目的 探讨慢肝养阴胶囊联合脱氧核苷酸钠治疗慢性乙型肝炎的临床疗效。方法 纳入2022年7月—2025年6月广东医科大学第一临床医学院收治的128例慢性乙型肝炎患者，按随机数字表法平均分为对照组和治疗组。对照组静脉滴注脱氧核苷酸钠注射液，100 mg/次，加入5%葡萄糖注射液250 mL，1次/d。在对照基础上，治疗组口服慢肝养阴胶囊，4粒/次，3次/d。两组患者疗程12周。比较两组临床疗效和临床表现缓解时间，以及治疗前后血清乙型肝炎表面抗原（HBsAg）、乙肝病毒脱氧核糖核酸（HBV DNA）、肝功能指标[丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、总胆红素（TBIL）]、症状自评量表（SCL-90）和慢性乙型肝炎病毒感染者生活质量量表（HBQOL）评分及血清转化生长因子-β1（TGF-β1）、CXC趋化因子家族配基17（CXCL17）、可溶性白细胞介素-2受体（sIL-2R）、颗粒蛋白前体（PGRN）水平。结果 治疗后，治疗组总有效率为93.75%，明显高于对照组的81.25%（P＜0.05）。治疗后，治疗组乏力、食欲减退等临床表现缓解时间显著短于对照组（P＜0.05）。治疗后，两组血清HBsAg、HBV DNA、ALT、AST、TBIL水平较治疗前均显著降低（P＜0.05），且治疗组明显低于对照组（P＜0.05）。治疗后，两组SCL-90评分比治疗前明显减少，而HBQOL评分明显升高（P＜0.05），且治疗组评分显著优于对照组（P＜0.05）。治疗后，两组血清TGF-β1、CXCL17、sIL-2R和PGRN水平均显著低于治疗前（P＜0.05），而治疗组血清水平明显低于对照组（P＜0.05）。结论 慢肝养阴胶囊联合脱氧核苷酸钠治疗慢性乙型肝炎，能有效缓解临床表现，进一步减轻机体免疫炎症损害和肝脏损伤，抑制HBV复制及纤维化，使患者肝功能、心理状态和生活质量得到改善。

Objective To explore the clinical efficacy of Mangan Yangyin Capsules combined with sodium deoxyribonucleotide in treatment of chronic hepatitis B. Methods A total of 128 patients with chronic hepatitis B admitted to the First School of Clinical Medical, Guangdong Medical University from July 2022 to June 2025 were enrolled and equally divided into a control group and a treatment group using a random number table method. Patients in the control group were treated with intravenous infusion of Sodium Deoxyribonucleotide Injection, 100 mg/time, added to 250 mL of 5% glucose injection, once daily. On the basis of the control group, patients in the treatment group were po administered with Mangan Yangyin Capsules, 4 capsules/time, three times daily. The treatment course for both groups was 12 weeks. The clinical efficacy and remission time of clinical manifestations between two groups were compared, as well as serum levels of hepatitis B surface antigen (HBsAg), hepatitis B virus DNA (HBV DNA), liver function indices [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL)], Symptom Checklist-90 (SCL-90) score, Hepatitis B Quality of Life (HBQOL) scale score, and serum levels of transforming growth factor-β1 (TGF-β1), CXC chemokine ligand 17 (CXCL17), soluble interleukin-2 receptor (sIL-2R), and progranulin (PGRN) before and after treatment. Results After treatment, the total effective rate in the treatment group was 93.75%, which was significantly higher than that in the control group (81.25%, P < 0.05). After treatment, the time to relief of clinical manifestations such as fatigue and poor appetite in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, serum levels of HBsAg, HBV DNA, ALT, AST, and TBIL in both groups were significantly decreased compared with before treatment (P < 0.05), and the levels in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, SCL-90 scores in both groups were significantly decreased, while HBQOL scores were significantly increased compared with before treatment (P < 0.05), and the scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, serum levels of TGF-β1, CXCL17, sIL-2R, and PGRN in both groups were significantly lower than those before treatment (P < 0.05), and the serum levels in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Mangan Yangyin Capsules combined with sodium deoxyribonucleotide in treatment of chronic hepatitis B can effectively alleviate clinical manifestations, further reduce immune inflammation damage and liver injury, inhibit HBV replication and fibrosis, and improve patients' liver function, psychological status, and quality of life.

广东省基础与应用基础研究基金项目（2023A1515010530）