目的 探討珠子肝泰聯(lián)合替比夫定治療慢性乙型肝炎的臨床療效。方法 選取2018年10月—2020年10月在平煤神馬醫(yī)療集團總醫(yī)院治療的116例慢性乙型肝炎患者，隨機分為對照組（58例）和治療組（58例）。對照組口服替比夫定片，600 mg/次，1次/d。治療組患者在對照組的基礎(chǔ)上飯后口服珠子肝泰膠囊，4粒/次，3次/d。兩組患者連續(xù)服用8周。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀緩解時間，肝功能指標(biāo)總膽紅素（TBIL）、天冬氨酸氨基轉(zhuǎn)移酶（AST）、丙氨酸氨基轉(zhuǎn)移酶（ALT）和白蛋白（ALB）水平，血清白細胞介素4（IL-4）、白細胞介素10（IL-10）、腫瘤壞死因子α（TNF-α）和轉(zhuǎn)化生長因子β1（TGF-β1）水平及不良反應(yīng)情況。結(jié)果 治療后，治療組患者臨床療效明顯優(yōu)于對照組（96.55%vs 82.76%，P<0.05）。治療后，治療組患者臨床癥狀緩解時間均早于對照組（P<0.05）。治療后，兩組患者肝功能指標(biāo)TBIL、AST、ALT水平均明顯降低，而ALB水平明顯升高（P<0.05），且治療組肝功能明顯好于對照組（P<0.05）。治療后，兩組患者血清IL-4、IL-10、TNF-α、TGF-β1水平均低于治療前（P<0.05），且治療組明顯低于對照組（P<0.05）。治療組患者藥物不良反應(yīng)發(fā)生率明顯低于對照組（P<0.05）。結(jié)論 珠子肝泰與替比夫定聯(lián)合治療效果顯著，能夠有效改善慢性乙型肝炎患者臨床癥狀，恢復(fù)肝功能，降低炎性因子水平，安全有效。

Objective To investigate the efficacy of Zhuzi Gantai Capsules combined with telbivudine in treatment of chronic hepatitis B. Methods Patients (116 cases) with chronic hepatitis B in General Hospital of Pingmei Shenma Medical Group from October 2018 to October 2020 were randomly divided into control (58 cases) and treatment (58 cases) groups. Patients in the control group were po administered with Telbivudine Tablets, 600 mg/time, once daily. Patients in the treatment group were po administered with Zhuzi Gantai Capsules, 4 grains/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, the improvement time of clinical symptoms, the liver function of TBIL, AST, ALT and ALB levels, the serum inflammatory factor of IL-4, IL-10, TNF-α and TGF-β1 levels, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical effect in the treatment group was significantly better than that in the control group (96.55% vs 82.76%, P < 0.05). After treatment, the improvement time of clinical symptoms in the treatment group was earlier than that in the control group (P < 0.05). After treatment, the levels of liver function indexes TBIL, AST and ALT in two groups were significantly decreased, while the level of ALB were significantly increased (P < 0.05), and the liver function in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the levels of serum IL-4, IL-10, TNF-α and TGF-β1 in two groups were significantly lower than those before treatment (P < 0.05), and those in the treatment group were significantly lower than those in the control group (P < 0.05). The incidence of adverse drug reactions in the treatment group was significantly lower than that in the control group (P < 0.05). Conclusion Zhuzi Gantai Capsules combined with telbivudine is effective in treatment of patients with chronic hepatitis B, which can effectively improve the clinical symptoms, restore liver function and reduce the level of inflammatory factors.

R978.7

天晴肝病研究基金資助[肝基字（2017）第18號]