目的 探讨肝爽颗粒联合恩替卡韦对乙型肝炎肝硬化患者血浆 D⁃二聚体水平的影响。 方法 356例血浆D⁃二聚体升高的乙型肝炎肝硬化患者随机分为两组：观察组191例肝爽颗粒联合恩替卡韦疗 程48周，对照组165例单用恩替卡韦。疗程均48周。采用重复测量方差分析比较两组基线、治疗6、12个月时血 浆D⁃二聚体水平的变化。结果 两组患者基线时血浆D⁃二聚体分别为（3.44 ± 1.33）mg/L和（3.59 ± 1.30）mg/L （P > 0.05）。重复测量方差分析显示，组间的主效应显著，F = 58.953，P < 0.001，偏η2 = 0.143；时间的主效应显 著，F = 545.167，P < 0.001，偏η2 = 0.606；时间与组别的交互效应显著，F = 10.117，P < 0.001，偏η2 = 0.028。治疗 后6个月、12个月，观察组的血浆D⁃二聚体水平下降均高于对照组（P < 0.05）；每组内基线、6个月、12个月血浆D⁃二聚体水平下降两两比较差异均有统计学意义（P < 0.05）。两组的门静脉血栓形成、腹水和消化道出 血的发生率差异均有统计学意义（P < 0.05）。结论 肝爽颗粒联合恩替卡韦与单用恩替卡韦相比，能显著降 低乙型肝炎肝硬化患者血浆D⁃二聚体水平，且随时间的延长效果更明显，有效预防门静脉血栓的形成。

Objective To investigate the effect of Ganshuang granule combined with entecavir on plasma D⁃dimer level in patients with hepatitis B related cirrhosis. Methods Patients with hepatitis B related cirrhosis with elevated D ⁃ dimer were randomly divided into two groups：The observation group （191 cases） took the Ganshuang granule 0.3 grams/time，3 times/day，Entecavir 0.5 mg/time，1 time/day of 48 weeks. 165 cases in the control group were treated with entecavir 0.5 mg/time，once a day for 48 weeks. The changes of plasma D⁃dimer levels at baseline，6 months and 12 months of treatment were compared by repeated measurement analysis of variance. Results the plasma D⁃dimer of the two groups was 3.44 ± 1.33 mg/L and 3.59 ± 1.30 mg/L at baseline （P > 0.05）. Repeated measurement ANOVA showed that the main effect between groups was significant，F = 58.953，P < 0.001，partial η2 = 0.143；The main effect of time was significant，F = 545.167，P < 0.001，partial η2 = 0.606；The interaction effect between time and group was significant，F = 10.117，P < 0.001，partial η2 = 0.028. At 6 and 12 months after treatment，the decrease of plasma D⁃dimer level in the observation group was higher than that in the control group（P < 0.05）；The level of plasma D⁃dimer decreased at baseline，6 months and 12 months in each group（P < 0.05）. There were significant differences in the incidence of portal vein thrombosis， ascites and gastrointestinal bleeding between the two groups（P < 0.05）. Conclusion Compared with entecavir alone，Ganshuang granule combined with entecavir could significantly reduce the level of plasma D⁃dimer in patients with hepatitis B cirrhosis，and the effect was more obvious with the extension of time，which could effectively prevent the formation of portal vein thrombosis.