[an error occurred while processing this directive]

Journal of Chinese Integrative Medicine ›› 2003, Vol. 1 ›› Issue (2): 99-102.doi: 10.3736/jcim20030205

Previous Articles     Next Articles

Clinical features of primary biliary cirrhosis and treatment of it by integrated traditional Chinese and Western medicine

Jian Jiang(), Miao He   

  1. Department of Internal Medicine, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine,Shanghai 200021, China
  • Received:2003-05-12 Online:2003-06-20 Published:2018-10-19

RichHTML

3

PDF (PC)

385

Like

Objective

To investigate the clinical features of primary biliary cirrhosis (PBC) and its treatment by integrated traditional Chinese and western medicine.


Methods

16 PBC patients were observed. Ursodeoxycholic acid (UDCA) was used in the dose of 13 to 15 mg·kg -1·d -1, with some traditional Chinese herb prescription.


Results

(1) The proportion of women to men was 15:1, the mean age was 52.5 years. AMA-M2 was positive in 14 subjects (87.5%). Biliary tract enzymes and ESR were elevated in all subjects. The ratio of hypercholesterolemia (CHOL) and abnormity in IgM was high (62.5%). Fatigue, pruritus, arthralgia, jaundice, splenomegaly were noted in more than half cases. Every patient had one to four complications. (2) ALP, GGT and Glb declined evidently after 3 months' treatment by western medicine associated with traditional Chinese medicine, and declined markedly after 12 months’ treatment (P<0.05 respectively). TBIL and CHOL declined gradually during the treatment course. Symptoms and signs were lightened.


Conclusion

PBC has complicated and especial clinical features. UDCA therapy is effective in PBC, while traditional Chinese medicine has extraordinary effect in treating the symptoms and signs.

Key words: primary biliary cirrhosis, clinical features, therapy, integrated traditional Chinese and western medicine

CLC Number: 

  • R657-31

"

项目 治疗前(n) 治疗3个月(n) 治疗6个月(n) 治疗9个月(n) 治疗12个月(n)
ALP（IU/L） 677.73±450.20(16) 401.64±268.50 (15) 451.54±355.07(13) 450.38±406.54(12) 376.00±287.07(12)*
GGT（IU/L） 693.07±558.36(16) 437.73±518.20(15) 379.98±345.61(13) 356.77±276.20(13)* 325.72±253.23(12)*
ALT（IU/L） 117.40± 93.68(16) 75.27± 74.19(15)* 58.09± 44.10(13)* 54.23± 30.75(13)* 47.58± 36.77(12)*
AST（IU/L） 127.46±101.79(16) 78.51± 40.39(15) 69.65± 28.79(13)* 72.35± 41.52(13) 59.75± 28.82(12)*
TBA（μmol/L） 86.48± 89.65(16) 62.47± 54.27(14) 43.63± 30.34(11) 55.12± 66.62(12) 39.81± 42.49(11)
TBIL（μmol/L） 38.46± 29.37(16) 30.70± 21.59(15) 33.81± 39.19(12) 24.81± 14.37(13) 29.37± 19.90(12)
DBIL（μmol/L） 18.53± 12.11(16) 13.25± 11.53(15) 15.63± 20.12(12) 11.56± 8.91(12) 13.73± 12.19(12)
CHOL（mmol/L） 8.47± 4.41(16) 7.45± 3.56(14) 7.13± 3.50(12) 6.53± 3.18(12) 6.43± 2.91(10)
Alb（g/L） 40.23± 4.15(16) 42.22± 3.12(14) 43.02± 3.23(13) 41.63± 4.94(12) 41.30± 4.57(12)
Glb（g/L） 43.92± 9.61(16) 37.75± 5.81(14)* 38.83± 7.71(13) 38.25± 5.44(12) 37.98± 5.27(12) *
P-Alb（mg/L） 243.96± 95.26(16) 263.71±106.85(13) 281.40±112.36(12) 291.20±107.01(11) 242.29± 98.79(11)
ESR（mm/h） 63.27± 27.73(13) 58.54± 35.16(13) 56.40± 36.50(10) 58.41±26.99(11) 65.30±28.46(10)
WBC（×109/L） 5.79± 2.58(14) 5.89± 1.79(13) 5.87± 2.11(10) 5.76±1.84(11) 5.21±1.89(12)
RBC（×1012/L） 3.66± 0.42(13) 3.74± 0.51(13) 3.98± 1.04(11) 3.95± 1.12(11) 3.68±0.42(12)
HGB（g/L） 119.54± 9.42(13) 121.58± 9.23(12) 123.27± 10.74(11) 128.18± 28.72(11) 117.50±7.99(12)
PLT（×109/L） 141.50± 87.08(16) 173.85± 76.44(13) 155.36± 64.81(11) 151.77± 62.81(11) 138.17± 59.97(12)

