目的 探讨利肝隆颗粒联合富马酸替诺福韦二吡呋酯片治疗慢性乙型肝炎的安全性和有效性。方法 选取2019年12月—2020年9月在郑州大学第一附属医院随访治疗的174例慢性乙型肝炎患者，按照入组顺序分成对照组（87例）和治疗组（87例）。对照组口服富马酸替诺福韦二吡呋酯片，0.3 g/次，1次/d；治疗组患者在对照组基础上口服利肝隆颗粒，10 g/次，3次/d。两组患者均连续治疗3个月。观察两组患者临床疗效，比较治疗前后两组患者肝功能指标丙氨酸氨基转移酶（ALT）、谷氨酸转移酶（AST）、总胆红素（TBIL）和总蛋白（TP），CLDQ评分、症状积分`、HBeAg转阴率、HBeAb转阳率和HBV DNA定量值。结果 治疗组总有效率为89.66%，明显高于对照组的73.56%（P<0.05）。治疗后，两组患者ALT、AST、TBIL值均显著下降，而TP值显著升高（P<0.05），且治疗组明显优于对照组（P<0.05）。治疗后，两组患者CLDQ评分明显升高，而症状积分明显降低（P<0.05），且治疗组比对照组改善更显著（P<0.05）。治疗后，对照组HBeAg转阴率、HBeAb转阳率均明显低于治疗组（P<0.05）。治疗后，两组HBV DNA定量值较治疗前明显降低（P<0.05），且治疗组下降更明显（P<0.05）。结论 利肝隆颗粒联合富马酸替诺福韦二吡呋酯片能显著提升慢性乙型肝炎的临床效果，改善患者的临床症状和生活质量。

Objective To investigate the safety and effectiveness of Liganlong Granules combined with tenofovir and dipyridyl in treatment of chronic hepatitis B. Methods Patients (174 cases) with chronic hepatitis B in the First Affiliated Hospital of Zhengzhou University from December 2019 to September 2020 were divided into control (87 cases) and treatment (87 cases) groups by the order of inclusion. Patients in the control group were po administered with Tenofovir disoproxil fumarate Tablets, 0.3 g/time, once daily. Patients in the treatment group were po administered with Liganlong Granules on the basis of the control group, 10 g/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacy was evaluated, and the liver function indexes of ALT, AST, TBIL and TP, CLDQ scores, symptom scores, negative conversion rate of HBeAg, positive conversion rate of HBeAb and quantitative value of HBV DNA in two groups before and after treatment were compared. Results The total clinical effective rate of the treatment group was 89.66%, which was significantly higher than 73.56% of the control group (P < 0.05). After treatment, the values of ALT, AST and TBIL in two groups were significantly decreased, while the TP values were significantly increased (P < 0.05), and which in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the CLDQ score in two groups were significantly increased, while the symptom score were significantly decreased (P < 0.05), and the improvement in the treatment group was more significant than that in the control group (P < 0.05). After treatment, the negative conversion rate of HBeAg and the positive rate of HBeAb in the control group were significantly lower than those in the treatment group. After treatment, the quantitative value of HBV DNA in two groups was significantly lower than that before treatment (P < 0.05), especially in the treatment group (P < 0.05). Conclusion Liganlong Granules combined with tenofovir and dipyridyl in treatment of chronic hepatitis B can significantly improve the clinical effect of chronic hepatitis B and improve the clinical symptoms and quality of life of patients with chronic hepatitis B.

R975

河南省医学科技攻关计划项目（SBGJ2018023）