目的 探討茵梔黃注射液聯(lián)合熊去氧膽酸治療自身免疫性肝炎的臨床療效。方法 選取2015年5月-2016年5月在天津市第五中心醫(yī)院接受治療的自身免疫性肝炎患者84例，根據(jù)治療方案的差別分為對照組（42例）和治療組（42例）。對照組患者口服熊去氧膽酸膠囊，250 mg/次，3次/d。治療組在對照組的基礎(chǔ)上靜脈滴注茵梔黃注射液，10 mL加入10%葡萄糖溶液250 mL，2次/d。兩組患者均連續(xù)治療8周。評價(jià)兩組患者臨床療效，同時(shí)比較兩組丙氨酸轉(zhuǎn)氨酶（ALT）、天氨酸轉(zhuǎn)氨酶（AST）、直接膽紅素（DBIL）和總膽紅素（TBIL）等肝功能，以及透明質(zhì)酸（HA）、層黏蛋白（LN）、Ⅲ型前膠原（PC-Ⅲ）和Ⅳ型膠原（Ⅳ-C）等肝纖維化指標(biāo)和血清IgG、IgM水平變化。結(jié)果 治療后，兩組患者總有效率分別為76.19%、92.86%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組ALT、AST、DBIL和TBIL水平均顯著降低，同組治療前后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05），且治療后治療組肝功能水平優(yōu)于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者血清HA、LN、PC-Ⅲ和Ⅳ-C均明顯降低，同組治療前后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組肝纖維化指標(biāo)比對照組降低的更明顯（P<0.05）。治療后，兩組患者血清IgG、IgM水平均明顯降低，同組治療前后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組免疫學(xué)指標(biāo)降低程度更顯著，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 茵梔黃注射液聯(lián)合熊去氧膽酸治療自身免疫性肝炎具有很好的臨床效果，能夠促進(jìn)肝功能改善，還可改善肝纖維化，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of Yinzhihuang Injection combined with ursodeoxycholic acid in treatment of autoimmune hepatitis. Methods Patients (84 cases) with autoimmune hepatitis in the Fifth Center Hospital of Tianjin from May 2015 to May 2016 were divided into the control (42 cases) and treatment (42 cases) groups according to different treatments. The patients in the control group were po administered with Ursodeoxycholic Acid Capsules, 250 mg/time, three times daily. The patients in the treatment group were iv administered with Yinzhihuang Injection on the basis of the control group, 10 mL added into 10% glucose solution 250 mL, twice daily. The patients in two groups were treated for 8 weeks. After treatment, the clinical efficacies were evaluated, and the changes of liver functions including ALT, AST, DBIL, and TBIL, and liver fibrosis indexes including HA, LN, PC-Ⅲ, and Ⅳ-C, also serum IgG and IgM levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.19% and 92.86%, respectively, and there were differences between two groups (P<0.05). After treatment, the ALT, AST, DBIL, and TBIL levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the liver functions in the treatment group were significant better than those in the control group, with significant difference between two groups (P<0.05). After treatment, serum HA, LN, PC-Ⅲ, and Ⅳ-C levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the liver fibrosis indexes in the treatment group were significant lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, serum IgG and IgM levels were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the decrease degree of the two indexes in the treatment group was more significant than those in the control group, with significant difference between two groups (P<0.05). Conclusion Yinzhihuang Injection combined with ursodeoxycholic acid has a significant clinical effect in treatment of autoimmune hepatitis, can significantly improve the liver function and hepatic fibrosis, which has a certain clinical application value.