目的 探讨参芪肝康胶囊联合拉米夫定治疗慢性乙型肝炎的临床疗效。方法 选取2016年4月—2017年4月在中山医院青浦分院治疗的慢性乙型肝炎患者82例，根据用药的差别分为对照组（41例）和治疗组（41例）。对照组口服拉米夫定片，0.1 g/次，1次/d；治疗组在对照组的基础上口服参芪肝康胶囊，2 g/次，3次/d。两组患者均经48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转阴率及肝功能指标、肝纤维化指标和血清学指标。结果 治疗后，对照组和治疗组临床总有效率分别为80.49%和97.56%，两组比较差异具有统计学意义（P<0.05）。治疗24、48周后，治疗组HBV-DNA和HBeAg转阴率均明显高于同期对照组（P<0.05）。治疗24、48周后，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）、三型前胶原N端肽（PC-Ⅲ）、四型胶原（Ⅳ-C）、层黏连蛋白（LN）、白细胞介素-17（IL-17）、白细胞介素-18（IL-18）、基质金属蛋白酶-13（MMP-13）、肿瘤坏死因子-α（TNF-α）水平均明显降低（P<0.05），且治疗组上述指标水平明显低于同期对照组（P<0.05）。结论 参芪肝康胶囊联合拉米夫定治疗慢性乙型肝炎不仅有利于肝功能改善，还可有效抑制肝纤维化、降低机体炎性因子水平。

Objective To investigate the clinical efficacy of Shenqi Gankang Capsules combined with lamivudine in treatment of chronic hepatitis B. Methods Patients (82 cases) with chronic hepatitis B in Qingpu Branch of Zhongshan Hospital from April 2016 to April 2017 were divided into control (41 cases) and treatment (41 cases) groups according to different treatments. Patients in the control group were po administered with Lamivudine Tablets, 0.1 g/time, once daily. Patients in the treatment group were po administered with Shenqi Gankang Capsules on the basis of the control group, 2 g/time, three times daily. Patients in two groups were treated for 48 weeks. After treatment, the clinical efficacy was evaluated, and the negative rate of HBV-DNA and HBeAg, the liver function indexes, the liver fibrosis indexes and the serological indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 80.49% and 97.56% respectively, and there were differences between two groups (P<0.05). After treatment for 24 and 48 weeks, the negative rate of HBV-DNA and HBeAg in the treatment group was significantly higher than that in the control group of the same period (P<0.05). After treatment for 24 and 48 weeks, the ALT, AST, TBIL, TBA, HA, LN, PC-Ⅲ Ⅳ-C, TNF-α, IL-17, IL-18, and MMP-13 levels 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 of the same period (P<0.05). Conclusion Shenqi Gankang Capsules combined with lamivudine in treatment of chronic hepatitis B can significantly improve the liver function, reduce the inflammatory response and inhibit liver fibrosis.