目的 探討復(fù)方鱉甲軟肝片聯(lián)合前列地爾治療慢性乙型肝炎肝硬化的臨床療效。方法 選取2013年4月—2016年6月在雅安市人民醫(yī)院接受治療的126例慢性乙型肝炎肝硬化患者作為研究對(duì)象，隨機(jī)分為對(duì)照組和治療組，兩組各63例。對(duì)照組患者口服復(fù)方鱉甲軟肝片，4片/次，3次/d；治療組患者在對(duì)照組的基礎(chǔ)上靜脈注射前列地爾注射液，5 μg加入到10 mL生理鹽水中，1次/d。兩組患者均治療6周。觀察兩組的乙肝病毒的脫氧核糖核酸（HBV-DNA）轉(zhuǎn)陰率、乙肝E抗原（HBeAg）轉(zhuǎn)陰率及HBeAg轉(zhuǎn)換率，比較治療前后兩組患者的Child-Pugh評(píng)分、肝功能指標(biāo)以及肝纖維化指標(biāo)的變化。結(jié)果 治療組的HBV-DNA轉(zhuǎn)陰率、HBeAg轉(zhuǎn)陰率和HBeAg轉(zhuǎn)換率分別為77.8%、54.0%、44.4%，均顯著高于對(duì)照組的55.6%、30.2%、27.0%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；兩組患者的Child-Pugh評(píng)分均降低，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組的Child-Pugh評(píng)分明顯低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者的丙氨酸氨基轉(zhuǎn)移酶（ALT）和總膽紅素（TBIL）顯著降低，凝血酶原活動(dòng)度（PTA）升高，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組的肝功能指標(biāo)明顯優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者的透明質(zhì)酸（HA）、Ⅲ型前膠原（PCⅢ）、IV型膠原（Ⅳ-C）、層黏連蛋白（LN）均顯著降低，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組的肝纖維化指標(biāo)明顯低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 復(fù)方鱉甲軟肝片聯(lián)合前列地爾治療慢性乙型肝炎肝硬化療效顯著，可有效改善肝功能和肝纖維化，具有一定的臨床推廣應(yīng)用價(jià)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.