目的 探讨至灵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2022年4月—2024年3月在中国人民解放军联勤保障部队第九一〇医院治疗的慢性乙型肝炎患者共计112例，按随机数字表法分为对照组和治疗组，每组56例。对照组口服富马酸丙酚替诺福韦片，1片/次，1次/d。治疗组患者在对照组基础上口服至灵胶囊，2粒/次，3次/d。两组持续治疗6个月。比较两组治疗效果、血清指标和淋巴细胞指标。结果 治疗后，治疗组的总有效率为94.64%，对照组的总有效率为82.14%，组间差异显著（P＜0.05）。治疗组患者HBV-DNA转阴率、HBeAg/抗-HBe转换率、HBeAg转阴率均高于对照组（P＜0.05）。治疗后，两组的总胆红素（TBil）、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）均明显降低（P＜0.05）；治疗组的TBil、ALT、AST低于对照组（P＜0.05）。治疗后，两组的CD3⁺、CD4⁺、CD8⁺均降低，CD4⁺/CD8⁺均升高（P＜0.05）；治疗组CD3⁺、CD4⁺、CD8⁺低于对照组，CD4⁺/CD8⁺高于对照组（P＜0.05）。结论 至灵胶囊联合富马酸丙酚替诺福韦片可提高慢性乙型肝炎患者的治疗效果，改善肝功能，促进HBeAg转阴，调节免疫功能。

Objective To explore the clinical efficacy of Zhiling Capsules combined with Tenofovir Alafenamide Fumarate Tablets in treatment of chronic hepatitis B. Methods 112 Patients with chronic hepatitis B in The 910th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army were divided into control and treatment group according to the random number table method, 56 cases in each group. Patients in the control group took Tenofovir alafenamide Fumarate Tablets, 1 tablets each time, once daily. Patients in the treatment group po administered with Zhiling Capsules, 2 capsules each time, 3 times daily. Two groups received continuous treatment for 6 months. Therapeutic effects, serum indicators, and lymphocyte indicators between two groups were compared. Results The total effective rate of the treatment group after treatment was higher than that of the control group (94.64% vs 82.14%, P < 0.05). The HBV-DNA negative conversion rate, HBeAg/anti-HBe conversion rate, and HBeAg negative conversion rate in the treatment group were higher than those in the control group (P < 0.05). TBil, ALT, and AST in two groups were significantly decreased (P < 0.05), and TBil, ALT, and AST in the treatment group after treatment were lower than those in the control group (P < 0.05). CD3⁺, CD4⁺, and CD8⁺ in the two groups were decreased, but CD4⁺/CD8⁺ was increased (P < 0.05). CD3⁺, CD4⁺, and CD8⁺ in the treatment group were lower than those in the control group, but CD4⁺/CD8⁺ was higher than those in the rtreatment group (P< 0.05). Conclusion Zhiling Capsules combined with Tenofovir Alafenamide Fumarate Tablets can improve the therapeutic effect of patients with chronic hepatitis B, improve liver function, promote HBeAg negative conversion, and further regulate immune function.

R978

泉州市科技计划项目（2023C020YR）