目的 探讨片仔癀胶囊联合富马酸替诺福韦二吡呋酯片治疗慢性乙型病毒性肝炎的临床疗效。方法 选择2017年4月—2020年4月在安阳市第五人民医院治疗102例慢性乙型病毒性肝炎患者，根据住院序号分成对照组（51例）和治疗组（51例）。对照组患者口服富马酸替诺福韦二吡呋酯片，300 mg/次，1次/d；治疗组患者在对照组基础上口服片仔癀胶囊，0.6 g/次，3次/d。两组患者均经4个月治疗。观察两组患者临床疗效，比较治疗前后两组患者HBV-DNA和HBeAg转阴率，肝功能指标丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TBIL）和总胆汁酸（TBA），血清趋化因子配体-13（CXCL-13）、白细胞介素-17（IL-17）、IL-37、肺泡巨噬细胞移动抑制因子（MIF）和巨噬细胞炎症因子-1β（MIP-1β）水平及PSQI、CLDQ和MADRS评分。结果 治疗后，对照组总有效率为82.35%，显著低于治疗组的98.04%（P<0.05）。治疗后，治疗组HBV-DNA和HBeAg转阴率均高于对照组（P<0.05）。治疗后，两组患者肝功能指标ALT、AST、TBIL、TBA显著降低（P<0.05），且治疗组降低更明显（P<0.05）。治疗后，两组患者血清CXCL-13、IL-17、IL-37、MIF、MIP-1β水平均显著改善（P<0.05），以治疗组改善最明显（P<0.05）。治疗后，两组PSQI评分、CLDQ评分、MADRS评分均显著改善（P<0.05），以治疗组改善最明显（P<0.05）。结论 片仔癀胶囊联合富马酸替诺福韦二吡呋酯片治疗慢性乙型病毒性肝炎可促进患者肝功能恢复，促使HBV-DNA、HBeAg转阴，有利于提高患者睡眠质量，改善患者负面情绪。

Objective To investigate the clinical efficacy of Pianzaihuang Capsules combined with tenofovir in treatment of chronic hepatitis B. Methods Patients (102 cases) with chronic hepatitis B in the Fifth People's Hospital of Anyang from April 2017 to April 2020 were divided into control (51 cases) and treatment (51 cases) groups based on hospitalization serial numbers. 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 Pianzaihuang Capsules on the basis of the control group, 0.6 g/time, three times daily. Patients in two groups were treated for 4 months. After treatment, the clinical efficacy was evaluated, and the negative rate of HBV-DNA and HBeAg, liver function index of ALT, AST, TBIL and TBA, the serum levels of CXCL-13, IL-17, MIF, MIP-1β, and IL-37, and the scores of PSQI, CLDQ and MADRS in two groups before and after treatment were compared. Results After treatment, the effective rate of the control group was 82.35%, which was significantly lower than that of the treatment group (98.04%) (P<0.05). After treatment, the negative conversion rates of HBV-DNA and HBeAg in the treatment group were higher than those in the control group (P<0.05). After treatment, the liver function indexes ALT, AST, TBIL and TBA in the two groups were significantly decreased (P<0.05), and especially in the treatment group (P<0.05). After treatment, the serum levels of CXCL-13, IL-17, IL-37, MIF and MIP-1 β were significantly improved in two groups (P<0.05), and especially in the treatment group (P<0.05). After treatment, PSQI score, CLDQ score, and MADRS score were significantly improved in two groups (P<0.05), and especially in the treatment group (P<0.05). Conclusion Pianzaihuang Capsules combined with tenofovir in treatment of chronic hepatitis B can promote the recovery of liver function, promote the negative conversion of HBV-DNA and HBeAg, which is conducive to improve sleep quality and patients' negative emotions.

R978

北京医卫健康公益基金-医学科学研究基金资助项目（B20097AN）