目的 探讨维肝福泰片联合熊去氧胆酸治疗原发性胆汁性肝硬化的临床疗效。方法 回顾性分析2018年2月—2019年2月在安阳市第五人民医院治疗的102例原发性胆汁性肝硬化患者的临床资料，依据用药的不同分为对照组和治疗组，每组各51例。对照组口服熊去氧胆酸胶囊，每天10 mg/kg；治疗组在对照组基础上口服维肝福泰片，3片/次，3次/d。两组患者均连续治疗6个月。观察两组患者临床疗效，比较治疗前后两组患者肝功相关指标丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、碱性磷酸酶（ALP）、总胆红素（TBIL）、谷氨酰转肽酶（GGT），黄疸、面色晦暗、肝区不适、皮肤瘙痒和乏力消失时间及血清白细胞介素-17（IL-17）、血小板衍生生长因子（PDGF）、IL-22、转化生长因子-β（TGF-β）、二胺氧化酶（DAO）、内毒素和D-乳酸水平。结果 经治疗，对照组总有效率明显低于治疗组（82.35% vs 98.04%，P<0.05）。经治疗，两组ALT、AST、ALP、TBiL、GGT水平均显著下降，且治疗组最降低最明显（P<0.05）。经治疗，治疗组临床症状消失时间均显著早于对照组（P<0.05）。治疗后，两组患者血清IL-17、PDGF和IL-22水平均显著降低，而TGF-β水平明显升高（P<0.05），且治疗组明显好于对照组（P<0.05）。治疗后，两组患者血清DAO、内毒素、D-乳酸水平均显著下降（P<0.05），且治疗组下降最明显（P<0.05）。结论 维肝福泰片联合熊去氧胆酸治疗原发性胆汁性肝硬化疗效显著，不但可显著改善患者临床体征和肝功能水平，而且对患者肠黏膜屏障功能的恢复也有着积极作用。

Objective To investigate the clinical efficacy of Weigan Futai Tablets combined with ursodeoxycholic acid in treatment of primary biliary cirrhosis. Methods The clinical data of 102 patients with primary biliary cirrhosis in the Fifth People's Hospital of Anyang from February 2018 to February 2019 were retrospectively analyzed. These patients were divided into control and treatment groups according to the difference of drugs, and each group had 51 cases. Patients in the control group were po administered with Ursodeoxycholic Acid Capsules, 10 mg/kg daily. Patients in the treatment group po administered with Weigan Futai Tablets on the basis of the control group, 3 tablets/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacy was evaluated, and the liver function indexes of ALT, AST, ALP, TBiL and GGT, and the disappearance time of jaundice, dark complexion, liver discomfort, skin itching and fatigue, and the serum levels of IL-17, PDGF, IL-22 and TGF-β in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the control group was significantly lower than that of the treatment group (82.35% vs 98.04%, P<0.05). After treatment, the levels of ALT, AST, ALP, TBiL, and GGT were significantly decreased in two groups (P<0.05), and which in treatment group were more significantly decreased (P<0.05). After treatment, the disappearance time of clinical symptoms in treatment group was significantly earlier than that in control group (P<0.05). After treatment, the serum levels of IL-17, PDGF, and IL-22 in two groups were significantly decreased, while the levels of TGF-β were significantly increased (P<0.05), and the treatment group was significantly better than the control group (P<0.05). After treatment, the levels of serum DAO, endotoxin and D-lactic acid in two groups were significantly decreased (P<0.05), especially in the treatment group (P<0.05). Conclusion Weigan Futai Tablets combined with ursodeoxycholic acid in treatment of primary biliary cirrhosis has a remarkable curative effect, which can not only significantly improve the clinical signs and liver function of patients, but also play a positive role in the recovery of intestinal mucosal barrier function.

R975

北京医卫健康公益基金项目（YWJKJJHKYJJ-B17715）