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目的:探讨柔肝化纤颗粒联合核苷类抗病毒药物对乙型肝炎失代偿期肝硬化患者肝肾功能、门静脉系统血流动力学、血管活性、抗病毒指标及对天冬氨酸氨基转移酶-血小板比值指数（aspartate aminotransferase-platelet ratio index，APRI）的影响。方法:采用病例对照研究方法，收集2017年6月至2019年12月于唐山市传染病院和华北理工大学附属医院住院的乙型肝炎失代偿期肝硬化患者150例。应用计算机随机数字法分为对照组和观察组，每组各75例。对照组给予常规护肝和抗病毒治疗；观察组在对照组治疗的基础上加用柔肝化纤颗粒。观察两组患者的肝肾功能、门静脉系统血流动力学、血管活性、抗病毒指标及对APRI的变化。计量资料的两组间比较采用独立样本n t检验，同组间治疗前后比较采用配对n t检验，计数资料采用n χ2检验。n 结果:两组患者性别、年龄、肝硬化病程、肝功能Child分级、治疗前各项指标基数资料比较差异均无统计学意义（均n P>0.05）。治疗后两组患者丙氨酸氨基转移酶（alanine aminotransferase，ALT）、天门冬氨酸氨基转移酶（aspartate aminotransferase，AST）、门静脉内径（diameter of portal vein，Dpv）、脾静脉内径（diameter of splenic vein，Dsv）、内皮素1、一氧化氮、胰高血糖素（glucagon，GLA）、APRI均较治疗前降低；组间比较，观察组ALT（51.60±15.97）U/L、AST（62.65±26.28）U/L、尿素氮（10.25±1.65）mmol/L、肌酐（78.54±14.09）μmol/L、Dpv（10.20±1.10）mm、Dsv（8.08±0.68）mm、内皮素1（31.93±6.35）ng/L、一氧化氮（41.38±8.06）μg/L、GLA（69.54±12.14）mg/L、APRI 3.14±1.35明显低于对照组［（97.49±30.87）U/L、（96.03±25.63）U/L、（17.49±2.55）mmol/L、（116.43±22.77）μmol/L、（13.42±1.26）mm、（10.44±0.83）mm、（44.34±11.88）ng/L、（63.47±15.50）μg/L、（107.11±25.29）mg/L、5.91±1.93］，差异均有统计学意义（n t值分别为11.43、7.87、20.64、12.26、16.62、18.99、7.98、10.96、11.60、10.23，均n P0.05). After treatment, alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea nitrogen, creatinine,diameter of portal vein (Dpv), diameter of splenic vein (Dsv), endothelin-1, nitric oxide, glucagon (GLA), APRI,were all lower than before treatment. Comparison between groups, observation group ALT (51.60±15.97) U/L, AST (62.65±26.28) U/L, urea nitrogen (10.25±1.65) mmol/L, creatinine (78.54±14.09) μmol/L, Dpv (10.20±1.10) mm, Dsv (8.08±0.68) mm, endothelin-1 (31.93±6.35) ng/L, nitric oxide (41.38±8.06) μg/L, GLA (69.54±12.14) mg/L, APRI (3.14±1.35), were significantly lower than those of control group ((97.49±30.87) U/L, (96.03±25.63) U/L, (17.49±2.55) mmol/L, (116.43±22.77) μmol/L, (13.42±1.26) mm, (10.44±0.83) mm, (44.34+11.88) ng/L, (63.47±15.50) μg/L, (107.11+25.29) mg/L, (5.91±1.93)), the differences were statistically significant (n t values were respectively 11.43, 7.87, 20.64, 12.26, 16.62, 18.99, 7.98, 10.96, 11.60, 10.23, all n P<0.05). After treatment, albumin, portal vein velocity (Vpv), and velocity of splenic vein blood flow (Vsv) were all higher in the two groups than before treatment. However, there was no significant difference in Vsv of the control group before and after treatment (n t=0.51, n P=0.613). Comparison between groups, albumin (39.42±7.35) g/L, Vpv ((25.72±4.06) cm/s), Vsv ((24.22±6.15) cm/s) in the observation group were significantly higher than those in the control group (34.66±7.95) g/L, (19.38±3.46) cm/s, (19.54±5.88) cm/s (n t values were 3.81, 10.28, 4.76, all n P<0.05). After treatment, the total effective rate (96.00%(72/75)n vs. 86.67%(65/75), n χ2=4.13, n P=0.042), HBV DNA negative conversion rate (76.00%(57/75) n vs. 58.67%(44/75), n χ2=5.12, n P=0.024), HBeAg negative conversion rate (50.67%(38/75) n vs. 30.67%(23/75), n χ2=6.22, n P=0.013) and serum HBeAg/HBeAb conversion (28.00%(21/75) n vs. 13.33%(10/75), n χ2=4.92, n P=0.027) in observation group were higher than those in control group, and the differences were statistically significant (n P0.05).n Conclusion:Rougan Huaxian Granules combined with nucleoside antiviral drugs has significant effect on patients with decompensated liver cirrhosis of hepatitis B, improve liver and kidney function, liver fibrosis and hemodynamics of the portal vein system, increase vascular activity function, and reduce hepatitis B virus (HBV) DNA load, HBV replication, aspartate transaminase-platelet ratio index, APRI, Toll-like receptor (TLR-4) and transforming growth factor β1 (TGF-β1) levels and improves the body′s immune status.