目的 探讨甘草酸二铵肠溶胶囊联合富马酸替诺福韦二吡呋酯片治疗乙型肝炎肝硬化的临床疗效。方法 纳入海军军医大学第三附属医院在2022年6月—2024年11月收治的90例乙型肝炎肝硬化患者的临床资料，按治疗方式不同将患者分为对照组和治疗组，每组45例。对照组患者口服富马酸替诺福韦二吡呋酯片，1片/次，1次/d。治疗组在对照组基础上口服甘草酸二铵肠溶胶囊，3粒/次，3次/d。两组持续治疗3个月。比较两组患者的治疗效果、肝脏硬度、纤维化程度、肝功能、肝纤维化指标。结果 治疗后，治疗组的总有效率（95.56%）明显高于对照组的总有效率（82.22%），差异有统计学意义（P＜0.05）。两组治疗后的肝脏硬度测定（LSM）和肝纤维化评分显著降低（P＜0.05），且治疗组治疗后LSM和肝纤维化评分低于对照组（P＜0.05）。治疗后，两组的天冬氨酸氨基转移酶/丙氨酸氨基转移酶（AST/ALT）、总胆红素（TBil）显著降低，白蛋白（ALB）显著升高（P＜0.05）；治疗组治疗后的AST/ALT、TBil低于对照组，ALB高于对照组（P＜0.05）。治疗后，两组的层黏连蛋白（LN）、骨桥蛋白（OPN）、CC型修饰趋化因子11（CCL11）显著降低（P＜0.05），且治疗组LN、OPN、CCL11明显低于对照组（P＜0.05）。结论 甘草酸二铵肠溶胶囊联合富马酸替诺福韦二吡呋酯片可提高乙型肝炎肝硬化的临床疗效，改善肝功能，降低纤维化程度。

Objective To investigate the clinical efficacy of Diammonium Glycyrrhizinate Enteric-coated Capsules combined with Tenofovir Disoproxil Fumarate Tablets in treatment of hepatitis B cirrhosis. Methods The clinical data of 90 patients with hepatitis B cirrhosis admitted to the Third Affiliated Hospital of Naval Medical University from June 2022 to November 2024 were included. The patients were divided into control group and treatment group according to different treatment methods, with 45 cases in each group. The control group were po administered with Tenofovir Disoproxil Fumarate Tablets, 1 tablets/time, once daily. The treatment group was po administered with Diammonium Glycyrrhizinate Enteric-coated Capsules on the basis of the control group, 3 capsules/time, 3 times daily. Two groups were treated continuously for 3 months. The treatment efficacy, liver hardness, fibrosis degree, liver function, and liver fibrosis indicators were compared between two groups. Results After treatment, the total effective rate of the treatment group (95.56%) was significantly higher than that of the control group (82.22%), and the difference was statistically significant (P < 0.05). The liver stiffness measurement (LSM) and liver fibrosis score were significantly reduced in two groups after treatment (P < 0.05), and the LSM and liver fibrosis score in the treatment group were lower than those in the control group after treatment (P < 0.05). After treatment, the levels of aspartate aminotransferase/alanine aminotransferase (AST/ALT) and total bilirubin (TBil) significantly decreased in two groups, while albumin (ALB) significantly increased (P < 0.05). The AST/ALT and TBil levels in the treatment group were lower than those in the control group after treatment, while ALB levels were higher than those in the control group (P < 0.05). After treatment, the levels of laminin (LN), osteopontin (OPN), and CC modified chemokine 11 (CCL11) in two groups were significantly reduced (P < 0.05), and LN, OPN, and CCL11 in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Diammonium Glycyrrhizinate Enteric-coated Capsules combined with Tenofovir Disoproxil Fumarate Tablets can improve the clinical efficacy of hepatitis B cirrhosis, improve liver function, and reduce fibrosis degree.

R977