目的 探讨加味逍遥丸联合富马酸替诺福韦二吡呋酯片治疗肝郁脾虚型慢性乙肝的临床疗效。方法 选取2016年9月-2017年9月青岛市海慈医院收治的肝郁脾虚型慢性乙肝患者116例，按照随机数字表法将患者分为对照组和治疗组，每组各58例。对照组口服富马酸替诺福韦二吡呋酯片，300 mg/次，1次/d。治疗组在对照组治疗的基础上口服加味逍遥丸，6 g/次，2次/d。两组患者均连续治疗9个月。观察两组患者临床疗效，比较治疗前后两组肝功能指标、乙肝标志物转阴率和T淋巴细胞亚群水平。结果 治疗后，对照组和治疗组总有效率分别为79.31%、93.10%，两组比较差异具有统计学意义（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）、碱性磷酸酶（ALP）水平均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组肝功能指标水平显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，对照组和治疗组乙肝表面抗原（HBsAg）转阴率分别为17.24%、32.76%，e抗原（HbeAg）转阴率分别为34.48%、53.44%，乙肝病毒的脱氧核糖核酸（HBV-DNA）转阴率分别为75.86%、89.66%，两组比较差异具有统计学意义（P<0.05）。治疗后，治疗组CD3⁺、CD4⁺、CD4⁺/CD8⁺、CD56⁺水平均显著升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组T淋巴细胞亚群水平显著高于对照组，两组比较差异具有统计学意义（P<0.05）。结论 加味逍遥丸联合替富马酸替诺福韦二吡呋酯片治疗肝郁脾虚型慢性乙肝具有较好的临床疗效，能改善患者肝功能，提高乙肝标志物转阴率，调节免疫功能，具有一定临床推广应用价值。

Objective To explore the clinical efficacy of Jiawei Xiaoyao Pills combined with Tenofovir Disoproxil Fumarate Tablets in treatment of chronic hepatitis B with liver depression and spleen deficiency. Methods Patients (116 cases) with chronic hepatitis B with liver depression and spleen deficiency in Qingdao Haici Hospital from September 2016 to September 2017 were randomly divided into control and treatment groups, and each group had 58 cases. Patients in the control group were po administered with Tenofovir Disoproxil Fumarate Tablets, 300 mg/time, once daily. Patients in the treatment group were po administered with Jiawei Xiaoyao Pills on the basis of the control group, 6 g/time, twice daily. Patients in two groups were treated for 9 months. After treatment,the clinical efficacy was evaluated, and the liver function indexes, the negative rates of hepatitis B markers and the levels of T lymphocyte subsets in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 79.31% and 93.10%, respectively, and there was difference between two groups (P<0.05). After treatment, the levels of ALT, AST, TBIL, and ALP 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). After treatment, the negative rates of HBsAg in the control and treatment groups were 17.24% and 32.76%, respectively, the negative rates of HbeAg in the control and treatment groups were 34.48% and 53.44%, respectively, and the negative rates of HBV-DNA in the control and treatment groups were 75.86% and 89.66%, respectively, and there was difference between two groups (P<0.05). After treatment, CD3⁺, CD4⁺, CD4⁺/CD8⁺, and CD56⁺ levels in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And T lymphocyte subsets levels in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). Conclusion Jiawei Xiaoyao Pills combined with Tenofovir Disoproxil Fumarate Tablets has clinical curative effect in treatment of chronic hepatitis B with liver depression and spleen deficiency, can improve liver function, improve the negative rates of hepatitis B markers, and regulate immune function, which has a certain clinical application value.