目的 探討乙肝扶正膠囊聯(lián)合富馬酸丙酚替諾福韋片治療慢性乙型肝炎的臨床療效。方法 選取2019年11月—2022年10月在四川省第三人民醫(yī)院就診的118例慢性乙型肝炎患者，按照計(jì)算機(jī)隨機(jī)排列分為對(duì)照組和治療組，每組各59例。對(duì)照組口服富馬酸丙酚替諾福韋片，25 mg/次，1次/d。治療組在對(duì)照組基礎(chǔ)上口服乙肝扶正膠囊，4粒/次，3次/d。兩組患者連續(xù)口服6個(gè)月。觀察兩組的臨床療效，比較肝纖維化指標(biāo)、肝功能指標(biāo)和炎癥反應(yīng)指標(biāo)。結(jié)果 治療后，治療組總有效率明顯高于對(duì)照組（91.53% vs 77.97%，P＜0.05）。治療后，兩組的脾靜脈門徑（SVD）、門靜脈主干內(nèi)徑（mPVD）、肝臟硬度值（LSM）均顯著下降（P＜0.05），治療組SVD、mPVD、LSM較對(duì)照組降低更明顯（P＜0.05）。治療后，兩組的谷氨酰轉(zhuǎn)肽酶（GGT）、丙氨酸氨基轉(zhuǎn)移酶（ALT）、乙肝病毒的脫氧核糖核酸（HBV-DNA）明顯低于治療前（P＜0.05），且治療組的GGT、ALT、HBV-DNA低于對(duì)照組（P＜0.05）。治療后，兩組的血清結(jié)締組織生長因子（CTGF）、白細(xì)胞介素-17（IL-17）、透明質(zhì)酸（HA）水平均低于治療前（P＜0.05），治療組血清CTGF、IL-17、HA水平明顯低于對(duì)照組（P＜0.05）。結(jié)論 乙肝扶正膠囊聯(lián)合富馬酸丙酚替諾福韋片治療慢性乙型肝炎的療效確切，能顯著改善患者肝纖維化程度和肝功能，降低炎癥反應(yīng)指標(biāo)水平，且治療安全性良好。

Objective To investigate the clinical effect of Yigan Fuzheng Capsules combined with Tenofovir alafenamide Fumarate Tablets in treatment of chronic hepatitis B. Methods Patients (118 cases) with chronic hepatitis B in the Third People's Hospital of Sichuan Province from November 2019 to October 2022 were divided into control and treatment groups according to the computer random arrangement method, and each group had 59 cases. Patients in the control group were po administered with Tenofovir alafenamide Fumarate Tablets, 25 mg/time, once daily. Patients in the treatment group were po administered with Yigan Fuzheng Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and liver fibrosis index, liver function index, and inflammatory response index in two groups were compared. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (91.53% vs 77.97%, P < 0.05). After treatment, SVD, mPVD, and LSM in two groups were significantly decreased (P < 0.05), and SVD, mPVD, and LSM in the treatment group were more significantly decreased than those in the control group (P < 0.05). After treatment, GGT, ALT, and HBV-DNA of two groups were significantly lower than before treatment (P < 0.05), and GGT, ALT, and HBV-DNA of the treatment group were lower than those of the control group (P < 0.05). After treatment, the serum levels of CTGF, IL-17, and HA in two groups were significantly decreased (P < 0.05), and the serum levels of CTGF, IL-17, and HA in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Yigan Fuzheng Capsules combined with Tenofovir alafenamide Fumarate Tablets has definite efficacy in treatment of chronic hepatitis B, which can significantly improve the degree of liver fibrosis and liver function in patients, reduce the levels of inflammatory response indicators, with good safety.

R975

成都市醫(yī)學(xué)科研課題（2022394）