减少胆汁淤积相关的瘙痒 (cholestasis-associated pruritus, CAP):有中等质量的证据表明,利福平能显著减少 CAP。[56]Tandon P, Rowe BH, Vandermeer B, et al. The efficacy and safety of bile acid binding agents, opioid antagonists, or rifampin in the treatment of cholestasis-associated pruritus. Am J Gastroenterol. 2007;102:1528-1536.http://www.ncbi.nlm.nih.gov/pubmed/17403073?tool=bestpractice.com[57]Khurana S, Singh P. Rifampin is safe for treatment of pruritus due to chronic cholestasis: a meta-analysis of prospective randomized-controlled trials. Liver Int. 2006;26:943-948.http://www.ncbi.nlm.nih.gov/pubmed/16953834?tool=bestpractice.com[58]Prince MI, Burt AD, Jones DE. Hepatitis and liver dysfunction with rifampicin therapy for pruritus in primary biliary cirrhosis. Gut. 2002;50:436-439.http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=11839728http://www.ncbi.nlm.nih.gov/pubmed/11839728?tool=bestpractice.com
证据 C 疾病预后:以熊去氧胆酸与安慰剂相比,熊去氧胆酸是否延缓疾病的进展,证据不统一。对熊去氧胆酸的个体反应差异可能是出现相互矛盾的结果的原因。[37]Carbone M, Mells G, Pells G, et al. Sex and age are determinants of the clinical phenotype of primary biliary cirrhosis and response to ursodeoxycholic acid. Gastroenterology 2013;144:560-569.http://www.ncbi.nlm.nih.gov/pubmed/23246637?tool=bestpractice.com[38]Pares A, Caballeria L, Rodes J, et al. Long-term effects of ursodeoxycholic acid in primary biliary cirrhosis: results of a double-blind controlled multicentric trial. J Hepatol. 2000;32:561-566.http://www.ncbi.nlm.nih.gov/pubmed/10782903?tool=bestpractice.com[39]Poupon RE, Poupon R, Balkau B. Ursodiol for the long-term treatment of primary biliary cirrhosis. N Engl J Med. 1994;330:1342-1347.http://content.nejm.org/cgi/content/full/330/19/1342http://www.ncbi.nlm.nih.gov/pubmed/8152446?tool=bestpractice.com[40]Heathcote EJ, Cauch-Dudek K, Walker V, et al. The Canadian Multicenter Double-blind Randomized Controlled Trial of ursodeoxycholic acid in primary biliary cirrhosis. Hepatology. 1994;19:1149-1156.http://www.ncbi.nlm.nih.gov/pubmed/8175136?tool=bestpractice.com[41]Lindor KD, Dickson ER, Baldus WP, et al. Ursodeoxycholic acid in the treatment of primary biliary cirrhosis. Gastroenterology. 1994;106:1284-1290.http://www.ncbi.nlm.nih.gov/pubmed/8174890?tool=bestpractice.com[42]Combes B, Carithers RL Jr, Maddrey WC, et al. A randomized, double-blind, placebo-controlled trial of ursodeoxycholic acid in primary biliary cirrhosis. Hepatology. 1995;22:759-766.http://www.ncbi.nlm.nih.gov/pubmed/7657280?tool=bestpractice.com[43]Poupon RE, Lindor KD, Cauch-Dudek K, et al. Combined analysis of randomized controlled trials of ursodeoxycholic acid in primary biliary cirrhosis. Gastroenterology. 1997;113:884-890.http://www.ncbi.nlm.nih.gov/pubmed/9287980?tool=bestpractice.com[44]Goulis J, Leandro G, Burroughs AK. Randomised controlled trials of ursodeoxycholic-acid therapy for primary biliary cirrhosis: a meta-analysis. Lancet. 1999;355:1053-1060.http://www.ncbi.nlm.nih.gov/pubmed/10509495?tool=bestpractice.com[45]Poupon RE, Lindor KD, Pares A, et al. Combined analysis of the effect of treatment with ursodeoxycholic acid on histologic progression in primary biliary cirrhosis. J Hepatol. 2003;39:12-16.http://www.ncbi.nlm.nih.gov/pubmed/12821038?tool=bestpractice.com[46]Gong Y, Huang Z, Christensen E, et al. Ursodeoxycholic acid for patients with primary biliary cirrhosis: an updated systematic review and meta-analysis of randomized clinical trials using Bayesian approach as sensitivity analyses. Am J Gastroenterol. 