poor PBC response and risk type.Results: 1.1 serological indicator 1)The level of AST,ALP,γ-GT,A and G difference was statistically significantly high in poor response group(P < 0.05);There was no statistical significance(P > 0.05)difference as for the level of ALT,TBIL,DBIL,RBC,WBC,HB.By chi-square test,we find that proportion of TCM syndrome types from high to low in turn are liver and gallbladder damp heat syndrome,blood stasis hot syndrome,cold dampness parked inside,each liver and kidney Yin deficiency,phlegm and blood stasis resistance collaterals syndrome,qi and Yin deficiency syndrome(P < 0.05).2)By logistic regression analysis,the risk factors for poor PBC response is liver and gallbladder damp heat syndrome,phlegm and blood stasis resistance collaterals syndrome,alkaline phosphatase,poor response to UDCA contribution strength of damp and hot liver syndrome,phlegm and blood stasis resistance collaterals syndrome,ALP(P < 0.05).1.2 TCM syndrome type distribution For 6 kinds of syndrome types of patients in the poor reply group,and the liver and gallbladder damp and hot syndrome,cold dampness syndrome,phlegm and blood stasis group complex,liver and kidney Yin deficiency syndrome,qi and Yin deficiency syndrome,blood stasis heat exchange by the highest levels of PLT,and statistically significant difference(P < 0.05).Compared with those of other syndrome dialectical for liver and gallbladder damp heat syndrome,the median baseline ALP,baseline AST,baseline TBil is the highest(P < 0.05),and median baseline ALB is the lowest(P < 0.05).1.3 Related factors analysis of poor reply group.Using the multi-factor Logistic regression analysis,we found the ALP,liver and gallbladder damp heat syndrome and blood stasis heat knot phlegm and blood stasis group complex are risk factors for UDCA poor response(P < 0.05).Conclusion: with the increase of alkaline phosphatase(ALP),liver and gallbladder damp heat syndrome,phlegm and blood stasis group complex,PBCpatient are more likely to have a higher probability of UDCA poor response.