"

症状/体征 治疗前 治疗后
显效 有效 无效
症状
乏力 10（62.5） 6（60.0） 4（40.0）
瘙痒 10（62.5） 10（100.0）
关节疼痛 9（56.3） 9（100.0）
口干和/或眼干 5（31.3） 4（80.0） 1（20.0）
肝区疼痛 4（25.0） 2（50.0） 2（50.0）
口腔溃疡 3（18.8） 3（100.0）
腹痛 3（18.8） 3（100.0）
体征
脾肿大 12（75.0） 1（8.3） 2（16.6） 9（75.1）
黄疸 8（50.0） 6（75.0） 2（25.0）
肝肿大 6（37.5） 1 （16.6） 1（16.6） 4（66.8）
食道静脉曲张 5（31.3） 5（100.0）
门静脉系统扩张 3（18.8） 3（100.0）
腹水 3（18.8） 3（100.0）
猖獗龋 3（18.8） 3（100.0）
既往病史
骨折 3（18.8）
上消化道出血 2（12.5）
[1] Heathcote EJ . Management of primary biliary cirrhosis[J]. Hepatology, 2000,31(4):1005-1013
doi: 10.1007/s11938-003-0051-4 pmid: 14585238
[2] 井上恭一 . 原发性胆汁性肝硬化的诊疗研究进展[J]. 日本医学介绍, 1997,18(10):454-455
[3] 姚光弼 . 重视原发性胆汁性肝硬化的临床研究[J]. 中华肝脏病杂志, 2002,10(5):325-326
doi: 10.3760/j.issn:1007-3418.2002.05.001
[4] 蒋健, 高月求 . 原发性胆汁性肝硬化的诊断和治疗[J]. 美国中华医药杂志, 2001,7(2):16-18
doi: 10.3969/j.issn.1008-7125.2009.04.006
[5] 梁扩寰 . 肝脏病学(第1版)[M]. 北京: 人民卫生出版社, 1995,( 第1版):625-635
[6] 张烜, 林进, 唐福林 , 等. 原发性胆汁性肝硬化的临床及病理分析[J]. 中华风湿病学杂志, 2001,5(2):98-101
doi: 10.3760/j:issn:1007-7480.2001.02.007
[7] Doniach D, Roitt IM, Walker JG , et al. Tissue antibodies in primary biliary cirrhosis, active chronic(lupoid) hepatitis, cryptogenic cirrhosis and other liver diseases and their clinical implications[J]. Clin Exp Immunol, 1966,1(3):237-262
[8] Fussey S, Guest JR, James OF , et al. Identification and analysis of the major M2 autoantigens in primary biliary cirrhosis[J]. Proc Natl Acad Sci USA, 1988,85(22):8654-8658
doi: 10.1073/pnas.85.22.8654 pmid: 2037146
[9] Goodman Zd, McNally PR, Davis DR , et al. Autoimmune cholangitis: a variant of primary biliary cirrhosis. Clinicopathologic and serologic correlations in 200 cases[J]. Dig Dis Sci, 1995,40(6):1232-1242
doi: 10.1007/BF02065530 pmid: 7781439
[10] 张福奎, 贾继东, 钱林学 , 等. 抗线粒体抗体阴性原发性胆汁性肝硬化的临床特征[J]. 肝脏, 2002,7(3):150-152
[11] 蒋健, 张玉喜 . 结合型N-乙酰氨基葡萄糖胺的产生与作用[J]. 肝脏, 2002,7(2):114-115
doi: 10.3969/j.issn.1008-1704.2002.02.022
[12] Jazrawi RP, de Caestecker JS, Goggin PM , et al. Kinetics of hepatic bile acid handling in cholestatic liver disease: effect of ursodeoxycholic acid[J]. Gastroenterology, 1994,106(1):134-142
doi: 10.1016/S0016-5085(94)94899-2
[13] Setchell KD, Rodrigues CM, Clerici C , et al. Bile acid concentrations in human and rat liver tissue and in hepatocyte nuclei[J]. Gastroenterology, 1997,112(1):226-235
doi: 10.1016/S0016-5085(97)70239-7
[14] Guldutana S, Zimmer G, Imhof M , et al. Molecular aspects of membrane stabilization by ursodeoxycholate[J]. Gastroenterology, 1993,104(6):1736-1744
doi: 10.1016/0016-5085(93)90653-T
[15] Calmus Y, Weill B, Ozier Y , et al. Immunosuppressive properties of chenodeoxycholic and ursodeoxycholic acids in the mouse[J]. Gastroenterology, 1992,103(2):617-621
doi: 10.1016/0016-5085(92)90855-S pmid: 1386050
[16] Angulo P, Batts KP, Therneau TM , et al. Long-term ursodeoxycholic acid delays histological progression in primary biliary cirrhosis[J]. Hepatology, 1999,29(3):644-647
doi: 10.1002/hep.510290301 pmid: 10051462
