目的 探討六味五靈片聯(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2021年11月—2024年5月山西醫(yī)科大學(xué)第一醫(yī)院感染病科診治的120例慢性乙型肝炎患者，按照隨機(jī)數(shù)字法將患者分為對(duì)照組60例和治療組60例。對(duì)照組口服富馬酸丙酚替諾福韋片，25 mg/次，每日1次。治療組在對(duì)照組的基礎(chǔ)上口服六味五靈片，1.0 g/次，每日3次。兩組連續(xù)治療24周。觀察對(duì)比兩組療效情況，比較兩組治療前后中醫(yī)證候積分、血清總膽紅素（TBIL）、丙氨酸氨基轉(zhuǎn)移酶（ALT）、天冬氨酸氨基轉(zhuǎn)移酶（AST）、γ-谷氨酰轉(zhuǎn)肽酶（GGT）、層黏連蛋白（LN）、Ⅲ型前抗原（PC-Ⅲ）、透明質(zhì)酸（HA）、IV型膠原（IV-C）、肝臟硬度數(shù)值（LSM）、簡(jiǎn)明健康狀況調(diào)查量表（SF-36）、白細(xì)胞介素17（IL-17）、轉(zhuǎn)化生長(zhǎng)因子-β1（TGF-β1）、血清可溶性Ⅰ型補(bǔ)體受體（sCR1）、血清高爾基體跨膜糖蛋白73（GP73）水平的變化情況。結(jié)果 治療后，治療組總有效率是97.06%，顯著高于對(duì)照組的85.29%（P＜0.05）。治療后，兩組TBIL、ALT、AST、GGT水平均顯著降低（P＜0.05）；與對(duì)照組對(duì)比，治療組TBIL、ALT、AST、GGT水平均較低（P＜0.05）。治療后，兩組LN、PC-Ⅲ、HA、IV-C指標(biāo)均顯著降低（P＜0.05）；治療后，與對(duì)照組對(duì)比，治療組LN、PC-Ⅲ、HA、IV-C指標(biāo)均較低（P＜0.05）。治療后，兩組LSM顯著降低，而SF-36評(píng)分顯著升高（P＜0.05）；治療后，治療組LSM低于對(duì)照組，而SF-36評(píng)分高于對(duì)照組（P＜0.05）。結(jié)論 六味五靈片聯(lián)合富馬酸丙酚替諾福韋片治療慢性乙型肝炎效果較佳，可明顯改善患者肝功能，提高患者生活質(zhì)量，值得借鑒與推廣。

Objective To explore the effects of Liuwei Wuling Tablets combined with tenofovir alafenamide in treatment of chronic hepatitis B. Methods A total of 120 patients with chronic hepatitis B diagnosed and treated in the Infectious Disease Department of the First Hospital of Shanxi Medical University from November 2021 to May 2024 were selected and divided into control group (60 cases) and treatment group (60 cases) according to random number method. Patients in control group were po administered with Tenofovir alafenamide Fumarate Tablets, 25 mg/time, once daily. Patients in treatment group were po administered with Liuwei Wuling Tablets on the basis of control group, 1.0 g/time, three times daily. Both groups were treated continuously for 24 weeks. The efficacy of t two groups was observed and compared. The changes of TCM syndrome scores, serum TBIL, ALT, AST, GGT, LN, PC-Ⅲ, HA, IV-C, Liver hardness value (LSM), SF-36 score, IL-17, TGF-β1, sCR1, and GP73 were compared before and after treatment. Results After treatment, the total effective rate of treatment group was 97.06%, significantly higher than that of control group (85.29%) (P < 0.05). After treatment, the levels of TBIL, ALT, AST, and GGT in both groups were significantly decreased (P < 0.05). Compared with control group, the levels of TBIL, ALT, AST, and GGT in treatment group were lower (P < 0.05). After treatment, LN, PC-Ⅲ, HA, and IV-C were significantly decreased in both groups (P < 0.05). After treatment, LN, PC-Ⅲ, HA and IV-C indexes in treatment group were lower than those in control group (P < 0.05). After treatment, LSM was significantly decreased in both groups, but SF-36 score was significantly increased (P < 0.05). After treatment, LSM in treatment group was lower than that in control group, but SF-36 score was higher than that in control group (P < 0.05). Conclusion Liuwei Wuling Tablets combined with tenofovir alafenamide has a good effect in treatment of chronic hepatitis B, and can obviously improve the liver function and improve the life quality of patients, which is worth learning and promoting.

R975

吳階平醫(yī)學(xué)基金會(huì)臨床科研專項(xiàng)資助基金項(xiàng)目（320.6750.2023-06-37）