目的 探討六味五靈片聯(lián)合復(fù)方甘草酸苷治療活動性慢性乙型肝炎肝硬化的臨床療效。方法 選取2015年2月-2016年2月在駐馬店市中心醫(yī)院接受治療的78例活動性慢性乙型肝炎肝硬化患者為研究對象，根據(jù)治療方案的差別分為對照組（39例）和治療組（39例）。對照組患者口服復(fù)方甘草酸苷片，75 mg/次，3次/d。治療組在對照組的基礎(chǔ)上口服六味五靈片，1.5 g/次，3次/d。兩組患者均經(jīng)過48周治療。評價兩組患者臨床療效，同時比較治療前后兩組患者HBV-DNA和乙型肝炎E抗原（HBeAg）轉(zhuǎn)陰率、肝功能、肝纖維化指標(biāo)以及肝硬度和Child-Pugh評分。結(jié)果 治療后，對照組和治療組的總有效率分別為79.49%和94.87%，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療24、48周后，治療組中HBV-DNA和HBeAg轉(zhuǎn)陰率均分別高于同期對照組患者，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者肝功能血清丙氨酸氨基轉(zhuǎn)移酶（ALT）、門冬氨酸轉(zhuǎn)氨酶（AST）、總膽紅素（TBIL）均顯著降低，白蛋白（ALB）明顯升高，同組比較差異具有統(tǒng)計學(xué)意義（P<0.05）；且治療組患者肝功能顯著優(yōu)于對照組（P<0.05）。治療后，兩組患者血清透明質(zhì)酸（HA）、層黏連蛋白（LN）、Ⅲ型前膠原肽（PC-Ⅲ）、Ⅳ型膠原（Ⅳ-C）均明顯降低（P<0.05）；且治療組上述肝纖維化指標(biāo)顯著低于對照組患者（P<0.05）。治療后，兩組患者肝硬度和Child-Pugh評分均明顯降低（P<0.05）；且治療組患者肝硬度和Child-Pugh評分明顯低于對照組患者（P<0.05）。結(jié)論 六味五靈片聯(lián)合復(fù)方甘草酸苷治療活動性慢性乙型肝炎肝硬化可有效改善患者肝功能和肝纖維化指標(biāo)，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical efficacy of Liuwei Wuling Tablets combined with compound glycyrrhizin in treatment of active chronic hepatitis B cirrhosis. Methods Patients (78 cases) with active chronic hepatitis B cirrhosis in Zhumadian Central Hospital from February 2015 to February 2016 were divided into control (39 cases) and treatment (39 cases) groups according to different treatments. Patients in the control group were po administered with Compound Glycyrrhizin Tablets, 75 mg/time, three times daily. Patients in the treatment group were po administered with Liuwei Wuling Tablets on the basis of the control group, 1.5 g/time, three times daily. Patients in two groups were treated for 48 weeks. After treatment, the clinical efficacy was evaluated, and HBV-DNA and HBeAg negative rate, liver function, liver fibrosis indexes, liver cirrhosis and Child-Pugh scores in two groups before and after treatment was compared. Results After treatment, the clinical efficacy in the control and treatment groups were 79.49% and 94.87%, respectively, and there were differences between two groups (P<0.05). After treatment for 24 and 48 weeks, the HBV-DNA and HBeAg negative rate in the treatment group were higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, the ALT, AST and TBIL level in two groups was significantly decreased, but ALB was significantly increased, and the difference was statistically significant in the same group (P<0.05). The liver function in the treatment group was significantly better than that in the control group (P<0.05). After treatment, the serum HA, LN, PC-Ⅲ, and Ⅳ-C level in two groups was significantly decreased (P<0.05), and the liver fibrosis indexes in the treatment group were significantly lower than that in the control group (P<0.05). After treatment, the liver stiffness and Child-Pugh scores in two groups were significantly decreased (P<0.05), and the liver cirrhosis and Child-Pugh scores in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Liuwei Wuling Tablets combined with compound glycyrrhizin can effectively improve the liver function and liver fibrosis indexes in treatment of active chronic hepatitis B cirrhosis, which has a certain clinical application value.