目的 觀察九味肝泰膠囊聯(lián)合恩替卡韋治療兒童慢性乙型肝炎的臨床療效。方法 選取2013年7月-2015年3月十堰市太和醫(yī)院收治的慢性乙型肝炎患兒189例，隨機分為九味肝泰組、恩替卡韋組和聯(lián)合治療組，每組各63例。九味肝泰組口服九味肝泰膠囊，1粒/次，3次/d。恩替卡韋組口服恩替卡韋分散片，0.5片/次，1次/d。聯(lián)合治療組口服九味肝泰膠囊和恩替卡韋分散片，用法用量同上。3組患者均治療6個月。觀察兩組的臨床療效，比較兩組肝功能、白細胞介素（IL-10）、透明質(zhì)酸（HA）、轉(zhuǎn)化生長因子-β₁（TGF-β₁）、乙型肝炎病毒脫氧核糖核酸（HBV-DNA）、谷胱甘肽（GSH）、丙二醛（MDA）和超氧化物歧化酶（SOD）的情況。結(jié)果 治療后，九味肝泰組、恩替卡韋組和聯(lián)合治療組愈顯率分別為73.01%、82.53%、95.23%，總有效率分別為88.88%、93.65%、98.41%，聯(lián)合治療組組愈顯率和總有效率明顯優(yōu)于九味肝泰組和恩替卡韋組，3組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，3組總膽紅素（TBIL）、谷氨酸轉(zhuǎn)移酶（GGT）、丙氨酸轉(zhuǎn)氨酶（ALT）、總膽汁酸（TBA）和天氨酸轉(zhuǎn)氨酶（AST）水平均顯著降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且聯(lián)合治療組這些觀察指標的下降程度明顯優(yōu)于恩替卡韋組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，3組IL-10、HA和TGF-βl水平均顯著下降，而恩替卡韋組和聯(lián)合治療組HBV-DNA水平均顯著下降，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且聯(lián)合治療組這些觀察指標的下降程度明顯優(yōu)于九味肝泰組和恩替卡韋組，3組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，3組GSH和SOD水平均明顯升高，MDA水平均明顯降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且聯(lián)合治療組這些觀察指標的改善程度明顯優(yōu)于恩替卡韋組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 九味肝泰膠囊聯(lián)合恩替卡韋治療兒童慢性乙型肝炎具有較好的臨床療效，可顯著改善肝功能，調(diào)節(jié)炎性反應(yīng)，安全性較好，具有一定的臨床推廣應(yīng)用價值。

Objective To observe the clinical effect of Jiuwei Gantai Capsules combined with entecavir in treatment of children with chronic hepatitis B. Methods Children (189 cases) with chronic hepatitis B in Taihe Hospital from July 2013 to March 2015 were randomly divided into Jiuwei Gantai, entecavir and combined treatment groups, and each group had 63 cases. Children in the Jiuwei Gantai group were po administered with Jiuwei Gantai Capsules, 1 grain/time, three times daily. Children in the entecavir group were po administered with Entecavir Dispersible Tablets, 0.5 tablet/time, once daily. Children in the combined treatment group were po administered with Jiuwei Gantai Capsules and Entecavir Dispersible Tablets, usage and dosage as above. Children among three groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and liver function, IL-10, HA, TGF-β₁, HBV-DNA, GSH, MDA, and SOD in two groups were compared. Results After treatment, the healing rate in the Jiuwei Gantai and entecavir combined treatment groups were 73.01%, 82.53%, and 95.23%, respectively, the clinical efficacies in the Jiuwei Gantai and entecavir groups were 88.88%, 93.65% and 98.41%, respectively, and the healing rate and clinical efficacies in the combined treatment group were significantly better than those in Jiuwei Gantai and entecavir groups (P<0.05). After treatment, the levels of TBIL, GGT, ALT, TBA, and AST in three groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the combined treatment group were significantly lower than those in the entecavir group, with significant difference between two groups (P<0.05). After treatment, the levels of IL-10, HA, and TGF-βl in three groups were significantly decreased, but the levels of HBV-DNA in the entecavir and combined treatment groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the combined treatment group were significantly lower than those in the Jiuwei Gantai and entecavir groups, with significant difference among three groups (P<0.05). After treatment, the levels of GSH and SOD in three groups were significantly increased, but the levels of MDA in three groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the combined treatment group were significantly better than those in the Entecavir group, with significant difference between two groups (P<0.05). Conclusion Jiuwei Gantai Capsules combined with entecavir has clinical curative effect in treatment of children with chronic hepatitis B, can improve liver function, and regulate inflammatory response, with good safety, which has a certain clinical application value.