目的 探討甘草酸二銨腸溶膠囊聯(lián)合富馬酸替諾福韋二吡呋酯片治療乙型肝炎肝硬化的臨床療效。方法 納入海軍軍醫(yī)大學第三附屬醫(yī)院在2022年6月—2024年11月收治的90例乙型肝炎肝硬化患者的臨床資料，按治療方式不同將患者分為對照組和治療組，每組45例。對照組患者口服富馬酸替諾福韋二吡呋酯片，1片/次，1次/d。治療組在對照組基礎上口服甘草酸二銨腸溶膠囊，3粒/次，3次/d。兩組持續(xù)治療3個月。比較兩組患者的治療效果、肝臟硬度、纖維化程度、肝功能、肝纖維化指標。結果 治療后，治療組的總有效率（95.56%）明顯高于對照組的總有效率（82.22%），差異有統(tǒng)計學意義（P＜0.05）。兩組治療后的肝臟硬度測定（LSM）和肝纖維化評分顯著降低（P＜0.05），且治療組治療后LSM和肝纖維化評分低于對照組（P＜0.05）。治療后，兩組的天冬氨酸氨基轉(zhuǎn)移酶/丙氨酸氨基轉(zhuǎn)移酶（AST/ALT）、總膽紅素（TBil）顯著降低，白蛋白（ALB）顯著升高（P＜0.05）；治療組治療后的AST/ALT、TBil低于對照組，ALB高于對照組（P＜0.05）。治療后，兩組的層黏連蛋白（LN）、骨橋蛋白（OPN）、CC型修飾趨化因子11（CCL11）顯著降低（P＜0.05），且治療組LN、OPN、CCL11明顯低于對照組（P＜0.05）。結論 甘草酸二銨腸溶膠囊聯(lián)合富馬酸替諾福韋二吡呋酯片可提高乙型肝炎肝硬化的臨床療效，改善肝功能，降低纖維化程度。

Objective To investigate the clinical efficacy of Diammonium Glycyrrhizinate Enteric-coated Capsules combined with Tenofovir Disoproxil Fumarate Tablets in treatment of hepatitis B cirrhosis. Methods The clinical data of 90 patients with hepatitis B cirrhosis admitted to the Third Affiliated Hospital of Naval Medical University from June 2022 to November 2024 were included. The patients were divided into control group and treatment group according to different treatment methods, with 45 cases in each group. The control group were po administered with Tenofovir Disoproxil Fumarate Tablets, 1 tablets/time, once daily. The treatment group was po administered with Diammonium Glycyrrhizinate Enteric-coated Capsules on the basis of the control group, 3 capsules/time, 3 times daily. Two groups were treated continuously for 3 months. The treatment efficacy, liver hardness, fibrosis degree, liver function, and liver fibrosis indicators were compared between two groups. Results After treatment, the total effective rate of the treatment group (95.56%) was significantly higher than that of the control group (82.22%), and the difference was statistically significant (P < 0.05). The liver stiffness measurement (LSM) and liver fibrosis score were significantly reduced in two groups after treatment (P < 0.05), and the LSM and liver fibrosis score in the treatment group were lower than those in the control group after treatment (P < 0.05). After treatment, the levels of aspartate aminotransferase/alanine aminotransferase (AST/ALT) and total bilirubin (TBil) significantly decreased in two groups, while albumin (ALB) significantly increased (P < 0.05). The AST/ALT and TBil levels in the treatment group were lower than those in the control group after treatment, while ALB levels were higher than those in the control group (P < 0.05). After treatment, the levels of laminin (LN), osteopontin (OPN), and CC modified chemokine 11 (CCL11) in two groups were significantly reduced (P < 0.05), and LN, OPN, and CCL11 in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Diammonium Glycyrrhizinate Enteric-coated Capsules combined with Tenofovir Disoproxil Fumarate Tablets can improve the clinical efficacy of hepatitis B cirrhosis, improve liver function, and reduce fibrosis degree.

R977