目的:研究4种水飞蓟素类药物治疗慢性乙型肝炎肝损伤的疗效和经济成本。方法:慢性乙型肝炎门诊患者144例随机分为水飞蓟素片组(A组),复方益肝灵胶囊组(B组),水飞蓟宾葡甲胺片组(C组),当飞利肝宁胶囊组(D组),每组36例。观察各组患者用药4周前后ALT、AST等生化指标,统计各组治疗总有效率,计算疗程费用、药物成本-效果(C/E)及敏感度分析。结果:4组治疗总有效率分别为72.22%、75.00%、61.11%和77.78%,差异无统计学意义(P>0.05)。4组C/E值分别为2.33,2.89,3.01和3.49,A组的C/E值最低,A组为最优治疗方案。最小成本敏感度分析与C/E结果一致。结论:水飞蓟素片为治疗慢性乙型肝炎肝损伤较为有效、经济的药物,在实际治疗过程中仍需根据患者的实际情况合理选择药物。 Objective: To study the efficacy and economic cost of four kinds of silymarin in the treatment of chronic hepatitis B liver injury. Methods: One hundred and fourteen patients with chronic hepatitis B were randomly divided into three groups: silymarin group (group A), compound Yiganling capsule group (group B) and silybin group (group C) Ning capsule group (D group), 36 cases in each group. The biochemical indexes, such as ALT and AST, were observed before and after 4 weeks of treatment in each group. The total effective rate of each group was calculated, and the cost of treatment, cost-effectiveness (C / E) and sensitivity analysis were calculated. Results: The total effective rates of the four groups were 72.22%, 75.00%, 61.11% and 77.78% respectively, with no significant difference (P> 0.05). The C / E values ​​of the 4 groups were 2.33, 2.89, 3.01 and 3.49 respectively, the C / E value of the group A was the lowest, and the group A was the optimal treatment. The minimum cost sensitivity analysis is consistent with the C / E results. Conclusion: Silymarin tablets for the treatment of chronic hepatitis B liver injury more effective and economical drugs, in the actual treatment of patients still need to be based on the actual situation of the rational choice of drugs.