目的 探討利肝隆顆粒聯(lián)合富馬酸替諾福韋二吡呋酯片治療慢性乙型肝炎的安全性和有效性。方法 選取2019年12月—2020年9月在鄭州大學(xué)第一附屬醫(yī)院隨訪治療的174例慢性乙型肝炎患者，按照入組順序分成對(duì)照組（87例）和治療組（87例）。對(duì)照組口服富馬酸替諾福韋二吡呋酯片，0.3 g/次，1次/d；治療組患者在對(duì)照組基礎(chǔ)上口服利肝隆顆粒，10 g/次，3次/d。兩組患者均連續(xù)治療3個(gè)月。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)丙氨酸氨基轉(zhuǎn)移酶（ALT）、谷氨酸轉(zhuǎn)移酶（AST）、總膽紅素（TBIL）和總蛋白（TP），CLDQ評(píng)分、癥狀積分`、HBeAg轉(zhuǎn)陰率、HBeAb轉(zhuǎn)陽率和HBV DNA定量值。結(jié)果 治療組總有效率為89.66%，明顯高于對(duì)照組的73.56%（P<0.05）。治療后，兩組患者ALT、AST、TBIL值均顯著下降，而TP值顯著升高（P<0.05），且治療組明顯優(yōu)于對(duì)照組（P<0.05）。治療后，兩組患者CLDQ評(píng)分明顯升高，而癥狀積分明顯降低（P<0.05），且治療組比對(duì)照組改善更顯著（P<0.05）。治療后，對(duì)照組HBeAg轉(zhuǎn)陰率、HBeAb轉(zhuǎn)陽率均明顯低于治療組（P<0.05）。治療后，兩組HBV DNA定量值較治療前明顯降低（P<0.05），且治療組下降更明顯（P<0.05）。結(jié)論 利肝隆顆粒聯(lián)合富馬酸替諾福韋二吡呋酯片能顯著提升慢性乙型肝炎的臨床效果，改善患者的臨床癥狀和生活質(zhì)量。

Objective To investigate the safety and effectiveness of Liganlong Granules combined with tenofovir and dipyridyl in treatment of chronic hepatitis B. Methods Patients (174 cases) with chronic hepatitis B in the First Affiliated Hospital of Zhengzhou University from December 2019 to September 2020 were divided into control (87 cases) and treatment (87 cases) groups by the order of inclusion. Patients in the control group were po administered with Tenofovir disoproxil fumarate Tablets, 0.3 g/time, once daily. Patients in the treatment group were po administered with Liganlong Granules on the basis of the control group, 10 g/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacy was evaluated, and the liver function indexes of ALT, AST, TBIL and TP, CLDQ scores, symptom scores, negative conversion rate of HBeAg, positive conversion rate of HBeAb and quantitative value of HBV DNA in two groups before and after treatment were compared. Results The total clinical effective rate of the treatment group was 89.66%, which was significantly higher than 73.56% of the control group (P < 0.05). After treatment, the values of ALT, AST and TBIL in two groups were significantly decreased, while the TP values were significantly increased (P < 0.05), and which in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the CLDQ score in two groups were significantly increased, while the symptom score were significantly decreased (P < 0.05), and the improvement in the treatment group was more significant than that in the control group (P < 0.05). After treatment, the negative conversion rate of HBeAg and the positive rate of HBeAb in the control group were significantly lower than those in the treatment group. After treatment, the quantitative value of HBV DNA in two groups was significantly lower than that before treatment (P < 0.05), especially in the treatment group (P < 0.05). Conclusion Liganlong Granules combined with tenofovir and dipyridyl in treatment of chronic hepatitis B can significantly improve the clinical effect of chronic hepatitis B and improve the clinical symptoms and quality of life of patients with chronic hepatitis B.

R975

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（SBGJ2018023）