目的研究肝苏颗粒联合替比夫定片治疗慢性乙型肝炎的临床疗效。方法选取2014年1月—2017年2月四川大学华西医院收治的慢性乙型肝炎患者120例为研究对象,随机将所有患者分为对照组和治疗组,每组各60例。对照组口服替比夫定片,1片/次,1次/d;治疗组在对照组治疗的基础上口服肝苏颗粒,1袋/次,3次/d。两组患者均持续治疗48周。观察两组的临床疗效,比较两组的血清乙肝标志物和肝功能指标。结果治疗后,对照组和治疗组的总有效率分别为81.67%、95.00%,两组比较差异有统计学意义（P〈0.05）。治疗后,对照组和治疗组乙肝表面抗原（HBs Ag）转阴率分别为25.00%、61.67%,乙肝病毒的脱氧核糖核酸（HBV-DNA）转阴率分别为31.67%、55.00%,两组比较差异均具有统计学意义（P〈0.05）。治疗后,两组血清天门冬氨酸氨基转氨酶（AST）、丙氨酸氨基转移酶（ALT）、谷氨酰转肽酶（GGT）和总胆红素（TBIL）水平均显著下降,同组治疗前后比较差异有统计学意义（P〈0.05）;且治疗组肝功能指标明显低于对照组,两组比较差异具有统计学意义（P〈0.05）。结论肝苏颗粒联合替比夫定片治疗慢性乙型肝炎具有较好的临床疗效,能提高HBs Ag转阴率和HBV-DNA转阴率,改善患者肝功能,安全性较高,具有一定临床推广应用价值。
Objective To study the clinical effect of Gansu Granules combined with Telbivudine Tablets in treatment of chronic hepatitis B. Methods Patients（120 cases） with chronic hepatitis B in West China Hospital of Sichuan University from January 2014 to February 2017 were randomly divided into control and treatment groups, and each group had 60 cases. Patients in the control group were po administered with Telbivudine Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Gansu Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 48 weeks. After treatment, the clinical efficacies were evaluated, and serum hepatitis B markers and liver function indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.67% and 95.00%, respectively, and there was difference between two groups（P〈0.05）. After treatment, the negative rates of HBs Ag in the control and treatment groups were 25.00% and 61.67%, respectively, and the negative rates of HBV-DNA in the control and treatment groups were 31.67% and 55.00%, respectively, and there was difference between two groups（P〈0.05）. After treatment, the levels of AST, ALT, GGT, and TBIL in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the liver function indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Gansu Granules combined with Telbivudine Tablets has clinical curative effect in treatment of chronic hepatitis B, can increase the negative rates of HBs Ag and HBV-DNA, improve live function, which has a certain clinical application value.