目的 探讨乙肝扶正胶囊联合富马酸丙酚替诺福韦片治疗慢性乙型肝炎的临床疗效。方法 选取2019年11月—2022年10月在四川省第三人民医院就诊的118例慢性乙型肝炎患者，按照计算机随机排列分为对照组和治疗组，每组各59例。对照组口服富马酸丙酚替诺福韦片，25 mg/次，1次/d。治疗组在对照组基础上口服乙肝扶正胶囊，4粒/次，3次/d。两组患者连续口服6个月。观察两组的临床疗效，比较肝纤维化指标、肝功能指标和炎症反应指标。结果 治疗后，治疗组总有效率明显高于对照组（91.53% vs 77.97%，P＜0.05）。治疗后，两组的脾静脉门径（SVD）、门静脉主干内径（mPVD）、肝脏硬度值（LSM）均显著下降（P＜0.05），治疗组SVD、mPVD、LSM较对照组降低更明显（P＜0.05）。治疗后，两组的谷氨酰转肽酶（GGT）、丙氨酸氨基转移酶（ALT）、乙肝病毒的脱氧核糖核酸（HBV-DNA）明显低于治疗前（P＜0.05），且治疗组的GGT、ALT、HBV-DNA低于对照组（P＜0.05）。治疗后，两组的血清结缔组织生长因子（CTGF）、白细胞介素-17（IL-17）、透明质酸（HA）水平均低于治疗前（P＜0.05），治疗组血清CTGF、IL-17、HA水平明显低于对照组（P＜0.05）。结论 乙肝扶正胶囊联合富马酸丙酚替诺福韦片治疗慢性乙型肝炎的疗效确切，能显著改善患者肝纤维化程度和肝功能，降低炎症反应指标水平，且治疗安全性良好。

Objective To investigate the clinical effect of Yigan Fuzheng Capsules combined with Tenofovir alafenamide Fumarate Tablets in treatment of chronic hepatitis B. Methods Patients (118 cases) with chronic hepatitis B in the Third People's Hospital of Sichuan Province from November 2019 to October 2022 were divided into control and treatment groups according to the computer random arrangement method, and each group had 59 cases. Patients in the control group were po administered with Tenofovir alafenamide Fumarate Tablets, 25 mg/time, once daily. Patients in the treatment group were po administered with Yigan Fuzheng Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and liver fibrosis index, liver function index, and inflammatory response index in two groups were compared. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (91.53% vs 77.97%, P < 0.05). After treatment, SVD, mPVD, and LSM in two groups were significantly decreased (P < 0.05), and SVD, mPVD, and LSM in the treatment group were more significantly decreased than those in the control group (P < 0.05). After treatment, GGT, ALT, and HBV-DNA of two groups were significantly lower than before treatment (P < 0.05), and GGT, ALT, and HBV-DNA of the treatment group were lower than those of the control group (P < 0.05). After treatment, the serum levels of CTGF, IL-17, and HA in two groups were significantly decreased (P < 0.05), and the serum levels of CTGF, IL-17, and HA in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Yigan Fuzheng Capsules combined with Tenofovir alafenamide Fumarate Tablets has definite efficacy in treatment of chronic hepatitis B, which can significantly improve the degree of liver fibrosis and liver function in patients, reduce the levels of inflammatory response indicators, with good safety.

R975

成都市医学科研课题（2022394）