[1] Hui-min Liu, Xian-bo Wang, Yu-juan Chang, Li-li Gu. Systematic review and meta-analysis of randomized controlled trials of integrative medicine therapy for treatment of chronic severe hepatitis. Journal of Chinese Integrative Medicine, 2012, 10(11): 1211-1228.
[2] Li-xin Lang, Xiao-bo Wang, Wei Hou. Successful treatment of adult idiopathic pulmonary hemosiderosis with integrated traditional Chinese and Western medicine: A report of one case. Journal of Chinese Integrative Medicine, 2011, 9(5): 531-532.
[3] the Project Group for Demonstration Study of Syndrome Differentiation Protocol Effect Evaluation of Acute Ischemic Stroke, Yan Huang, Jian-wen Guo. Outcome and safety assessment of an herbal medicine treatment protocol for yin pattern of acute ischemic stroke. Journal of Chinese Integrative Medicine, 2010, 8(5): 417-426.
[4] Hao Li , Long-tao Liu, Wen-ming Zhao, Jian-gang Liu, Ming-jiang Yao, Yong-xiang Han, Yan-peng Shen, Xing-dong Liu, Li Liu, Xue-mei Wang, Lin-lin Cai, Jie Guan. Traditional Chinese versus integrative treatment in elderly patients with isolated systolic hypertension: A multicenter, randomized, double-blind controlled trial. Journal of Chinese Integrative Medicine, 2010, 8(5): 410-416.
[5] Ni-da Cao, Ai-guang Zhao, Jin-kun Yang. Survival time of advanced gastric cancer patients treated with integrated traditional Chinese and Western medicine therapy. Journal of Chinese Integrative Medicine, 2010, 8(2): 116-120.
[6] Song-lin Cheng, Xiao-yun Liu, Wei-xi Zhang. Integrated traditional Chinese and Western medicine in treating 31 cases of myasthenia gravis. Journal of Chinese Integrative Medicine, 2008, 6(9): 964-967.
[7] Yi-fei Wang, Bo-hua Li, Ming Zhang, Wen-bin Xu, Rong Zhou, Min Zhou. Stage-based treatment of gouty arthritis by combination therapy of traditional Chinese and Western medicines: a randomized controlled trial. Journal of Chinese Integrative Medicine, 2008, 6(6): 576-580.
[8] Yi-ping Chen. Clinical study of integrative medicine in treatment of nephropathy: strategy and innovation. Journal of Chinese Integrative Medicine, 2008, 6(5): 446-448.
[9] Yan-hui Sun, Yong-qing Cao, Jin-gen Lu, Xiu-tian Guo. Clinical observation of incision and drainage with ultracision-harmonic scalpel and thread-drawing in children with anal fistula: a report of 21 cases. Journal of Chinese Integrative Medicine, 2008, 6(4): 414-415.
[10] Chi-shing Cho. Progress of integrative medicine, human papillomavirus vaccine and molecular targeted therapy for cervical cancer. Journal of Chinese Integrative Medicine, 2008, 6(2): 203-208.
[11] Hong-qiang Wei, Zong-wen Huang, Hui Li. Early treatment with integrated traditional Chinese and Western medicine in adhesive intestinal obstruction. Journal of Chinese Integrative Medicine, 2008, 6(10): 1062-1064.
[12] xin-lin Yang, Hai-ying Fan, Xiao-hang Hu. Treatment effectiveness of traditional Chinese medicine for different types of absence seizures. Journal of Chinese Integrative Medicine, 2007, 5(6): 692-694.
[13] Hai-min Xu​, Yun-feng Qiu​, Wei-min Wang​. Diagnoses and treatment of 125 patients with biliary acute pancreatitis. Journal of Chinese Integrative Medicine, 2006, 4(5): 537-538.
