目的 探讨健肝灵胶囊联合替比夫定片治疗慢性乙型肝炎的临床疗效。方法 选取2016年1月-2017年1月在汕头潮南民生医院治疗的慢性乙型肝炎患者84例，根据用药的差别分为对照组（42例）和治疗组（42例）。对照组口服替比夫定片，600 mg/次，1次/d；治疗组在对照组基础上口服健肝灵胶囊，1.3 g/次，3次/d。两组患者均治疗48周。观察两组患者临床疗效，同时比较治疗前后两组患者肝纤维化指标、肝功能指标、血清学指标和氧化应激指标变化情况。结果 治疗后，对照组和治疗组临床有效率分别为80.95%和97.62%，两组比较差异具有统计学意义（P<0.05）。治疗24、48周后，两组血清透明质酸（HA）、三型前胶原N端肽（PC-Ⅲ）、四型胶原（Ⅳ-C）、层黏连蛋白（LN）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TBIL）、总胆汁酸（TBA）、降钙素原（PCT）、白细胞介素-17（IL-17）、基质金属蛋白酶-13（MMP-13）和丙二醛（MDA）水平均显著降低，γ-干扰素（FN-γ）、白细胞介素-2（IL-2）、超氧化物歧化酶（SOD）和谷胱甘肽过氧化物酶（GSH-PX）水平显著升高，同组比较差异具有统计学意义（P<0.05），且治疗后治疗组这些指标水平明显优于对照组，两组比较差异具有统计学意义（P<0.05）。结论 健肝灵胶囊联合替比夫定片治疗慢性乙型肝炎能够显著改善患者肝功能，提高机体免疫能力，降低机体炎症反应，改善机体氧化应激状态。

Objective To investigate the clinical efficacy of Jianganling Capsules combined with telbivudine in treatment of chronic hepatitis B. Methods Patients (84 cases) with chronic hepatitis B in Shantou Chaonan Minsheng Hospital from January 2016 to January 2017 were divided into control (42 cases) and treatment (42 cases) groups according to different treatment. Patients in the control group were po administered with Telbivudine Tablets, 600 mg/time, once daily. Patients in the treatment group were po administered with Jianganling Capsules on the basis of the control group, 1.3 g/time, three times daily. Patients in two groups were treated for 48 weeks. After treatment, the clinical efficacy was evaluated, and the liver fibrosis indexes, the liver function indexes, the serological indexes, the oxidative stress indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 80.95% and 97.62% respectively, and there were differences between two groups (P<0.05). After treatment for 24 and 48 weeks, the HA, LN, PC-Ⅲ, Ⅳ-C, ALT, AST, TBIL, TBA, PCT, IL-17, MMP-13, and MDA levels in two groups were significantly decreased, and IFN-γ, IL-2, SOD, and GSH-Px levels were significantly increased, and the difference was statistically significant in the same group (P<0.05), and these indexes in the treatment group after treatment were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Jianganling Capsules combined with telbivudine in treatment of chronic hepatitis B can significantly improve the liver function and immunity, reduce the inflammatory response and improve the oxidative stress state.

汕头市医疗科技计划项目[汕府科（2015）123号]