乙肝舒康胶囊联合替诺福韦治疗慢性乙型肝炎的疗效及其对免疫功能的影响

目的探讨乙肝舒康胶囊联合替诺福韦对慢性乙型病毒性肝炎（CHB）患者的疗效及其对免疫功能的影响。方法选取2017年1月-2019年5月邯郸市中心医院收治的105例CHB患者作为研究对象，依照治疗方式将患者分为对照组（52例）和观察组（53例）。对照组口服富马酸替诺福韦二吡呋酯片，300 mg/次，1次/d；观察组在对照组治疗的基础上口服乙肝舒康胶囊，4粒/次，3次/d。两组均治疗6个月。观察两组患者的临床疗效、HBeAg转阴率和HBV-DNA转阴率，同时比较两组治疗前后的总胆红素（TBIL）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、层黏连蛋白（LN）、透明质酸酶（HA）、III型前胶原肽（PC-III）、Ⅳ型胶原（IV-C）水平及免疫功能指标。结果治疗后，观察组的临床总有效率为98.11%，显著高于对照组的80.77%，两组比较差异有统计学意义（P<0.05）。治疗后，观察组的HBeAg、HBV-DNA转阴率均明显高于对照组，差异均具有统计学意义（P<0.05）。治疗后，两组血清TBIL、ALT、AST、LN、HA、PC-III及IV-C水平均明显降低（P<0.05）；且观察组治疗后血清TBIL、ALT、AST、LN、HA、PC-III及IV-C水平明显低于对照组（P<0.05）。治疗后，两组CD3⁺、CD4⁺水平均明显高于治疗前，CD8⁺水平均低于治疗前（P<0.05）；观察组治疗后CD3⁺、CD4⁺、CD8⁺水平的改善优于对照组（P<0.05）。结论乙肝舒康胶囊联合替诺福韦治疗CHB的临床疗效显著，能够改善患者的肝功能，延缓肝纤维化，提高机体免疫功能。

Efficacy of Yigan Shukang Capsules combined with tenofovir in treatment of chronic hepatitis B and its effect on immune function

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.