目的 探討心肝寶膠囊聯(lián)合替比夫定片治療活動(dòng)性代償期乙型肝炎肝硬化的臨床療效。方法 選擇2014年5月-2017年5月于洛陽市第一人民醫(yī)院就診的活動(dòng)性代償期乙型肝炎肝硬化患者94例為研究對(duì)象，采用隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各47例。對(duì)照組口服替比夫定片，1片/次，1次/d。治療組在對(duì)照組治療的基礎(chǔ)上口服心肝寶膠囊，5粒/次，3次/d。兩組患者均連續(xù)治療6個(gè)月。觀察兩組的臨床療效，比較兩組的肝功能指標(biāo)、抗病毒相關(guān)指標(biāo)、肝纖維化指標(biāo)、肝脾影像學(xué)指標(biāo)。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為76.6%、89.4%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組天門冬氨酸氨基轉(zhuǎn)移酶（AST）、白蛋白（ALB）、丙氨酸氨基轉(zhuǎn)移酶（ALT）、總膽紅素（TBIL）水平均顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組肝功能指標(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）。治療后，治療組乙肝病毒的脫氧核糖核酸（HBV-DNA）轉(zhuǎn)陰率、e抗原陽性（HbeAg）血清學(xué)轉(zhuǎn)換率、ALT復(fù)常率、HBeAg轉(zhuǎn)換率均顯著高于對(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Ⅲ型前膠原（PC-Ⅲ）、透明質(zhì)酸（HA）、Ⅳ型膠原（Ⅳ-C）和層黏連蛋白（LN）水平均顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組肝纖維化指標(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）。治療后，兩組脾靜脈內(nèi)徑（D_sv）、門靜脈內(nèi)徑（D_pv）和脾厚度均顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組肝脾影像學(xué)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 心肝寶膠囊聯(lián)合替比夫定片治療活動(dòng)性代償期乙型肝炎肝硬化具有較好的臨床療效，可改善肝功能和肝纖維化，提高抗病毒療效，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effects of Xinganbao Capsules combined with Telbivudine Tablets in treatment of active compensatory hepatitis B cirrhosis. Methods Patients (94 cases) with active compensatory hepatitis B cirrhosis in the First People's Hospital of Luoyang from May 2014 to May 2017 were randomly divided into control and treatment groups, and each group had 47 cases. Patients in the control group were po administered with Telbivudine Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Xinganbao Capsules on the basis of the control group, 5 grains/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and liver function indexes, anti-virus related indexes, liver fiber indexes, liver and spleen imaging indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.6% and 89.4%, respectively, and there was difference between two groups (P<0.05). After treatment, the levels of AST, ALB, ALT, and TBIL in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And liver function indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, HBV-DNA conversion rates, HbeAg serological conversion rates, ALT recurrence rates, and HBeAg conversion rates in the treatment group were significantly higher than those in the control group, and there was difference between two groups (P<0.05). After treatment, the levels of PC-Ⅲ, HA, Ⅳ-C, and LN in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the liver fiber indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, D_sv, D_pv, and spleen thickness in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the liver and spleen imaging indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Xinganbao Capsules combined with Telbivudine Tablets has clinical curative effect in treatment of active compensatory hepatitis B cirrhosis, can improve liver function and liver fibrosis, and increase antiviral effect, which has a certain clinical application value.