目的 探討采用葉下珠膠囊聯(lián)合多烯磷脂酰膽堿治療慢性乙型肝炎的臨床效果。方法 選取重慶三峽中心醫(yī)院2015年4月—2017年4月收治的慢性乙型肝炎患者129例，隨機(jī)分成對照組（64例）和治療組（65例）。對照組靜脈滴注多烯磷脂酰膽堿注射液，15 mL加入5%葡萄糖注射液250 mL，1次/d；治療組患者在對照組基礎(chǔ)上口服葉下珠膠囊，2粒/次，3次/d。兩組患者均連續(xù)治療4周。觀察兩組患者臨床療效，比較治療前后兩組患者肝功能指標(biāo)、肝纖維化指標(biāo)和乙肝病毒標(biāo)志物轉(zhuǎn)陰率。結(jié)果 治療后，對照組臨床總有效率為76.56%，顯著低于治療組的92.31%，兩組比較差異具有統(tǒng)計學(xué)意義（P < 0.05）。治療后，兩組患者的肝功能指標(biāo)丙氨酸氨基轉(zhuǎn)移酶（ALT）、門冬氨酸氨基轉(zhuǎn)移酶（AST）和總膽紅素（TBIL）均顯著降低（P < 0.05），且治療組患者肝功能指標(biāo)水平明顯低于對照組（P < 0.05）。治療后，兩組患者的透明質(zhì)酸（HA）、IV膠原蛋白（IV-C）和Ⅲ型前膠原肽（PCⅢ）均顯著降低（P < 0.05），且治療組患者肝纖維化指標(biāo)低于對照組（P < 0.05）。治療后，治療組患者HBV-DNA和乙肝e抗原（HBeAg）轉(zhuǎn)陰率均顯著高于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P < 0.05）。結(jié)論 葉下珠膠囊聯(lián)合多烯磷脂酰膽堿治療慢性乙型肝炎療效顯著，安全性較高，具有一定的臨床推廣應(yīng)用價值。

Objective To explore the clinical effect of Yexiazhu Capsules combined with polyenoic phosphatidylcholine in treatment of chronic hepatitis B. Methods Patients (129 cases) with chronic hepatitis B in Chongqing Three Gorges Central Hospital from April 2015 to April 2017 were randomly divided into control (64 cases) and treatment (65 cases) groups. Patients in the control group were iv administered with Polyene Phosphatidylcholine Injection, 15 mL added into 5% glucose solution 250 mL, once daily. Patients in the treatment group were po administered with Yexiazhu Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the liver function indexes, liver fibrosis indexes, HBV marker negative rate in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 76.56%, which was significantly lower than 92.31% in the treatment group, and there were differences between two groups (P < 0.05). After treatment, the ALT, AST and TBIL levels in two groups were significantly decreased (P < 0.05), and the liver function indexes levels in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the HA, IV-C and PCⅢ levels in two groups were significantly decreased (P < 0.05), and the liver fibrosis indexes levels in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the negative rate of HBV-DNA and HBeAg in the treatment group was significantly higher than that in the control group, with significant difference between two groups (P < 0.05).Conclusion Yexiazhu Capsules combined with polyenoic phosphatidylcholine has significant effect in treatment of chronic hepatitis B with high safety, which has a certain clinical application value.