[14] De-jian Zhang, Ping Chen​, Huai-jin Cheng​. Clinical observat ion on t reatment of chronic prostati tis with integrated t radit ional Chinese and Western medicine therapy: A report of 167 cases. Journal of Chinese Integrative Medicine, 2006, 4(4): 420-422.
[15] Shi-gao Zhou, Xiang-jun Chen, Li Su, Xiao-yun Chen, Jun Zhou. Treatment of dermatomyositis with integrated traditional Chinese and Western medicine: A report of 46 cases. Journal of Chinese Integrative Medicine, 2006, 4(4): 417-419.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] Dong Yang, Yong-ping Du, Qing Shen, Wei Chen, Yan Yu, Guang-lei Chen. Expression of alpha-smooth muscle actin in renal tubulointerstitium in patients with kidney collateral stasis. Journal of Chinese Integrative Medicine, 2008, 6(1): 41-44
[2] Hai-feng Wei, Bai-liu Ya, Ling Zhao, Cui-fei Ye, Li Zhang, Lin Li. Evaluation of tongue manifestation of blood stasis syndrome and its relationship with blood rheological disorder in a rat model of transient brain ischemia. Journal of Chinese Integrative Medicine, 2008, 6(1): 73-76
[3] Xi Lin, Jian-ping Liu. Herbal medicines for viral myocarditis. Journal of Chinese Integrative Medicine, 2008, 6(1): 76
[4] Xi Lin, Jian-ping Liu. Tai chi for treating rheumatoid arthritis. Journal of Chinese Integrative Medicine, 2008, 6(1): 82
[5] Liang-ping Hu, Hui Gao. Discrimination of errors in statistical analysis of medical papers published in the first issue of 2006 in Journal of Chinese Integrative Medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 98-106
[6] Yan-bo Zhu , Qi Wang, Cheng-yu Wu, Guo-ming Pang, Jian-xiong Zhao, Shi-lin Shen, Zhong-yuan Xia , Xue Yan . Logistic regression analysis on relationships between traditional Chinese medicine constitutional types and overweight or obesity. Journal of Chinese Integrative Medicine, 2010, 8(11): 1023-1035
[7] Wei Xu, Meng Shi, Jian-gang Liu, Cheng-long Wang . Collagen protein expressions in ischemic myocardium of rats with acute myocardial infarction and effects of qi-tonifying, yin-tonifying and blood-activating herbs and detoxifying and blood-activating herbs. Journal of Chinese Integrative Medicine, 2010, 8(11): 1041-1047
[8] Tao Wang , Feng Qin. Effects of Chinese herbal medicine Xiaoyao Powder on monoamine neurotransmitters in hippocampus of rats with postpartum depression. Journal of Chinese Integrative Medicine, 2010, 8(11): 1075-1079
[9] Ying Xu , Chang-chun Zeng , Xiu-yu Cai , Rong-ping Guo , Guang Nie , Ying Jin. Chromaticity and optical spectrum colorimetry of the tongue color in different syndromes of primary hepatic carcinoma. Journal of Chinese Integrative Medicine, 2012, 10(11): 1263-1271
[10] Xiang-ying Mao , Qin Bian , Zi-yin Shen. Analysis of the osteogenetic effects exerted on mesenchymal stem cell strain C3H10T1/2 by icariin via MAPK signaling pathway in vitro. Journal of Chinese Integrative Medicine, 2012, 10(11): 1272-1278
[an error occurred while processing this directive]