目的 探究健肝乐颗粒与艾米替诺福韦联合治疗慢性乙型肝炎的临床疗效。方法 选取2022年1月—2025年10月咸宁市第一人民医院收治的150例慢性乙型肝炎患者，依据治疗方式的不同，对照组（75例）和治疗组（75例）。对照组口服艾米替诺福韦片，25 mg/次，1次/d。治疗组在对照组基础上联合口服健肝乐颗粒，6 g/次，2次/d。两组连续治疗24周。对比两组临床疗效、症状缓解时间、肝功能[丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、γ-谷氨酰转肽酶（GGT）、总胆红素（TBIL）水平]、白细胞介素-17（IL-17）、中性粒细胞与淋巴细胞比值（NLR）。结果 治疗后，治疗组总有效率（96.00%）较对照组（84.00%）显著提高（P＜0.05）。治疗后，治疗组食欲减退、乏力、恶心、肝区不适缓解时间均短于对照组（P＜0.05）。治疗后，两组TBIL、ALT、AST、GGT水平显著降低（P＜0.05）；治疗后治疗组TBIL、ALT、AST、GGT水平低于对照组（P＜0.05）。治疗后，两组IL-17、NLR水平较前显著降低（P＜0.05）；治疗后，治疗组NLR、IL-17水平低于对照组（P＜0.05）。结论 健肝乐颗粒联合艾米替诺福韦可提升慢性乙型肝炎患者疗效，该联合方案能够有效缓解患者临床症状，改善全身炎症状态，促进肝功能恢复。

Objective To investigate the clinical efficacy of Jianganle Granules combined with tenofovir amibufenamide in treatment of chronic hepatitis B. Methods A total of 150 patients with chronic hepatitis B who were admitted to Xiangning First People’s Hospital from January 2022 to October 2025 were selected. According to different treatment methods, they were divided into control group (75 cases) and treatment group (75 cases). Patients in control group were given oral Tenofovir Amibufenamide Tablets at a dose of 25 mg each time, once daily. Patients in treatment group were given oral Jianganle Granules in addition to control group, at a dose of 6 g each time, twice daily. Both groups were treated continuously for 24 weeks. The clinical efficacy, symptom relief time, liver function (ALT, AST, GGT, TBIL), IL-17, and NLR of two groups were compared. Results After treatment, the total effective rate of the treatment group (96.00%) was significantly higher than that of the control group (84.00%) (P < 0.05). After treatment, the relief times of anorexia, fatigue, nausea, and liver area discomfort in treatment group were all shorter than those in control group (P < 0.05). After treatment, the levels of TBIL, ALT, AST, and GGT in both groups significantly decreased (P < 0.05). After treatment, the levels of TBIL, ALT, AST, and GGT in treatment group were lower than those in control group (P < 0.05). After treatment, the levels of IL-17 and NLR in both groups significantly decreased compared to before (P < 0.05). After treatment, the levels of NLR and IL-17 in treatment group were lower than those in control group (P < 0.05). Conclusion The combination of Jianganle Granules and tenofovir amibufenamide can enhance the therapeutic effect of patients with chronic hepatitis B. This combined treatment can effectively alleviate the clinical symptoms of patients, improve the overall inflammatory state, and promote the recovery of liver function.

R975

湖北省自然科学基金计划一般面上项目(2025AFB015)