2007;102:1799-1807.http://www.ncbi.nlm.nih.gov/pubmed/17459023?tool=bestpractice.com[47]Rudic JS, Poropat G, Krstic MN, et al. Ursodeoxycholic acid for primary biliary cirrhosis. Cochrane Database Syst Rev. 2012;(12):CD000551.http://www.ncbi.nlm.nih.gov/pubmed/23235576?tool=bestpractice.com[48]Shi J, Wu C, Lin Y, et al. Long-term effects of mid-dose ursodeoxycholic acid in primary biliary cirrhosis: a meta-analysis of randomized controlled trials. Am J Gastroenterol. 2006;101:1529-1538.http://www.ncbi.nlm.nih.gov/pubmed/16863557?tool=bestpractice.com 系统评价或者受试者>200名的随机对照临床试验(RCT)。疾病预后:以熊去氧胆酸与安慰剂相比,熊去氧胆酸是否延缓疾病的进展,证据不统一。对熊去氧胆酸的个体反应差异可能是出现相互矛盾的结果的原因。[37]Carbone M, Mells G, Pells G, et al. Sex and age are determinants of the clinical phenotype of primary biliary cirrhosis and response to ursodeoxycholic acid. Gastroenterology 2013;144:560-569.http://www.ncbi.nlm.nih.gov/pubmed/23246637?tool=bestpractice.com[38]Pares A, Caballeria L, Rodes J, et al. Long-term effects of ursodeoxycholic acid in primary biliary cirrhosis: results of a double-blind controlled multicentric trial. J Hepatol. 2000;32:561-566.http://www.ncbi.nlm.nih.gov/pubmed/10782903?tool=bestpractice.com[39]Poupon RE, Poupon R, Balkau B. Ursodiol for the long-term treatment of primary biliary cirrhosis. N Engl J Med. 1994;330:1342-1347.http://content.nejm.org/cgi/content/full/330/19/1342http://www.ncbi.nlm.nih.gov/pubmed/8152446?tool=bestpractice.com[40]Heathcote EJ, Cauch-Dudek K, Walker V, et al. The Canadian Multicenter Double-blind Randomized Controlled Trial of ursodeoxycholic acid in primary biliary cirrhosis. Hepatology. 1994;19:1149-1156.http://www.ncbi.nlm.nih.gov/pubmed/8175136?tool=bestpractice.com[41]Lindor KD, Dickson ER, Baldus WP, et al. Ursodeoxycholic acid in the treatment of primary biliary cirrhosis. Gastroenterology. 1994;106:1284-1290.http://www.ncbi.nlm.nih.gov/pubmed/8174890?tool=bestpractice.com[42]Combes B, Carithers RL Jr, Maddrey WC, et al. A randomized, double-blind, placebo-controlled trial of ursodeoxycholic acid in primary biliary cirrhosis. Hepatology. 1995;22:759-766.http://www.ncbi.nlm.nih.gov/pubmed/7657280?tool=bestpractice.com[43]Poupon RE, Lindor KD, Cauch-Dudek K, et al. Combined analysis of randomized controlled trials of ursodeoxycholic acid in primary biliary cirrhosis. Gastroenterology. 1997;113:884-890.http://www.ncbi.nlm.nih.gov/pubmed/9287980?tool=bestpractice.com[44]Goulis J, Leandro G, Burroughs AK. Randomised controlled trials of ursodeoxycholic-acid therapy for primary biliary cirrhosis: a meta-analysis. Lancet. 1999;355:1053-1060.http://www.ncbi.nlm.nih.gov/pubmed/10509495?tool=bestpractice.com[45]Poupon RE, Lindor KD, Pares A, et al. Combined analysis of the effect of treatment with ursodeoxycholic acid on histologic progression in primary biliary cirrhosis. J Hepatol. 2003;39:12-16.http://www.ncbi.nlm.nih.gov/pubmed/12821038?tool=bestpractice.com[46]Gong Y, Huang Z, Christensen E, et al. Ursodeoxycholic acid for patients with primary biliary cirrhosis: an updated systematic review and meta-analysis of randomized clinical trials using Bayesian approach as sensitivity analyses. Am J Gastroenterol. 2007;102:1799-1807.http://www.ncbi.nlm.nih.gov/pubmed/17459023?tool=bestpractice.com[47]Rudic JS, Poropat G, Krstic MN, et al. Ursodeoxycholic acid for primary biliary cirrhosis. Cochrane Database Syst Rev. 2012;(12):CD000551.http://www.ncbi.nlm.nih.gov/pubmed/23235576?tool=bestpractice.com[48]Shi J, Wu C, Lin Y, et al. Long-term effects of mid-dose ursodeoxycholic acid in primary biliary cirrhosis: a meta-analysis of randomized controlled trials. Am J Gastroenterol. 2006;101:1529-1538.http://www.ncbi.nlm.nih.gov/pubmed/16863557?tool=bestpractice.com
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