目的 探讨水飞蓟宾联合丁二磺酸腺苷蛋氨酸治疗原发性胆汁性胆管炎的临床疗效。方法 选取中国人民解放军白求恩国际和平医院二五六临床部2010年3月-2016年6月收治的原发性胆汁性胆管炎患者121例，随机分成对照组（60例）和治疗组（61例）。对照组患者口服丁二磺酸腺苷蛋氨酸肠溶片，2片/次，2次/d；治疗组患者在对照组基础上口服水飞蓟宾葡甲胺片，2片/次，3次/d。所有患者均经过4周规律治疗。评价两组患者临床疗效，同时比较治疗前后两组患者肝功能指标、主要症状积分和不良反应情况。结果 治疗后，对照组的总有效率为81.67%，显著低于治疗组的96.72%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者丙氨酸氨基转移酶（ALT）、门冬氨酸转氨酶（AST）以及总胆红素（TBIL）水平均显著性降低，白球比（A/G）显著升高（P<0.05），且治疗组患者各指标均明显优于对照组患者（P<0.05）。治疗后，两组患者的主要症状乏力、皮肤瘙痒、纳差、肝区不适以及黄疸积分均明显降低（P<0.05），且治疗组患者主要症状积分降低的更明显（P<0.05）。结论 水飞蓟宾联合丁二磺酸腺苷蛋氨酸治疗原发性胆汁性胆管炎具有较好的临床疗效，且安全性较高，具有一定的临床推广应用价值。

Objective To explore the clinical efficacy of silybin combined with ademetionine 1,4-butanedisulfonate in treatment of primary biliary cirrhosis. Methods Patients (121 cases) with primary biliary cirrhosis in the 256 Clinical Department of Bethune International Peace Hospital of PLA from March 2010 to June 2016 were randomly divided into control (60 cases) and treatment (61 cases) groups. Patients in the control group were po administered with Ademetionine 1,4-Butanedisulfonate Enteric-coated Tablets, 2 tablets/time, twice daily. Patients in the treatment group were po administered with Silybin Meglumine Tablets on the basis of the control group, 2 tablets/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the liver function indexes, the main symptom scores and adverse events in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 81.67%, which was significantly lower than 96.72% in the treatment group, and the difference was statistically significant between two groups (P<0.05). After treatment, the ALT, AST, and TBIL level in two groups was significantly decreased, but A/G was significantly increased (P<0.05). And these indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the weakness, skin itch, anorexia, hepatic discomfort and jaundice scores in two groups were significantly decreased (P<0.05). And the main symptom scores in the treatment group decreased more obviously than those in the control group (P<0.05). Conclusion Silybin combined with ademetionine 1,4-butanedisulfonate has good clinical efficacy in treatment of primary biliary cirrhosis, with high safety, which has a certain clinical application value.