目的 探討甘草酸二銨腸溶膠囊聯(lián)合恩替卡韋分散片治療慢性乙型肝炎的臨床療效。方法 選擇2019年2月—2020年5月在河南大學(xué)淮河醫(yī)院就診治療的82例慢性乙型肝炎患者，按照隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各41例。對(duì)照組口服恩替卡韋分散片，0.5 mg/次，1次/d。治療組患者在對(duì)照組治療的基礎(chǔ)上口服甘草酸二銨腸溶膠囊，150 mg/次，3次/d。兩組患者連續(xù)治療6個(gè)月。觀察兩組患者臨床療效，比較兩組的肝功能指標(biāo)、肝纖維化指標(biāo)和血清因子指標(biāo)。結(jié)果 治療后，治療組的總有效率95.12%，顯著高于對(duì)照組的85.37%，組間差異有顯著性（P<0.05）。治療后，兩組患者丙氨酸氨基轉(zhuǎn)移酶（ALT）、天冬氨酸氨基轉(zhuǎn)移酶（AST）、總膽紅素（TBIL）水平與同組治療前數(shù)據(jù)相比均顯著降低，差異具有顯著性（P<0.05）；且治療組患者ALT、AST、TBIL水平均明顯低于對(duì)照組，組間比較有差異（P<0.05）。治療后，兩組患者透明質(zhì)酸（HA）、黏連蛋白（LN）、Ⅲ型前膠原（PCⅢ）水平與同組治療前數(shù)據(jù)相比較均顯著降低（P<0.05）；且治療組患者HA、LN、PCⅢ水平均明顯低于對(duì)照組，組間比較有差異（P<0.05）。治療后，兩組患者血清丙二醛（MDA）、白細(xì)胞介素-6（IL-6）、超敏C反應(yīng)蛋白（hs-CRP）水平與同組治療前數(shù)據(jù)相比較均明顯降低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），且治療組患者血清MDA、IL-6、hs-CRP水平均明顯低于對(duì)照組，組間比較有差異（P<0.05）。結(jié)論 甘草酸二銨腸溶膠囊聯(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，可改善肝功能，抑制肝纖維化，降低患者的血清因子水平，值得臨床上借鑒。

Objective To study the effects of Diammonium Glycyrrhizinate Enteric-coated Capsules combined with Entecavir Dispersible Tablets in treatment of chronic hepatitis B. Methods Patients (82 cases) with chronic hepatitis B in Huaihe Hospital of Henan University from February 2019 to May 2020 were divided into control and treatment groups according to the random number table method, and each group had 41 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 Diammonium Glycyrrhizinate Enteric-coated Capsules on the basis of the control group, 150 mg/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and liver function indexes, liver fibrosis indexes, and serum factor indexes in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.12%, which was significantly higher than 85.37% of the control group (P < 0.05). After treatment, the levels of ALT, AST, and TBIL in two groups were significantly lower than those before treatment (P < 0.05), and the levels of ALT, AST, and TBIL in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of HA, LN, and PCⅢ in two groups were significantly lower than those before treatment (P < 0.05), and the levels of HA, LN, and PCⅢ in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of MDA, IL-6, and hs-CRP in two groups were significantly lower than those before treatment in the same group (P < 0.05), and the serum levels of MDA, IL-6, and hs-CRP in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Diammonium Glycyrrhizinate Enteric-coated Capsules combined with Entecavir Dispersible Tablets has clinical curative effect in treatment of chronic hepatitis B, can improve liver function, inhibit liver fibrosis and reduce the serum factor level of patients, which is worthy of clinical reference.

R975

國(guó)家自然科學(xué)基金資助項(xiàng)目（81700187）