目的 探讨肝达康片联合阿德福韦酯胶囊治疗慢性乙型肝炎临床疗效。方法 选取2017年5月-2018年5月在重庆市大足区人民医院治疗的慢性乙型肝炎患者96例，根据入院号分为对照组（48例）和治疗组（48例）。对照组口服阿德福韦酯胶囊，10 mg/次，1次/d；治疗组在对照组基础上口服肝达康片，3 g/次，3次/d。入组者均治疗12周。观察两组患者临床疗效，同时比较治疗前后两组患者HBV-DNA和HBeAg转阴率、肝功能、肝纤维化、血清学指标及CLDQ和SF-36量表评分。结果 治疗后，对照组和治疗组临床有效率分别为81.25%和97.92%，两组比较差异具有统计学意义（P<0.05）。治疗后，治疗组患者HBV-DNA、HBeAg转阴率明显高于对照组（P<0.05）。治疗后，两组丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TBIL）、总胆汁酸（TBA）、透明质酸（HA）、层粘连蛋白（LN）、四型胶原（Ⅳ-C）、Ⅲ型前胶原N端肽（PC-Ⅲ）、白细胞介素-17（IL-17）、巨噬细胞移动抑制因子（MIF）、肿瘤坏死因子-α（TNF-α）、白细胞介素-22（IL-22）、转化生长因子-β1（TGF-β1）水平显著降低（P<0.05），且治疗组患者这些指标明显低于对照组（P<0.05）。治疗后，两组CLDQ量表评分、SF-36量表评分均显著升高（P<0.05），且治疗组患者CLDQ和SF-36量表评分明显高于对照组（P<0.05）。结论 肝达康片联合阿德福韦酯胶囊治疗慢性乙型肝炎可有效改善患者肝功能，降低机体炎症反应，促进HBV-DNA和HBeAg转阴，利于患者生活质量提高。

Objective To investigate the clinical efficacy of Gandakang Tablets combined with adefovir dipivoxil in treatment of chronic hepatitis B. Methods Patients (96 cases) with chronic hepatitis B in the Dazu District People's Hospital of Chongqing from May 2017 to May 2018 were divided into control (47 cases) and treatment (47 cases) groups based on visiting number. Patients in the control group were po administered with Adefovir Dipivoxil Capsules, 10 mg/time, once daily. Patients in the treatment group were po administered with Gandakang Tablets on the basis of the control group, 3 g/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the negative rate of HBV-DNA and HBeAg, liver function, liver fibrosis and serological indexes, CLDQ scale and SF-36 scale scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 81.25% and 97.92% respectively, and there were differences between two groups (P<0.05). After treatment, the negative rate of HBV-DNA and HBeAg in the treatment group was significantly higher than that in the control group (P<0.05). After treatment, the ALT, AST, TBIL, TBA, HA, LN, PCⅢ, Ⅳ-C, IL-17, MIF, TNF-α, IL-22 and TGF-β1 levels in two groups were significantly decreased (P<0.05), and these indexes levels in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the CLDQ scale and SF-36 scale scores in two groups were significantly increased (P<0.05), and these scores in the treatment group were significantly higher than those in the control group (P<0.05). Conclusion Gandakang Tablets combined with adefovir dipivoxil in treatment of chronic hepatitis B can effectively improve the liver function, reduce inflammation, promote the negative rate of HBV-DNA and HBeAg, and improve the quality of life.

R978.7