Abstract: Objective To evaluate the effectiveness of entecavir（ETV） monotherapy versus lamivudine （LAM） combined with adefovir dipivoxil（ADV） in patients with hepatitis B-associated decompensated cirrhosis after 48 weeks of treatment. Methods All randomized control trials（RCTs） of ETV monotherapy versus LAM combined with ADV for 48 week treatment of patients with hepatitis B-associated decompensated cirrhosis published before May 2015 were collected by searching Cochrane Library，MEDLINE，EMBASE，CENTRAL，Chinese National Knowledge Infrastructure（CNKI），Wan-Fang database and VIP database. Meta-analysis was carried out with RevMan 5.2 software. Results A total of 9 RCTs involving 311 cases in the combination therapy group and 305 in the monotherapy group were included. The Meta analysis showed that as compared with patients in ETV group，there were not greater improvement in hepatic functions in combined group at 48 weeks treatment，and the standard mean differences（SMDs） for elevation of albumin levels，reduction of bilirubin levels，reduction of prothrombin time，and，reduction of Child-Pugh-score were -0.10（95%CI-0.31~0.12，P=0.39），-0.00（95%CI -0.58~0.57，P=1.0），0.19（95%CI -0.01~0.40，P=0.07），-0.03（95%CI -0.24~0.18，P=0.76），respectively;The mortality， undetectable rate of serum HBV DNA，HBeAg seroconversion rate，and viral breakthrough rate in patients in combined groups at 48 weeks treatment（5.3%，68.8%，24.1%，5.0%） were not higher than those in ETV groups （4.5%，74.8%，23.4%，2.8%;P=0.83，P=0.19，P=0.96，P=0.39，respectively）.　Conclusion ETV and LAM combined with ADV had similar short-term effectiveness for patients with hepatitis B-associated decompensated cirrhosis at 48 weeks treatment，and their long-term efficacy needs further study.

Key words: Decompensated cirrhosis, Hepatitis B, Enticavir, Lamivudine, Adefovir dipivoxil, Meta-analysis