Fuzhenghuayu in Combination With Ursodeoxycholic Acid in Primary Biliary Cirrhosis

Ursodeoxycholic acid (UDCA) has been the only treatment for PBC approved by US and European drug administrations. Long-term use of UDCA (13-15 mg/kg/day) in patients with PBC improves serum liver biochemistries and survival free of liver transplantation. However, about 40% of patients do not respond to UDCA optimally as assessed by known criteria for biochemical response. Those patients represent the group in need for additional therapies, having increased risk of disease progression and decreased survival free of liver transplantation. And UDCA has less effect on PBC patients whose pathology stage 3-4. Liver fibrosis might jeopardize the UDCA effect. Fuzhenghuayu is a Chinese traditional medicine for liver fibrosis and cirrhosis. Both lab research and some clinical studies suggest that Fuzhenghuayu could significantly reverse liver fibrosis and cirrhosis due to different kind of etiology. Here the investigators start a random, open and parallel clinical research to explore the effect of Fuzhenghuayu combined with UDCA in the PBC treatment.

Normalization of alkaline phosphatase (ALP) or decrease of ALP by more than 40% compared to the baseline.

Histological evolution will be checked by liver biopsy at the end of the study to compare with baseline histological status.

The change of liver stiffness status at the end of the study compared to baseline checked by magnetic resonance elastography.

The symptom of pruritus will be evaluated by questionnaire before enrollment and at the end of the study.

The symptom of fatigue will be evaluated by Fatigue Impact Scale before enrollment and at the end of the study.

Inclusion Criteria: Signed informed consent Patient with PBC defined by 2 in 3 of the following criteria: Positive antimitochondrial antibody type M2; Abnormal serum alkaline phosphatases (ALP > 1,5N) and aminotransferase (AST or ALT > 1N) activities; Histological hepatic injuries consistent with PBC. Exclusion Criteria: Pregnancy or desire of pregnancy. Breast-feeding. Co-existing liver diseases such as acute or chronic viral hepatitis, alcoholic liver disease, choledocholithiasis, autoimmune hepatitis, biopsy-proven non-alcoholic fatty liver disease, Wilson's disease and hemochromatosis. History or presence of hepatic decompensation (e.g., variceal bleeds, encephalopathy, or poorly controlled ascites). History of urolithiasis, nephritis or renal failure (clearance of creatinine < 60 ml/mn). Hepatotoxic drugs use before recruiting. Fuzhenghuayu anaphylaxis.