目的:观察恩替卡韦联合复方鳖甲软肝片治疗乙型肝炎肝硬化对肝纤维化指标的影响。方法:收集2009年9月至2011年4月株洲市一医院消化内科门诊及住院的乙型肝炎肝硬化患者60例,随机分为恩替卡韦组和联合治疗组,每组30例;根据临床表现和肝功能检查结果将患者分为肝功能代偿期和失代偿期,恩替卡韦组和联合治疗组均有代偿期患者20例和失代偿期患者10例。恩替卡韦组予恩替卡韦治疗,联合治疗组加用复方鳖甲软肝片,疗程均为24周。治疗前和治疗后不同时间点检测血清HBVDNA水平、血生化指标及血清肝纤维化指标层粘连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原肽(PCⅢ)、Ⅳ型胶原(Ⅳ-C)水平,并评价治疗效果。结果:治疗前2组患者肝纤维化指标差异无统计学意义(均P>0.05)。治疗24周2组患者肝纤维化指标LN、HA、PCⅢ和Ⅳ-C与治疗前比较均显著下降(均P<0.05),联合治疗组血清肝纤维化指标较恩替卡韦组降低[LN:(76.01±38.76)ng/mL比(102.75±23.01)ng/mL;HA:(151.28±80.71)ng/mL比(236.12±92.12)ng/mL;PCⅢ:(15.69±7.02)ng/mL比(26.88±8.44)ng/mL;Ⅳ-C:(88.25±31.92)ng/mL比(129.71±29.10)ng/mL,均P<0.05]。2组乙型肝炎肝硬化代偿期患者的疗效均优于失代偿期患者(均P<0.05);乙型肝炎肝硬化代偿期患者中,联合治疗组的疗效优于恩替卡韦组(P<0.05),而失代偿期患者中2组疗效差异无统计学意义(P>0.05)。结论:恩替卡韦联合复方鳖甲软肝片联合治疗乙型肝炎肝硬化能明显提高疗效。 Objective: To observe the effects of entecavir and Fufang Biejia Ruangan Tablet on liver fibrosis in patients with hepatitis B cirrhosis. Methods: Sixty patients with hepatitis B cirrhosis from January 2009 to April 2011 in Zhuhai City Hospital were enrolled and randomly divided into entecavir group and combination therapy group, 30 cases in each group. According to the clinical manifestations and Liver function test results were divided into decompensated liver function and decompensated patients, entecavir group and combined treatment group, 20 patients with decompensated patients and 10 patients with decompensated. Entecavir group treated with entecavir, combination therapy group with compound Biejia Ruangan tablet, treatment were 24 weeks. Serum HBVDNA levels, blood biochemical markers and serum levels of hepatic fibrosis index laminin (LN), hyaluronic acid (HA), type Ⅲ procollagen peptide (PC Ⅲ) and type Ⅳ collagen (Ⅳ) were measured before treatment and at different time points after treatment -C) levels, and evaluate the treatment effect. Results: There was no significant difference in liver fibrosis between the two groups before treatment (all P> 0.05). The serum levels of LN, HA, PCⅢ and Ⅳ-C in two groups of patients at 24 weeks after treatment were significantly lower than those before treatment (all P <0.05), while those in the combined treatment group were lower than those in the entecavir group [LN: (76.01 ML, and the ratio of PCⅢ to (15.69 ± 7.02) ng / mL (26.88 ± 2.12) ng / mL; 8.44) ng / mL; Ⅳ-C: (88.25 ± 31.92) ng / mL ratio (129.71 ± 29.10) ng / mL, all P <0.05]. The efficacy of patients with decompensated hepatitis B cirrhosis was better than that of decompensated patients (all P <0.05). Among the patients with hepatitis B cirrhosis, the combined therapy group was superior to entecavir therapy group <0.05). However, there was no significant difference between the two groups in decompensated patients (P> 0.05). Conclusion: Entecavir combined with Fufang Biejia Ruangan Pian in the treatment of hepatitis B cirrhosis can significantly improve the curative effect.