目的 探讨茵芪肝复颗粒联合阿德福韦酯胶囊治疗慢性乙型肝炎肝硬化的临床疗效。方法 选取2016年4月-2019年10月天津市北辰医院收治的119例慢性乙型肝炎肝硬化患者为研究对象，将所有患者根据随机数字表法分为对照组（59例）和治疗组（60例）。对照组口服阿德福韦酯胶囊，10 mg/次，1次/d。治疗组患者在对照组的基础上口服茵芪肝复颗粒，18 g/次，3次/d。两组患者疗程为6个月。观察两组临床疗效，比较两组肝功能指标[丙氨酸氨基转移酶（ALT）、总胆红素（TBIL）、天门冬氨酸氨基转氨酶（AST）]、肝纤维化指标[透明质酸（HA）、层黏连蛋白（LN）、Ⅲ型前胶原（PC-Ⅲ）、Ⅳ型胶原（Ⅳ-C）]、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、HBeAg转换率。结果 治疗后，治疗组的临床总有效率为91.67%，高于对照组的74.58%（P<0.05）。治疗后，两组患者ALT、AST、TBIL水平均较治疗前下降（P<0.05），且治疗组肝功能指标低于对照组（P<0.05）。治疗后，两组患者HA、LN、PC-Ⅲ、Ⅳ-C水平均较治疗前下降（P<0.05），且治疗组肝纤维化指标水平低于对照组（P<0.05）。治疗后，治疗组的HBV-DNA转阴率、HBeAg转阴率、HBeAg转换率均高于对照组（P<0.05）。结论 茵芪肝复颗粒联合阿德福韦酯胶囊治疗慢性乙型肝炎肝硬化的疗效显著，可改善患者肝功能、肝纤维化指标，提高HBV-DNA转阴率、HBeAg转阴率、HBeAg转换率，安全性较好，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Yinqi Ganfu Granules combined with Adefovir Dipivoxil Capsules in treatment of chronic hepatitis B cirrhosis. Methods Patients (119 cases) with chronic hepatitis B cirrhosis in Tianjin Beichen Hospital from April 2016 to October 2019 were randomly divided into the control group (59 cases) and treatment group (60 cases). Patients in the control group were po administered with Adefovir Dipivoxil Capsules, 10 mg/time, once daily. Patients in the treatment group were po administered with Yinqi Ganfu Granules on the basis of the control group, 18 g/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and liver function indexes (ALT, TBIL, and AST), liver fibrosis indexes (HA, LN, PC-Ⅲ, and Ⅳ-C), HBV-DNA negative rate, HBeAg negative rate, and HBeAg conversion rate in two groups were compared. Results After treatment, the total clinical effective rate of the treatment group was 91.67%, which was higher than 74.58% of the control group (P<0.05). After treatment, the levels of ALT, AST, and TBIL in two groups were lower than those before treatment (P<0.05), and the liver function indexes in the treatment group were lower than those in the control group (P<0.05). After treatment, the levels of HA, LN, PC-III, and IV-C in two groups were lower than those before treatment (P<0.05), and the hepatic fibrosis indexes in the treatment group were lower than those in the control group (P<0.05). After treatment, the HBV-DNA negative rate, HBeAg negative rate, and HBeAg conversion rate in the treatment group were higher than those in the control group (P<0.05). Conclusion Yinqi Ganfu Granules combined with Adefovir Dipivoxil Capsules has clinical curative effect in treatment of chronic hepatitis B cirrhosis, can improve the liver function indexes and liver fibrosis indexes, improve the negative rate of HBV-DNA, HBeAg negative rate and HBeAg conversion rate, with good safety, which has a certain clinical application value.

R975

天津市科技发展指导性计划（医疗卫生）项目（TJSW2016022）