目的 探讨复方鳖甲软肝片联合前列地尔治疗慢性乙型肝炎肝硬化的临床疗效。方法 选取2013年4月—2016年6月在雅安市人民医院接受治疗的126例慢性乙型肝炎肝硬化患者作为研究对象，随机分为对照组和治疗组，两组各63例。对照组患者口服复方鳖甲软肝片，4片/次，3次/d；治疗组患者在对照组的基础上静脉注射前列地尔注射液，5 μg加入到10 mL生理盐水中，1次/d。两组患者均治疗6周。观察两组的乙肝病毒的脱氧核糖核酸（HBV-DNA）转阴率、乙肝E抗原（HBeAg）转阴率及HBeAg转换率，比较治疗前后两组患者的Child-Pugh评分、肝功能指标以及肝纤维化指标的变化。结果 治疗组的HBV-DNA转阴率、HBeAg转阴率和HBeAg转换率分别为77.8%、54.0%、44.4%，均显著高于对照组的55.6%、30.2%、27.0%，两组比较差异具有统计学意义（P<0.05）；两组患者的Child-Pugh评分均降低，同组治疗前后比较差异具有统计学意义（P<0.05）；且治疗后治疗组的Child-Pugh评分明显低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者的丙氨酸氨基转移酶（ALT）和总胆红素（TBIL）显著降低，凝血酶原活动度（PTA）升高，同组治疗前后比较差异具有统计学意义（P<0.05）；且治疗后治疗组的肝功能指标明显优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者的透明质酸（HA）、Ⅲ型前胶原（PCⅢ）、IV型胶原（Ⅳ-C）、层黏连蛋白（LN）均显著降低，同组治疗前后比较差异具有统计学意义（P<0.05）；且治疗后治疗组的肝纤维化指标明显低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 复方鳖甲软肝片联合前列地尔治疗慢性乙型肝炎肝硬化疗效显著，可有效改善肝功能和肝纤维化，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Compound Biejia Ruangan Tablets combined with alprostadil in treatment of chronic hepatitis B cirrhosis. Methods Patients (126 cases) with chronic hepatitis B cirrhosis in Ya'an People's Hospital from April 2013 to June 2016 were randomly divided into control and treatment groups, and each group had 63 cases. Patients in the control group were po administered with Compound Biejia Ruangan Tablets, 4 tablets/time, 3 times daily. Patients in the treatment group were iv administered with Alprostadil Injection on the basis of the control group, 5 μg added into 10 mL normal saline, once daily. Patients in two groups were treated for 6 weeks. After treatment, negative conversion ratios of HBV-DNA, HBeAg, and conversion rate of HBeAg was evaluated, Child-Pugh score, liver function indexes, and hepatic fibrosis indexes in two groups before and after treatment were compared. Results The negative conversion ratios of HBV-DNA, HBeAg, and conversion rate of HBeAg (77.8%, 54.0%, and 44.4%) in the treatment group were significantly higher than 55.6%, 30.2%, and 27.0% in the control group, with significant difference between two groups (P < 0.05). Child-Pugh score in two groups was significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And Child-Pugh score in the treatment group was significantly lower than that in the control group, with significant difference between two groups (P < 0.05). After treatment, ALT and TBIL in two groups was significantly decreased, but PTA was significantly increased, and the difference was statistically significant in the same group (P < 0.05). And liver function indexes in the treatment group were higher than those in the control group, with significant difference between two groups (P < 0.05). After treatment, HA, PCⅢ, Ⅳ-C, and LN in two groups was significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And hepatic fibrosis indexes in the treatment group were higher than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Compound Biejia Ruangan Tablets combined with alprostadil has good effect in treatment of chronic hepatitis B cirrhosis, and can improve liver functionand hepatic fibrosis, which has a certain clinical application value.