Search JIM Advanced Search

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

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] Tara Rajendran. Addressing the need for personalizing music therapy in integrative oncology. Journal of Integrative Medicine, 2022, 20(4): 281-283.
[2] Tara Rajendran, Martha Summa-Chadwick. The scope and potential of music therapy in stroke rehabilitation. Journal of Integrative Medicine, 2022, 20(4): 284-287.
[3] Lu Yin, Yun An, Xiao Chen, Hui-xin Yan, Tao Zhang, Xin-gang Lu, Jun-tao Yan. Local vibration therapy promotes the recovery of nerve function in rats with sciatic nerve injury. Journal of Integrative Medicine, 2022, 20(3): 265-273.
[4] Bin Zhao, Yong Chen, Shi-min Liao, Jian-ying Zheng, Shi-hua Yan, Dong-shu Zhang. Successfully treated recalcitrant atopic eczema with acupoint autohemotherapy: A case report and hypothesized mechanism of the therapy. Journal of Integrative Medicine, 2022, 20(2): 182-186.
[5] Yan-jun Lin, Kun-li Jiao, Bo Liu, Lu Fang, Shu Meng. Antiplatelet and myocardial protective effect of shexiang tongxin dropping pill in patients undergoing percutaneous coronary intervention: A randomized controlled trial. Journal of Integrative Medicine, 2022, 20(2): 126-134.
[6] Shu-yi Chen, Qun-wei Chen, Liu-mei Shou, Hong Pan, Shan-ming Ruan, Zhe-hao Liang, Qi-jin Shu. Stevens-Johnson syndrome/toxic epidermal necrolysis successfully treated with Chinese herbal medicine Pi-Yan-Ning: A case report. Journal of Integrative Medicine, 2021, 19(6): 555-560.
[7] Gai Ran, Xi-lin Feng, Yi-lin Xie, Qing-yun Zheng, Peng-peng Guo, Ming Yang, Ying-lu Feng, Chen Ling, Li-qing Zhu, Chen Zhong. The use of miR122 and its target sequence in adeno-associated virus-mediated trichosanthin gene therapy. Journal of Integrative Medicine, 2021, 19(6): 515-525.
[8] Xin Yin, Shu-bin Cai, Lan-ting Tao, Lu-ming Chen, Zhong-de Zhang, Su-hong Xiao, Arthur Yin Fan, Xu Zou. Recovery of a patient with severe COVID-19 by acupuncture and Chinese herbal medicine adjuvant to standard care. Journal of Integrative Medicine, 2021, 19(5): 460-466.
[9] Zahra Karimzadeh, Mansooreh Azizzadeh Forouzi, Haleh Tajadini, Mehdi Ahmadinejad, Callista Roy, Mahlagha Dehghan. Effects of lavender and Citrus aurantium on pain of conscious intensive care unit patients: A parallel randomized placebo-controlled trial. Journal of Integrative Medicine, 2021, 19(4): 333-339.
[10] Ning Zhang, Xiao-he Xiao. Integrative medicine in the era of cancer immunotherapy: Challenges and opportunities. Journal of Integrative Medicine, 2021, 19(4): 291-294.
[11] Riska Siregar, Aris Setyawan, Syahruramdhani Syahruramdhani. A model to standardize safety and quality of care for cupping therapy. Journal of Integrative Medicine, 2021, 19(4): 327-332.
[12] Bing-rong Li, Shi-yun Shao, Long Yuan, Ru Jia, Jian Sun, Qing Ji, Hua Sui, Li-hong Zhou, Yi Zhang, Hui Liu, Qi Li, Yan Wang, Bi-meng Zhang. Effects of mild moxibustion on intestinal microbiome and NLRP3 inflammasome in rats with 5-fluorouracil-induced intestinal mucositis. Journal of Integrative Medicine, 2021, 19(2): 144-157.
[13] Nurul Afiedia Roslim, Aryati Ahmad, Mardiana Mansor, Myat Moe Thwe Aung, Farrahdilla Hamzah, Haszalina Hassan, Pei Lin Lua. Hypnotherapy for overweight and obese patients: A narrative review. Journal of Integrative Medicine, 2021, 19(1): 1-5.
[14] Johannes Loeser, Brigitte Layer, Christopher Plata, Klaus-Maria Perrar, Tim Hucho, Rebecca Kulbida. Hirudotherapy attenuates arthritic pain in patients with various chronic pain syndromes: A retrospective analysis. Journal of Integrative Medicine, 2020, 18(5): 425-433.
[15] Toktam Sadat Firoozeei, Majid Barekatain, Mehrdad Karimi, Arman Zargaran, Shahin Akhondzadeh, Hossein Rezaeizadeh. Lavender and dodder combined herbal syrup versus citalopram in major depressive disorder with anxious distress: A double-blind randomized trial. Journal of Integrative Medicine, 2020, 18(5): 409-415.
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