目的 探讨肝胆舒康胶囊联合恩替卡韦治疗慢性乙型肝炎的临床效果与安全性。方法 选取2015年3月-2018年3月在达州市中心医院诊治的慢性乙型肝炎患者123例，随机分成对照组（61例）和治疗组（62例）。对照组患者口服恩替卡韦片，1片/次，1次/d；治疗组患者在对照组基础上口服肝胆舒康胶囊，4粒/次，3次/d。两组患者均治疗6个月。观察两组患者临床疗效，同时比较治疗前后两组患者GQOLI评分、CLDQ评分、HBV DNA转阴率、血清透明质酸（HA）、Ⅲ型胶原（PC-Ⅲ）和TNF-α水平及肝功能和不良反应情况。结果 治疗后，对照组和治疗组临床有效率分别为81.97%和95.16%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者GQOLI评分较治疗前显著降低（P<0.05），CLDQ评分较治疗前显著升高（P<0.05）；治疗后，治疗组患者GQOLI和CLDQ评分及HBV DNA转阴率均明显好于对照组（P<0.05）。治疗后，两组患者血清HA、PC-Ⅲ和TNF-α水平均较治疗前显著降低（P<0.05），且治疗组患者HA、PC-Ⅲ和TNF-α水平明显低于对照组（P<0.05）。治疗后，两组患者血清丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）较治疗前显著降低（P<0.05），总蛋白（TP）水平显著升高（P<0.05），且治疗组患者肝功能明显好于对照组（P<0.05）。治疗期间，对照组患者不良反应发生率为13.11%，明显高于治疗组患者的3.23%，两组比较差异具有统计学意义（P<0.05）。结论 肝胆舒康胶囊联合恩替卡韦治疗慢性乙型肝炎疗效显著，不但能减缓肝脏纤维化进程，而且还能够改善患者的生活质量。

Objective To investigate the clinical effect and safety of Gandan Shukang Capsules combined with entecavir in treatment of chronic hepatitis B. Methods Patients (123 cases) with chronic hepatitis B in Dazhou Central Hospital from March 2015 to March 2018 were randomly divided into control (61 cases) and treatment (62 cases) groups. Patients in the control group were po administered with Entecavir Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Gandan Shukang Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacy was evaluated, and the GQOLI scores, CLDQ scores, HBV DNA negative rate, serum levels of HA, PC-Ⅲ and TNF-α, liver function, adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 81.97% and 95.16% respectively, and there were differences between two groups (P<0.05). After treatment, the GQOLI scores in two groups were significantly decreased (P<0.05), but CLDQ scores were significantly increased (P<0.05). After treatment, the GQOLI scores, CLDQ scores, and HBV DNA negative rate in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum levels of HA, PC-Ⅲ, and TNF-α in two groups were significantly decreased (P<0.05), and these indexes in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the ALT and AST levels in two groups were significantly decreased (P<0.05), the TP levels were significantly increased (P<0.05), and these serum cytokines levels in the treatment group were significantly better than that in the control group (P<0.05). During the treatment, the adverse reactions rate in the control group was 13.11%, which was significantly higher than 3.23% in treatment the group, with significant difference between two groups (P<0.05). Conclusion Gandan Shukang Capsules combined with entecavir is effective in treatment of chronic hepatitis B, which can slow the process of liver fibrosis and improve the quality of life of patients.