目的探討乙肝舒康膠囊聯(lián)合替諾福韋對(duì)慢性乙型病毒性肝炎（CHB）患者的療效及其對(duì)免疫功能的影響。方法選取2017年1月-2019年5月邯鄲市中心醫(yī)院收治的105例CHB患者作為研究對(duì)象，依照治療方式將患者分為對(duì)照組（52例）和觀察組（53例）。對(duì)照組口服富馬酸替諾福韋二吡呋酯片，300 mg/次，1次/d；觀察組在對(duì)照組治療的基礎(chǔ)上口服乙肝舒康膠囊，4粒/次，3次/d。兩組均治療6個(gè)月。觀察兩組患者的臨床療效、HBeAg轉(zhuǎn)陰率和HBV-DNA轉(zhuǎn)陰率，同時(shí)比較兩組治療前后的總膽紅素（TBIL）、丙氨酸氨基轉(zhuǎn)移酶（ALT）、天冬氨酸氨基轉(zhuǎn)移酶（AST）、層黏連蛋白（LN）、透明質(zhì)酸酶（HA）、III型前膠原肽（PC-III）、Ⅳ型膠原（IV-C）水平及免疫功能指標(biāo)。結(jié)果治療后，觀察組的臨床總有效率為98.11%，顯著高于對(duì)照組的80.77%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，觀察組的HBeAg、HBV-DNA轉(zhuǎn)陰率均明顯高于對(duì)照組，差異均具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組血清TBIL、ALT、AST、LN、HA、PC-III及IV-C水平均明顯降低（P<0.05）；且觀察組治療后血清TBIL、ALT、AST、LN、HA、PC-III及IV-C水平明顯低于對(duì)照組（P<0.05）。治療后，兩組CD3⁺、CD4⁺水平均明顯高于治療前，CD8⁺水平均低于治療前（P<0.05）；觀察組治療后CD3⁺、CD4⁺、CD8⁺水平的改善優(yōu)于對(duì)照組（P<0.05）。結(jié)論乙肝舒康膠囊聯(lián)合替諾福韋治療CHB的臨床療效顯著，能夠改善患者的肝功能，延緩肝纖維化，提高機(jī)體免疫功能。

Objective To investigate the effect of Yigan Shukang Capsules combined with tenofovir in treatment of patients with chronic hepatitis B, and its effect on immune function. Methods A total of 105 CHB patients admitted to Handan Central Hospital from January 2017 to May 2019 were selected as the research subjects, and the patients were divided into control group (52 cases) and observation group (53 cases) according to the treatment methods. Patients in the control group were po administered with Tenofovir Disoproxil Fumarate Tablets, 300 mg/time, once daily. Patients in the observation group were po administered with Yigan Shukang Capsules on the basis of control group, 4 capsules/time, three times daily. Both groups were treated for 6 months. To observe the clinical efficacy, the negative conversion ratio of HBeAg and HBV-DNA, and the levels of TBIL, ALT, AST, LN, HA, PC III, IV-C and the levels of immune function before and after treatment were compared. Results After treatment, the total effective rate of the observation group was 98.11%, which was significantly higher than 80.77% of the control group, and the difference between two groups was statistically significant (P < 0.05). After treatment, the negative conversion rates of HBeAg and HBV-DNA in the observation group were significantly higher than those in the control group, with statistical significance (P < 0.05). After treatment, the serum levels of TBIL, ALT, AST, LN, HA, PC-III and IV-C in two groups were significantly decreased (P < 0.05). The levels of TBIL, ALT, AST, LN, HA, PC-III and IV-C in the observation group were significantly lower than those in the control group after treatment (P < 0.05). After treatment, the levels of CD3⁺ and CD4⁺ in both groups were significantly higher than those before treatment, and the levels of CD8⁺ were lower than that before treatment (P < 0.05). After treatment, the improvement of CD3⁺, CD4⁺ and CD8⁺ levels in observation group was better than those in control group (P < 0.05). Conclusion Yigan Shukang Capsules combined with tenofovir has significant clinical efficacy in treatment of CHB, which can improve the liver function of patients, delay liver fibrosis, and improve the immune function of the body.

R978.7

邯鄲市科學(xué)技術(shù)研究與發(fā)展計(jì)劃項(xiàng)目（1823208062ZC）