目的 探討肝蘇顆粒聯(lián)合拉米夫定和阿德福韋酯治療乙型肝炎肝硬化的臨床療效。方法 選取2014年5月-2015年5月在遂寧市中心醫(yī)院接受治療的乙型肝炎肝硬化患者82例，根據(jù)治療方案的差別分為對照組（41例）和治療組（41例）。對照組口服拉米夫定片，1片/次，1次/d；同時(shí)口服阿德福韋酯片，1片/次，1次/d。治療組在對照組基礎(chǔ)上口服肝蘇顆粒，1袋/次，3次/d。兩組患者均連續(xù)治療12個(gè)月。觀察兩組的臨床療效，同時(shí)比較兩組治療前后谷丙轉(zhuǎn)氨酶（ALT）、谷草轉(zhuǎn)氨酶（AST）、總膽紅素（TBIL）、白蛋白（ALB）、HBV-DNA轉(zhuǎn)陰率、門靜脈內(nèi)徑、脾臟厚度和脾靜脈寬度的變化。結(jié)果 治療后，對照組和治療組的總有效率分別為75.61%、92.68%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組ALT、AST和TBIL均顯著降低，ALB均顯著升高，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度均優(yōu)于同期對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。同組治療前及治療后3、6個(gè)月HBV-DNA轉(zhuǎn)陰率比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療12個(gè)月，兩組患者的門靜脈內(nèi)徑、脾臟厚度和脾靜脈寬度均顯著降低，同組治療前后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的降低程度優(yōu)于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 肝蘇顆粒聯(lián)合拉米夫定和阿德福韋酯治療乙型肝炎肝硬化療效確切，有利于患者肝功能改善，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical effect of Gansu Granules combined with lamivudine and adefovir dipivoxil in treatment of hepatitis B cirrhosis. Methods Patients (82 cases) with hepatitis B cirrhosis in Suining Central Hospital from May 2014 to May 2015 were divided into control (41 cases) and treatment (41 cases) groups according to different treatments. The patients in the control group were po administered with Lamivudine Tablets, 1 tablet/time, once daily, at the same time, they were po administered with Adefovir dipivoxil Tablets, 1 tablet/time, once daily. The patients in the treatment group were po administered with Gansu Granules on the basis of the control group, 1 bag/time, three times daily. The patients in two groups were treated for 12 months. After treatment, the efficacy was evaluated, the changes of ALT, AST, TBIL, ALB, negative conversion ratios of HBV-DNA, portal vein diameter, spleen thickness, and splenic vein width in two groups before and after treatment were compared. Results After treatment, the efficacies in the control and treatment groups were 75.61% and 92.68%, respectively, and there was difference between two groups (P<0.05). After treatment, ALT, AST, and TBIL in two groups were significantly decreased, ALB was significantly increased, and the difference was statistically significant in the same group (P<0.05). The improved degree of those observation indicators in the treatment group was better than that in the control group, with significant difference between two groups (P<0.05). The difference of the negative conversion ratios of HBV-DNA in the same group before treatment and treatment for 3 and 6 months was statistically significant (P<0.05). After treatment for 12 months, portal vein diameter, spleen thickness, and splenic vein width in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). The decrease degree of those observation indicators in the treatment group was better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Gansu Granules combined with lamivudine and adefovir dipivoxil has a definite clinical effect in treatment of hepatitis B cirrhosis, which is beneficial to improve the liver function of patients and has a certain clinical application value.