目的 探討扶正化瘀片聯合富馬酸替諾福韋二吡呋酯片治療慢性乙型肝炎患者的臨床療效。方法 選取2018年7月—2020年1月天津市第三中心醫(yī)院收治的240例慢性乙型肝炎患者作為研究對象，按照隨機數字表法將所有患者分為對照組和治療組，每組各120例。對照組口服富馬酸替諾福韋二吡呋酯片，300 mg/次，1次/d。治療組在對照組患者治療的基礎上口服扶正化瘀片，1.6 g/次，3次/d。兩組患者連續(xù)治療3個月。觀察兩組的臨床療效，比較兩組輔助性T細胞17（Th17）細胞、調節(jié)性T細胞（Treg）細胞、Th17/Treg、丙氨酸氨基轉移酶（ALT）、天冬氨酸氨基轉移酶（AST）、白蛋白（ALB）、總膽紅素（TBIL）水平。結果 治療后，治療組患者的臨床總有效率（95.83%）高于對照組（88.33%），差異有統(tǒng)計學意義（P<0.05）。治療后，兩組的ALT、AST、TBIL水平明顯降低，ALB水平明顯升高（P<0.05）；治療后治療組的ALB水平比對照組高，ALT、AST、TBIL水平低于對照組（P<0.05）。治療后，兩組的Th17細胞、Treg細胞、Th17/Treg明顯降低（P<0.05）；治療后治療組的Th17細胞、Treg細胞、Th17/Treg低于對照組（P<0.05）。結論 扶正化瘀片聯合富馬酸替諾福韋二吡呋酯片能提高慢性乙型肝炎的療效，改善肝功能，降低Th17細胞、Treg細胞水平。

Objective To investigate the clinical effect of Fuzheng Huayu Tablets combined with Tenofovir Disoproxil Fumarate Tablets in treatment of chronic hepatitis B. Methods Patients (240 cases) with chronic hepatitis B in Tianjin Third Central Hospital from June 2018 to January 2020 were randomly divided into control and treatment groups, and each group had 120 cases. 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 Fuzheng Huayu Tablets on the basis of the control group, 1.6 g/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and Th17, Treg, Th17/Treg, the levels of ALT, AST, ALB, and TBIL in two groups were compared. Results After treatment, the clinical total effective rate of the treatment group (95.83%) was higher than that of the control group (88.33%), and the difference was statistically significant (P<0.05). After treatment, the levels of ALT, AST, and TBIL in two groups were significantly decreased, but the level of ALB was significantly increased (P<0.05). And after treatment, the level of ALB in the treatment group was higher than that in the control group, but the levels of ALT, AST, and TBIL in the treatment group were lower than those in the control group (P<0.05). After treatment, Th17 cells, Treg cells, and Th17/Treg of two groups were significantly decreased (P<0.05). After treatment, Th17 cells, Treg cells, and Th17/Treg in the treatment group were lower than those in the control group, and the difference was statistically significant (P<0.05). Conclusion Fuzheng Huayu Tablets combined with Tenofovir Disoproxil Fumarate Tablets can improve the curative effect of chronic hepatitis B, improve liver function, and reduce the level of Th17 cells and Treg cells.

R975

天津市科技計劃項目（16JCQNJC10600/191072）