Objective To observe the clinical efficacy of the TCM syndrome differentiation treatment combined with antiviral treatment in HBV related compensated liver cirrhosis patients. Explore the related causative factors of the happening of decompensated liver cirrhosis. Methods In accordance with the method of retrospective cohort study， a total of 453 patients of compensated liver cirrhosis are divided into integrated Chinese and Western medicine cohort（TCM therapy and antiviral therapy） and Western medicine cohort（single antiviral treatment）（226 cases vs 227 cases） according to whether or not to accept the treatment of TCM. Observe and explore the accumulation incidence rates and the related causative factors of the happening of decompensated liver cirrhosis. Results In the third and fifth year， the accumulation incidence rates of decompensated liver cirrhosis of the integrated Chinese and western medicine cohort and the western medicine cohort are 4. 42% and 18.5%， 5.31% and 21.59% respectively， the differences have statistical significance（P<0.05）. The TCM syndrome differentiation treatment combined with antiviral treatment can reduce the incidence rate of decompensated liver cirrhosis by more than 7.63%. The incidence rates of ascites and esophagogastric variceal bleeding（EGVB） of the two cohorts are 4.42% and 18.5%， 5.31% and 21.59% respectively， the differences have statistical significance（P<0.05）. The related influence factors of decompensated cirrhosis happening might be older than 50 years（OR=2.744， 95%CI=1.521-4.950）， and having history of allergies（OR=2.148， 95%CI=1.016-4.543）， family（OR=1.833， 95%CI=1.108-3.035）， baseline HBsAg values higher than 1000（OR=2.294， 95%CI=1.307-4.027） and imaging improvement（OR=0.077， 95%CI=0.011-0.557）， etc. Conclusion The TCM syndrome differentiation treatment combined with antiviral treatment has good clinical effect， can reduce the cumulative incidence of decompensated liver cirrhosis to a certain extent. Imaging improvement may be the protection factor of HBV related compensated liver cirrhosis patients. Older than 50 years， and has allergies， family history and baseline HBsAg values higher than 1000 may be the risk factors of the liver decompensation cirrhosis.