目的 探討水飛薊賓聯(lián)合丁二磺酸腺苷蛋氨酸治療原發(fā)性膽汁性膽管炎的臨床療效。方法 選取中國人民解放軍白求恩國際和平醫(yī)院二五六臨床部2010年3月-2016年6月收治的原發(fā)性膽汁性膽管炎患者121例，隨機(jī)分成對(duì)照組（60例）和治療組（61例）。對(duì)照組患者口服丁二磺酸腺苷蛋氨酸腸溶片，2片/次，2次/d；治療組患者在對(duì)照組基礎(chǔ)上口服水飛薊賓葡甲胺片，2片/次，3次/d。所有患者均經(jīng)過4周規(guī)律治療。評(píng)價(jià)兩組患者臨床療效，同時(shí)比較治療前后兩組患者肝功能指標(biāo)、主要癥狀積分和不良反應(yīng)情況。結(jié)果 治療后，對(duì)照組的總有效率為81.67%，顯著低于治療組的96.72%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者丙氨酸氨基轉(zhuǎn)移酶（ALT）、門冬氨酸轉(zhuǎn)氨酶（AST）以及總膽紅素（TBIL）水平均顯著性降低，白球比（A/G）顯著升高（P<0.05），且治療組患者各指標(biāo)均明顯優(yōu)于對(duì)照組患者（P<0.05）。治療后，兩組患者的主要癥狀乏力、皮膚瘙癢、納差、肝區(qū)不適以及黃疸積分均明顯降低（P<0.05），且治療組患者主要癥狀積分降低的更明顯（P<0.05）。結(jié)論 水飛薊賓聯(lián)合丁二磺酸腺苷蛋氨酸治療原發(fā)性膽汁性膽管炎具有較好的臨床療效，且安全性較高，具有一定的臨床推廣應(yīng)用價(jià)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.