目的 探討至靈膠囊聯(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2022年4月—2024年3月在中國人民解放軍聯(lián)勤保障部隊第九一〇醫(yī)院治療的慢性乙型肝炎患者共計112例，按隨機數(shù)字表法分為對照組和治療組，每組56例。對照組口服富馬酸丙酚替諾福韋片，1片/次，1次/d。治療組患者在對照組基礎上口服至靈膠囊，2粒/次，3次/d。兩組持續(xù)治療6個月。比較兩組治療效果、血清指標和淋巴細胞指標。結果 治療后，治療組的總有效率為94.64%，對照組的總有效率為82.14%，組間差異顯著（P＜0.05）。治療組患者HBV-DNA轉陰率、HBeAg/抗-HBe轉換率、HBeAg轉陰率均高于對照組（P＜0.05）。治療后，兩組的總膽紅素（TBil）、丙氨酸轉氨酶（ALT）、天冬氨酸轉氨酶（AST）均明顯降低（P＜0.05）；治療組的TBil、ALT、AST低于對照組（P＜0.05）。治療后，兩組的CD3⁺、CD4⁺、CD8⁺均降低，CD4⁺/CD8⁺均升高（P＜0.05）；治療組CD3⁺、CD4⁺、CD8⁺低于對照組，CD4⁺/CD8⁺高于對照組（P＜0.05）。結論 至靈膠囊聯(lián)合富馬酸丙酚替諾福韋片可提高慢性乙型肝炎患者的治療效果，改善肝功能，促進HBeAg轉陰，調節(jié)免疫功能。

Objective To explore the clinical efficacy of Zhiling Capsules combined with Tenofovir Alafenamide Fumarate Tablets in treatment of chronic hepatitis B. Methods 112 Patients with chronic hepatitis B in The 910th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army were divided into control and treatment group according to the random number table method, 56 cases in each group. Patients in the control group took Tenofovir alafenamide Fumarate Tablets, 1 tablets each time, once daily. Patients in the treatment group po administered with Zhiling Capsules, 2 capsules each time, 3 times daily. Two groups received continuous treatment for 6 months. Therapeutic effects, serum indicators, and lymphocyte indicators between two groups were compared. Results The total effective rate of the treatment group after treatment was higher than that of the control group (94.64% vs 82.14%, P < 0.05). The HBV-DNA negative conversion rate, HBeAg/anti-HBe conversion rate, and HBeAg negative conversion rate in the treatment group were higher than those in the control group (P < 0.05). TBil, ALT, and AST in two groups were significantly decreased (P < 0.05), and TBil, ALT, and AST in the treatment group after treatment were lower than those in the control group (P < 0.05). CD3⁺, CD4⁺, and CD8⁺ in the two groups were decreased, but CD4⁺/CD8⁺ was increased (P < 0.05). CD3⁺, CD4⁺, and CD8⁺ in the treatment group were lower than those in the control group, but CD4⁺/CD8⁺ was higher than those in the rtreatment group (P< 0.05). Conclusion Zhiling Capsules combined with Tenofovir Alafenamide Fumarate Tablets can improve the therapeutic effect of patients with chronic hepatitis B, improve liver function, promote HBeAg negative conversion, and further regulate immune function.

R978

泉州市科技計劃項目（2023C020YR）