目的 分析復(fù)方鱉甲軟肝片聯(lián)合恩替卡韋治療慢性乙型肝炎肝纖維化的臨床療效。方法 以2013年1月-2015年5月陜西省安康市人民醫(yī)院消化內(nèi)科診治慢性乙型肝炎肝纖維化患者92例為研究對象，根據(jù)自愿原則分為觀察組（n=45）和對照組（n=47），觀察組給予復(fù)方鱉甲軟肝片聯(lián)合恩替卡韋治療，對照組僅給予恩替卡韋治療，兩組均治療48周，比較兩組的肝功能、肝纖維化、血清炎癥因子以及不良反應(yīng)。結(jié)果 治療后，兩組的丙氨酸氨基轉(zhuǎn)移酶（ALT）、天門冬氨酸氨基轉(zhuǎn)移酶（AST）、白蛋白/球蛋白（ALB/GLB）和總膽紅素（TBIL）均較治療前顯著降低（P<0.05），但兩組間比較，差異均無統(tǒng)計(jì)學(xué)意義。治療后，兩組的血清乙型肝炎病毒脫氧核糖核苷酸（HBV DNA）轉(zhuǎn)陰率比較差異無統(tǒng)計(jì)學(xué)意義。治療前，兩組的Ⅲ型前膠原（PCⅢ）、Ⅳ型膠原（Ⅳ-C）、透明質(zhì)酸（HA）、層黏蛋白（LN）水平比較，差異無統(tǒng)計(jì)學(xué)意義；治療后，兩組的PCⅢ、Ⅳ-C、HA和LN水平均較治療前顯著降低（P<0.05），且觀察組的PCⅢ、Ⅳ-C、HA和LN水平均低于對照組（P<0.05）。治療后，兩組的白介素-6（IL-6）、IL-4、IL-10和腫瘤壞死因子α（TNF-α）水平均較治療前顯著降低（P<0.05），且觀察組的IL-6、IL-4、IL-10和TNF-α水平均低于對照組（P<0.05）。兩組不良反應(yīng)發(fā)生率比較，差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 復(fù)方鱉甲軟肝片聯(lián)合恩替卡韋治療慢性乙型肝炎肝纖維化安全有效，可顯著改善肝功能，改善肝纖維化程度，降低患者血清炎癥因子水平。

Objective To investigate the clinical effects of Compound Biejia Ruangan Tablet (CBRT) combined with entecavir in patients with chronic hepatitis B with hepatic fibrosis. Methods Totally 92 cases of patients with hepatic fibrosis of chronic hepatitis B in Ankang people's hospital from January 2013 to May 2016 were divided into observation group (n=45) and control group (n=47), patients in observation group were treated with CBRT combined with entecavir, and patients in the control group were treated with entecavir. Treatment was for 48 weeks. The liver function, liver fibrosis, serum inflammatory factors, and adverse reactions were compared between two groups. Results After treatment, the ALT, AST, TBIL, and ALB/GLB levels of two group were significantly lower than those before treatment (P<0.05), but there was no significant difference between two groups after treatment. After treatment, the PCIII, IV-C, HA, LN, IL-6, IL-4, IL-10, and TNF-α levels of two group were significantly lower than those before treatment (P<0.05), and the PCIII, IV-C, HA, LN, IL-6, IL-4, IL-10, and TNF-α levels of observation group were significantly lower than those of control group (P<0.05); there was no statistically significant difference in the incidence of adverse reactions between two groups (P<0.05). Conclusion CBRT combined with entecavir is safe and effective to treat liver fibrosis of chronic hepatitis b, and it could significantly improve liver function, improve the degree of liver fibrosis, and reduce the level of serum inflammatory factors.