目的 探究硫普羅寧片聯(lián)合恩替卡韋分散片治療慢性乙型肝炎的臨床療效。方法 選取2014年3月-2016年11月于南充市中心醫(yī)院收治的HBeAg陽(yáng)性慢性乙型肝炎患者94例，按隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各47例。對(duì)照組患者口服恩替卡韋分散片，0.5 mg/次，1次/d，治療組在對(duì)照組治療的基礎(chǔ)上口服硫普羅寧片，0.1 g/次，3次/d。兩組均連續(xù)治療6個(gè)月。觀察兩組的臨床療效，比較兩組肝功能指標(biāo)、炎癥因子水平和血清病毒學(xué)指標(biāo)。結(jié)果 治療后，對(duì)照組總有效率78.72%，明顯低于治療組的93.62%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療3、6個(gè)月后，兩組血清丙氨酸氨基轉(zhuǎn)移酶（ALT）、天冬氨酸氨基轉(zhuǎn)移酶（AST）、總膽紅素（TBIL）水平均明顯下降，血清白蛋白水平明顯升高，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組與對(duì)照組同期比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療3、6個(gè)月后，兩組血清白介素（IL）-2、腫瘤壞死因子（TNF）-α水平均明顯下降，血清白介素（IL）-10水平明顯升高，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組與對(duì)照組同期比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。對(duì)照組HBV-DNA陰轉(zhuǎn)率為55.32%，HBeAg陰轉(zhuǎn)率為40.43%，HBeAg轉(zhuǎn)換率為34.04%；治療組HBV-DNA陰轉(zhuǎn)率59.57%，HBeAg陰轉(zhuǎn)率為38.30%，HBeAg轉(zhuǎn)換率為31.91%，兩組血清病毒學(xué)指標(biāo)比較差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 硫普羅寧片聯(lián)合恩替卡韋分散片治療慢性乙型肝炎具有較好的臨床療效，能有效改善肝功能，緩解炎癥因子紊亂，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the effect of Tiopronin Tablets combined with Entecavir Dispersible Tablets in treatment of chronic hepatitis B. Methods Patients (94 cases) with HBeAg-positive chronic hepatitis B in Nanchong Central Hospital from March 2014 to November 2016 were divided into control and treatment groups by random number table method, and each group had 47 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 Tiopronin Tablets on the basis of the control group, 0.1 g/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacy was evaluated, and the liver function indexes, inflammatory cytokines, and serum virology indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 78.72%, which was significantly lower than 93.62% in the treatment group, and there were differences between two groups (P<0.05). After treatment for 3 or 6 months, the levels of ALT, AST, and TBIL in two groups were significantly decreased, but the serum albumin levels in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the liver function indexes in the treatment group were significantly better than those in the control group in the same period, with significant difference between two groups (P<0.05). After treatment for 3 or 6 months, the levels of serum IL-2 and TNF-α in two groups were significantly decreased, but the levels of serum IL-10 in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the inflammatory cytokines in the treatment group were significantly better than those in the control group in the same period, with significant difference between two groups (P<0.05). The negative conversion rate of HBV-DNA, the negative conversion rate of HBeAg, and the conversion rate of HBeAg in the control group were 55.32%, 40.43%, and 34.04%, respectively, and those in the treatment group were 59.57%, 38.30%, and 31.91%, but there was no statistically significant difference between two groups. Conclusion Tiopronin Tablets combined with Entecavir Dispersible Tablets has good clinical effect in treatment of chronic hepatitis B, can significantly improve liver function and inflammatory factor disorder, which has a certain clinical application value.