目的 探討茵芪肝復(fù)顆粒聯(lián)合阿德福韋酯膠囊治療慢性乙型肝炎肝硬化的臨床療效。方法 選取2016年4月-2019年10月天津市北辰醫(yī)院收治的119例慢性乙型肝炎肝硬化患者為研究對象，將所有患者根據(jù)隨機(jī)數(shù)字表法分為對照組（59例）和治療組（60例）。對照組口服阿德福韋酯膠囊，10 mg/次，1次/d。治療組患者在對照組的基礎(chǔ)上口服茵芪肝復(fù)顆粒，18 g/次，3次/d。兩組患者療程為6個月。觀察兩組臨床療效，比較兩組肝功能指標(biāo)[丙氨酸氨基轉(zhuǎn)移酶（ALT）、總膽紅素（TBIL）、天門冬氨酸氨基轉(zhuǎn)氨酶（AST）]、肝纖維化指標(biāo)[透明質(zhì)酸（HA）、層黏連蛋白（LN）、Ⅲ型前膠原（PC-Ⅲ）、Ⅳ型膠原（Ⅳ-C）]、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、HBeAg轉(zhuǎn)換率。結(jié)果 治療后，治療組的臨床總有效率為91.67%，高于對照組的74.58%（P<0.05）。治療后，兩組患者ALT、AST、TBIL水平均較治療前下降（P<0.05），且治療組肝功能指標(biāo)低于對照組（P<0.05）。治療后，兩組患者HA、LN、PC-Ⅲ、Ⅳ-C水平均較治療前下降（P<0.05），且治療組肝纖維化指標(biāo)水平低于對照組（P<0.05）。治療后，治療組的HBV-DNA轉(zhuǎn)陰率、HBeAg轉(zhuǎn)陰率、HBeAg轉(zhuǎn)換率均高于對照組（P<0.05）。結(jié)論 茵芪肝復(fù)顆粒聯(lián)合阿德福韋酯膠囊治療慢性乙型肝炎肝硬化的療效顯著，可改善患者肝功能、肝纖維化指標(biāo)，提高HBV-DNA轉(zhuǎn)陰率、HBeAg轉(zhuǎn)陰率、HBeAg轉(zhuǎn)換率，安全性較好，具有一定的臨床推廣應(yīng)用價(jià)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

天津市科技發(fā)展指導(dǎo)性計(jì)劃（醫(yī)療衛(wèi)生）項(xiàng)目（TJSW2016022）