目的 探讨肝康宁联合替诺福韦治疗病毒性肝炎的临床疗效。方法 选取2017年5月—2018年5月在荆州市第二人民医院治疗的病毒性肝炎患者84例，根据就诊号分为对照组（42例）和治疗组（42例）。对照组口服富马酸替诺福韦二吡呋酯片，300 mg/次，1次/d；治疗组在对照组基础上口服肝康宁片，5 g/次，3次/d。两组患者均连续治疗12周。观察两组患者临床疗效，同时比较治疗前后两组患者肝功能、肝纤维化和细胞因子水平。结果 治疗后，对照组和治疗组临床有效率分别为80.95%和97.62%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TBIL）、总胆汁酸（TBA）、白细胞介素-18（IL-18）、降钙素原（PCT）、巨噬细胞移动抑制因子（MIF）、肿瘤坏死因子-α（TNF-α）、基质金属蛋白酶-13（MMP-13）、透明质酸（HA）、Ⅲ型前胶原N端肽（PC-Ⅲ）、Ⅳ型胶原（Ⅳ-C）、层黏连蛋白（LN）水平明显降低，同组比较差异具有统计学意义（P<0.05），且治疗组患者上述指标水平明显低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 肝康宁联合替诺福韦治疗病毒性肝炎不仅可以改善患者肝功能和肝纤维化，还可以降低机体炎性反应、增加机体免疫力。

Objective To investigate the clinical efficacy of Gankangning Tablets combined with tenofovir in treatment of viral hepatitis. Methods Patients (84 cases) with viral hepatitis in the Second People's Hospital of Jingzhou from May 2017 to May 2018 were divided into control (42 cases) and treatment (42 cases) groups based on visiting number. Patients in the control group were po administered with Tenofovir Disoproxil Fumarate Tablets, 300 mg/time, once daily. Patients in the treatment group were po administered with Gankangning Tablets on the basis of the control group, 5 g/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the liver function, the liver fibrosis and cytokine levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 80.95% and 97.62%, respectively, and there were differences between two groups (P < 0.05). After treatment, the ALT, AST, TBIL, TBA HA, LN, PC-Ⅲ, Ⅳ-C, IL-18, TNF-α, PCT, MIF and MMP-13 levels in two groups were significantly decreased, the difference was statistically significant in the same group (P < 0.05), and these indexes levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Gankangning Tablets combined with tenofovir in treatment of viral hepatitis can effectively improve the liver function and liver fibrosis, reduce the inflammatory reaction, improve the immune function.