目的 探討肝達(dá)康膠囊聯(lián)合恩替卡韋治療慢性乙型肝炎的臨床療效。方法 選取2017年6月—2019年1月于新鄉(xiāng)醫(yī)學(xué)院第一附屬醫(yī)院感染科就診的150例慢性乙型肝炎患者作為研究對象，所有患者隨機(jī)將分為對照組（n=75）和觀察組（n=75）。對照組口服馬來酸恩替卡韋片，1片/次，1次/d；觀察組在對照組治療的基礎(chǔ)上口服肝達(dá)康膠囊，8粒/次，3次/d。兩組均治療48周。觀察兩組患者的臨床療效，同時比較兩組的肝功能水平、乙肝病毒的脫氧核糖核酸（HBV DNA）和乙型肝炎E抗原（HBeAg）轉(zhuǎn)陰率、白細(xì)胞介素-17（IL-17）和白細(xì)胞介素-23（IL-23）水平。結(jié)果 治療后，觀察組總有效率為97.33%，顯著高于對照組的84.00%，差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者血清丙氨酸氨基轉(zhuǎn)移酶（ALT）、天冬氨酸氨基轉(zhuǎn)移酶（AST）和總膽紅素（TBIL）水平均顯著降低（P<0.05），觀察組治療后患者血清ALT、AST和TBIL水平顯著低于對照組（P<0.05）。治療24和48周后，觀察組HBV DNA轉(zhuǎn)陰率顯著高于同期對照組，差異均具有統(tǒng)計學(xué)意義（P<0.05）；治療48周后，觀察組HBeAg血清學(xué)轉(zhuǎn)換率顯著高于同期對照組，差異均具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者血清IL-17和IL-23水平均顯著降低（P<0.001），且觀察組患者治療后血清IL-17和IL-23水平顯著低于對照組（P<0.01）。結(jié)論 肝達(dá)康膠囊聯(lián)合恩替卡韋治療慢性乙型肝炎療效確切，且安全性較高，值得在臨床進(jìn)一步推廣使用。

Objective To explore the clinical effect of Gandakang Capsules combined with entecavir in treatment of chronic hepatitis B. Methods A total of 150 patients with chronic hepatitis B who visited the department of infectious diseases, the First Affiliated Hospital of Xinxiang Medical University from June 2017 to January 2019 were selected as the study subjects, and all the patients were randomly divided into the control group (n=75) and the observation group (n=75). Patients in the control group were po administered with Entecavir Maleate Tablets, 1 tablet/time, once daily. Patients in the observation group were po administered with Gandakang Capsules on the basis of control group, 8 grains/time, three times daily. Both groups were treated for 48 weeks. After treatment, the clinical efficacy in two groups was observed, and the liver function, HBV-DNA and HBeAg negative conversion rate, IL-17 and IL-23 levels were compared simultaneously. Results After treatment, the total effective rate of the observation group was 97.33%, which was significantly higher than 84.00% of the control group, with statistically significant difference (P<0.05). After treatment, the levels of serum ALT, AST and TBIL in two groups were significantly decreased (P<0.05), while the levels of serum ALT, AST and TBIL in the observation group were significantly lower than those in the control group (P<0.05). After 24 and 48 weeks of treatment, the HBV-DNA negative conversion rate in the observation group was significantly higher than that in the control group during the same period, and the difference was statistically significant (P<0.05). After 48 weeks of treatment, the HBeAg serological conversion rate in the observation group was significantly higher than that in the control group during the same period, with statistically significant differences (P<0.05). After treatment, the levels of serum IL-17 and IL-23 in two groups were significantly decreased (P<0.001), and the levels of serum IL-17 and IL-23 in the observation group were significantly lower than those in the control group (P<0.01). Conclusion Gandakang Capsules combined with entecavir is effective and safe in treatment of chronic hepatitis B, which is worthy of further promotion and use in clinic.

R975

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