目的 探讨乙肝扶正胶囊联合艾米替诺福韦片治疗慢性乙型肝炎的临床疗效。方法 选取2023年3月—2025年3月在安徽医科大学第二附属医院就诊的200例慢性乙型肝炎患者，患者按随机数字表法分为对照组和治疗组，每组100例。对照组口服艾米替诺福韦片，1片/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。两组持续治疗12周。比较两组患者的临床疗效、肝功能指标、病毒相关指标、血清炎性指标。结果 治疗组的总有效率为96.00%，对照组的总有效率为88.00%，组间比较差异非常显著（P＜0.05）。两组治疗后的天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）显著降低（P＜0.05），且治疗组治疗后AST、ALT均低于对照组（P＜0.05）。两组治疗后的HBV-DNA载量、乙型肝炎病毒表面抗体（HBsAb）、乙肝病毒前基因组RNA（HBV pgRNA）均明显降低（P＜0.05），且治疗组治疗后HBV-DNA载量、HBsAg、HBV pgRNA均低于对照组（P＜0.05）。两组治疗后的胞间黏附分子-1（ICAM-1）、甲壳质酶蛋白40（YKL-40）、血清淀粉样蛋白A/C-反应蛋白（SAA/CRP）明显降低（P＜0.05），且治疗组患者治疗后ICAM-1、YKL-40、SAA/CRP均低于对照组（P＜0.05）。结论 乙肝扶正胶囊联合艾米替诺福韦片可提高慢性乙型肝炎的治疗效果，改善肝功能，抑制HBV的活性，减轻炎性损伤。

Objective To investigate the clinical efficacy of Yigan Fuzheng Capsules combined with Tenofovir Amibufenamide Tablets in treatment of chronic hepatitis B. Methods 200 Patients with chronic hepatitis B treated at the Second Affiliated Hospital of Anhui Medical University from March 2023 to March 2025 were divided into control group and treatment group according to the random number table method, with 100 cases in each group. The control group received oral Tenofovir Amibufenamide Tablets at a dose of 1 tablet per dose, once daily. The treatment group took orally Yigan Fuzheng Capsules on the basis of the control group at a dose of 4 capsules per dose, three times daily. Two groups were treated for 12 weeks. The clinical efficacy, liver function indicators, viral-related indicators, and serum inflammatory markers were compared between two groups. Results The total effective rates of the treatment group and control group were 96.00% and 88.00%, respectively, with significant differences between two groups (P < 0.05). After treatment, the levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in two groups were significantly reduced (P< 0.05), and the AST and ALT levels in the treatment group were lower than those in the control group (P < 0.05). After treatment, the HBV DNA load, HBsAb, and hepatitis B pregenomic RNA (HBV pgRNA) in two groups were significantly reduced (P < 0.05), and the HBV DNA load, HBsAg, and HBV pgRNA in the treatment group were lower than those in the control group (P< 0.05). After treatment, the levels of intercellular adhesion molecule-1 (ICAM-1), chitinase protein 40 (YKL-40), and serum amyloid A/C-reactive protein (SAA/CRP) were significantly reduced in two groups (P < 0.05), and the levels of ICAM-1, YKL-40, and SAA/CRP in the treatment group were lower than those in the control group (P < 0.05). Conclusion Yigan Fuzheng Capsules combined with Tenofovir Amibufenamide Tablets can improve the therapeutic effect of chronic hepatitis B, improve liver function, inhibit the activity of HBV, and reduce inflammatory damage.

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安徽省高等学校自然科学研究项目（KJ2021A0323）