目的 探讨珠子肝泰联合替比夫定治疗慢性乙型肝炎的临床疗效。方法 选取2018年10月—2020年10月在平煤神马医疗集团总医院治疗的116例慢性乙型肝炎患者，随机分为对照组（58例）和治疗组（58例）。对照组口服替比夫定片，600 mg/次，1次/d。治疗组患者在对照组的基础上饭后口服珠子肝泰胶囊，4粒/次，3次/d。两组患者连续服用8周。观察两组患者临床疗效，比较治疗前后两组患者临床症状缓解时间，肝功能指标总胆红素（TBIL）、天冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）和白蛋白（ALB）水平，血清白细胞介素4（IL-4）、白细胞介素10（IL-10）、肿瘤坏死因子α（TNF-α）和转化生长因子β1（TGF-β1）水平及不良反应情况。结果 治疗后，治疗组患者临床疗效明显优于对照组（96.55%vs 82.76%，P<0.05）。治疗后，治疗组患者临床症状缓解时间均早于对照组（P<0.05）。治疗后，两组患者肝功能指标TBIL、AST、ALT水平均明显降低，而ALB水平明显升高（P<0.05），且治疗组肝功能明显好于对照组（P<0.05）。治疗后，两组患者血清IL-4、IL-10、TNF-α、TGF-β1水平均低于治疗前（P<0.05），且治疗组明显低于对照组（P<0.05）。治疗组患者药物不良反应发生率明显低于对照组（P<0.05）。结论 珠子肝泰与替比夫定联合治疗效果显著，能够有效改善慢性乙型肝炎患者临床症状，恢复肝功能，降低炎性因子水平，安全有效。

Objective To investigate the efficacy of Zhuzi Gantai Capsules combined with telbivudine in treatment of chronic hepatitis B. Methods Patients (116 cases) with chronic hepatitis B in General Hospital of Pingmei Shenma Medical Group from October 2018 to October 2020 were randomly divided into control (58 cases) and treatment (58 cases) groups. 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 Zhuzi Gantai Capsules, 4 grains/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, the improvement time of clinical symptoms, the liver function of TBIL, AST, ALT and ALB levels, the serum inflammatory factor of IL-4, IL-10, TNF-α and TGF-β1 levels, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical effect in the treatment group was significantly better than that in the control group (96.55% vs 82.76%, P < 0.05). After treatment, the improvement time of clinical symptoms in the treatment group was earlier than that in the control group (P < 0.05). After treatment, the levels of liver function indexes TBIL, AST and ALT in two groups were significantly decreased, while the level of ALB were significantly increased (P < 0.05), and the liver function in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the levels of serum IL-4, IL-10, TNF-α and TGF-β1 in two groups were significantly lower than those before treatment (P < 0.05), and those in the treatment group were significantly lower than those in the control group (P < 0.05). The incidence of adverse drug reactions in the treatment group was significantly lower than that in the control group (P < 0.05). Conclusion Zhuzi Gantai Capsules combined with telbivudine is effective in treatment of patients with chronic hepatitis B, which can effectively improve the clinical symptoms, restore liver function and reduce the level of inflammatory factors.

R978.7

天晴肝病研究基金资助[肝基字（2017）第18号]