目的 探討片仔癀膠囊聯(lián)合富馬酸替諾福韋二吡呋酯片治療慢性乙型病毒性肝炎的臨床療效。方法 選擇2017年4月—2020年4月在安陽市第五人民醫(yī)院治療102例慢性乙型病毒性肝炎患者，根據(jù)住院序號(hào)分成對(duì)照組（51例）和治療組（51例）。對(duì)照組患者口服富馬酸替諾福韋二吡呋酯片，300 mg/次，1次/d；治療組患者在對(duì)照組基礎(chǔ)上口服片仔癀膠囊，0.6 g/次，3次/d。兩組患者均經(jīng)4個(gè)月治療。觀察兩組患者臨床療效，比較治療前后兩組患者HBV-DNA和HBeAg轉(zhuǎn)陰率，肝功能指標(biāo)丙氨酸氨基轉(zhuǎn)移酶（ALT）、天冬氨酸氨基轉(zhuǎn)移酶（AST）、總膽紅素（TBIL）和總膽汁酸（TBA），血清趨化因子配體-13（CXCL-13）、白細(xì)胞介素-17（IL-17）、IL-37、肺泡巨噬細(xì)胞移動(dòng)抑制因子（MIF）和巨噬細(xì)胞炎癥因子-1β（MIP-1β）水平及PSQI、CLDQ和MADRS評(píng)分。結(jié)果 治療后，對(duì)照組總有效率為82.35%，顯著低于治療組的98.04%（P<0.05）。治療后，治療組HBV-DNA和HBeAg轉(zhuǎn)陰率均高于對(duì)照組（P<0.05）。治療后，兩組患者肝功能指標(biāo)ALT、AST、TBIL、TBA顯著降低（P<0.05），且治療組降低更明顯（P<0.05）。治療后，兩組患者血清CXCL-13、IL-17、IL-37、MIF、MIP-1β水平均顯著改善（P<0.05），以治療組改善最明顯（P<0.05）。治療后，兩組PSQI評(píng)分、CLDQ評(píng)分、MADRS評(píng)分均顯著改善（P<0.05），以治療組改善最明顯（P<0.05）。結(jié)論 片仔癀膠囊聯(lián)合富馬酸替諾福韋二吡呋酯片治療慢性乙型病毒性肝炎可促進(jìn)患者肝功能恢復(fù)，促使HBV-DNA、HBeAg轉(zhuǎn)陰，有利于提高患者睡眠質(zhì)量，改善患者負(fù)面情緒。

Objective To investigate the clinical efficacy of Pianzaihuang Capsules combined with tenofovir in treatment of chronic hepatitis B. Methods Patients (102 cases) with chronic hepatitis B in the Fifth People's Hospital of Anyang from April 2017 to April 2020 were divided into control (51 cases) and treatment (51 cases) groups based on hospitalization serial numbers. 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 Pianzaihuang Capsules on the basis of the control group, 0.6 g/time, three times daily. Patients in two groups were treated for 4 months. After treatment, the clinical efficacy was evaluated, and the negative rate of HBV-DNA and HBeAg, liver function index of ALT, AST, TBIL and TBA, the serum levels of CXCL-13, IL-17, MIF, MIP-1β, and IL-37, and the scores of PSQI, CLDQ and MADRS in two groups before and after treatment were compared. Results After treatment, the effective rate of the control group was 82.35%, which was significantly lower than that of the treatment group (98.04%) (P<0.05). After treatment, the negative conversion rates of HBV-DNA and HBeAg in the treatment group were higher than those in the control group (P<0.05). After treatment, the liver function indexes ALT, AST, TBIL and TBA in the two groups were significantly decreased (P<0.05), and especially in the treatment group (P<0.05). After treatment, the serum levels of CXCL-13, IL-17, IL-37, MIF and MIP-1 β were significantly improved in two groups (P<0.05), and especially in the treatment group (P<0.05). After treatment, PSQI score, CLDQ score, and MADRS score were significantly improved in two groups (P<0.05), and especially in the treatment group (P<0.05). Conclusion Pianzaihuang Capsules combined with tenofovir in treatment of chronic hepatitis B can promote the recovery of liver function, promote the negative conversion of HBV-DNA and HBeAg, which is conducive to improve sleep quality and patients' negative emotions.

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北京醫(yī)衛(wèi)健康公益基金-醫(yī)學(xué)科學(xué)研究基金資助項(xiàng)目（B20097AN）