目的 探討肝泰舒膠囊聯(lián)合恩替卡韋分散片治療慢性乙型肝炎的臨床療效。方法 回顧性分析2018年6月—2019年6月在鄭州大學(xué)第一附屬醫(yī)院治療的104例慢性乙型肝炎患者的臨床資料，采用雙色球隨機分組法分成對照組和治療組，每組各52例。對照組口服恩替卡韋分散片，0.5 mg/次，1次/d；治療組在對照組基礎(chǔ)上口服肝泰舒膠囊，1.6 g/次，3次/d；兩組患者均治療5個月。觀察兩組患者臨床療效，比較治療前后兩組患者HBV-DNA和HBeAg轉(zhuǎn)陰率，天冬氨酸氨基轉(zhuǎn)移酶（AST）、血小板（PLT）、總膽紅素（TBIL）和丙氨酸氨基轉(zhuǎn)移酶（ALT）水平，血清組織蛋白酶S（CatS）、甲殼質(zhì)酶蛋白40（YKL-40）、巨噬細胞移動抑制因子（MIF）、基質(zhì)金屬蛋白酶抑制因子2（TIMP2）和轉(zhuǎn)化生長因子β1（TGFβ1）水平及肝組織硬度（LSM）、纖維化-4（FIB-4）、血小板比率指數(shù)（APRI）變化情況。結(jié)果 治療后，對照組總有效率為82.69%，顯著低于治療組98.08%（P<0.05）。治療后，治療組HBV-DNA轉(zhuǎn)陰率和HBeAg血清轉(zhuǎn)換率上均高于對照組（P<0.05）。治療后，兩組AST、ALT、PLT、TBIL均顯著降低（P<0.05），且治療組降低最明顯（P<0.05）。治療后，兩組血清CatS、YKL-40、MIF、TIMP2、TGF-β1水平均顯著下降（P<0.05），且治療組更明顯（P<0.05）。治療后，兩組LSM、FIB-4、APRI均明顯下降（P<0.05），且治療組更顯著（P<0.05）。結(jié)論 肝泰舒膠囊聯(lián)合恩替卡韋分散片治療慢性乙型肝炎可有效改善患者肝功能，抑制肝纖維化進程，促進HBV-DNA、HBeAg轉(zhuǎn)陰，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical efficacy of Gantaishu Capsules combined with entecavir in treatment of chronic hepatitis B.Methods The clinical data of 104 patients with chronic hepatitis B in the First Affiliated Hospital of Zhengzhou University from From June 2018 to June 2019 were analyzed retrospectively, and randomly divided into control and treatment groups by the double chromosphere, and each group had 52 cases. Patients in the control group were po administered with Entecavir Dispersible Tablets, 0.5 mg/time, once daily. Patients in the treatment group were po administered with Gantaishu Capsules on the basis of the control group, 1.6 g/time, three times daily. Patients in two groups were treated for 5 months. After treatment, the clinical efficacy was evaluated, and the negative rate of HBV-DNA and HBeAg, the levels of AST, ALT, PLT, and TBIL, the levels of serum CatS, YKL-40, MIF, TIMP2, and TGF-β1, and the change of LSM, FIB-4 and APRI in two groups before and after treatment were compared.Results After treatment, total effective rate of the control group was 82.69%, which was significantly lower than 98.08% of the treatment group (P<0.05). After treatment, the negative conversion rate of HBV-DNA and the seroconversion rate of HBeAg in the treatment group were higher than those in the control group (P<0.05). After treatment, AST, ALT, PLT and TBIL in two groups were significantly decreased (P<0.05), especially in the treatment group (P<0.05). After treatment, the serum levels of CatS, YKL-40, MIF, TIMP2, and TGF- β 1 were significantly decreased in two groups (P<0.05), especially in the treatment group (P<0.05). After treatment, LSM, FIB-4, and APRI were significantly decreased in two groups (P<0.05), especially in the treatment group (P<0.05).Conclusion Gantaishu Capsules combined with Entecavir Dispersible Tablets in treatment of chronic hepatitis B can effectively improve liver function, inhibit the process of liver fibrosis and promote the negative conversion of HBV-DNA and HBeAg, which has a certain clinical application value.

R975

國家自然科學(xué)基金青年科學(xué)基金資助項目（81902470）