目的 探討五靈膠囊聯(lián)合異甘草酸鎂治療慢性乙型肝炎的臨床療效。方法 選取2020年1月—2023年1月滄州市第三醫(yī)院收治的260例慢性乙型肝炎患者，按隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各130例。對(duì)照組靜脈滴注異甘草酸鎂注射液，0.1 g/次，以0.9%氯化鈉注射液（250 mL）稀釋，1次/d。治療組在對(duì)照組治療基礎(chǔ)上飯后30 min口服五靈膠囊，5粒/次，3次/d。兩組療程12周。觀察兩組臨床療效和癥狀好轉(zhuǎn)時(shí)間；比較兩組治療前后乙型肝炎病毒脫氧核糖核酸（HBV DNA）水平，肝功能指標(biāo)[天冬氨酸轉(zhuǎn)氨酶（AST）、丙氨酸轉(zhuǎn)氨酶（ALT）和總膽紅素（TBIL）]，疲勞量表-14(FS-14)、肝病生存質(zhì)量量表1.0(LDQOL 1.0)、癥狀自評(píng)量表（SCL-90）評(píng)分及血清白細(xì)胞介素-23(IL-23)、T淋巴細(xì)胞免疫球蛋白黏蛋白分子-3(TIM-3)、血管生成素-2(Ang-2)和基質(zhì)金屬蛋白酶-2(MMP-2)水平。結(jié)果 治療后，治療組總有效率是96.15%，顯著高于對(duì)照組的85.38%(P<0.05)。治療后，治療組肝區(qū)不適、食欲減退、乏力、惡心好轉(zhuǎn)時(shí)間短于對(duì)照組（P<0.05）。治療后，兩組血清HBV DNA和AST、ALT、TBIL水平都低于同組治療前（P<0.05）；治療后，治療組血清HBV DNA水平和肝功能指標(biāo)低于對(duì)照組（P<0.05）。治療后，兩組FS-14、SCL-90評(píng)分都顯著減少（P<0.05），而LDQOL1.0評(píng)分均顯著增加（P<0.05）；治療后，治療組FS-14、LDQOL 1.0、SCL-90評(píng)分改善優(yōu)于對(duì)照組（P<0.05）。治療后，兩組血清IL-23、TIM-3、Ang-2、MMP-2水平都低于同組治療前（P<0.05）；治療后，治療組血清IL-23、TIM-3、Ang-2、MMP-2水平低于對(duì)照組（P<0.05）。結(jié)論 五靈膠囊聯(lián)合異甘草酸鎂治療慢性乙型肝炎能有效加速癥狀好轉(zhuǎn)，抑制HBV感染和炎癥反應(yīng)程度，減輕肝損傷，利于患者身心狀態(tài)及生活質(zhì)量提升，值得臨床推廣應(yīng)用。

Objective To explore the clinical efficacy of Wuling Capsules combined with magnesium isoglycyrrhizinate in treatment of chronic hepatitis B. Methods A total of 260 patients with chronic hepatitis B admitted to Cangzhou Third Hospital from January 2020 to January 2023 were selected and divided into control group and treatment group according to random number table method, with 130 patients in each group. Patients in control group were iv administered with Magnesium Isoglycyrrhizinate Injection, 0.1 g/time, diluted with 0.9% sodium chloride injection（250 mL）, once daily. Patients in treatment group were po administered with Wuling Capsules on basis of control group, 5 capsules/time, 3 times daily. Both groups were treated for 12 weeks. The clinical efficacy and symptom improvement time of two groups was evaluated, The levels of hepatitis B virus deoxyribonucleic acid（HBV DNA）, liver function indexes（AST, ALT, and TBIL）, FS-14 score, LDQOL 1.0 score, SCL-90 score, and serum IL-23, TIM-3, Ang-2, MMP-2 before and after treatment were compared between two groups. Results After treatment, the total effective rate of the treatment group was 96.15%, which was significantly higher than that of the control group 85.38%（P＜0.05）. After treatment, the improvement time of hepatic discomfort, anorexia, fatigue and nausea in treatment group was shorter than that in control group（P＜0.05）. After treatment, the levels of serum HBV DNA, AST, ALT and TBIL, in two groups were lower than those before treatment（P＜0.05）. After treatment, the serum HBV DNA level and liver function indexes in treatment group were lower than those in control group（P＜0.05）. After treatment, the scores of FS-14 and SCL-90 in both groups were significantly decreased（P＜0.05）, but the scores of LDQOL 1.0 were significantly increased（P＜0.05）. After treatment, the scores of FS-14, LDQOL 1.0, and SCL-90 in treatment group were better than those in control group（P＜0.05）. After treatment, serum levels of IL-23, TIM-3, Ang-2, and MMP-2 in two groups were lower than those before treatment（P＜0.05）. After treatment, the levels of IL-23, TIM-3, Ang-2, and MMP-2 in treatment group were lower than those in control group（P＜0.05）. Conclusion Wuling Capsules combined with magnesium isoglycyrrhizinate in treatment of chronic hepatitis B can effectively accelerate the improvement of symptoms, inhibit the degree of HBV infection and inflammation, reduce liver damage, and improve the physical and mental state and quality of life of patients, which is worthy of clinical promotion and application.

R975

滄州市重點(diǎn)研發(fā)計(jì)劃指導(dǎo)項(xiàng)目(213106125)