Abstract： Objective To investigate the efficacy of tenofovir alafenamide fumarate(TAF)combined with bicyclol in the treatment of chronic hepatitis B combined with fatty liver.Methods Selected 88 patients with chronic hepatitis B combined with fatty liver,admitted to The First People's Hospital of Nankang District between April 2020 and August 2022 as study subjects.They were randomly assigned to either the control group and the observation group,with 44 patients in each group.The control group received TAF therapy,while the observation group were treated with TAF and bicyclol tablets.After 48 weeks of treatment,compared the therapeutic outcomes and changes in relevant indicators between the two groups.Results After 48 weeks of treatment,both groups reduced serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)activities.The hepatic fat control attenuation index(CAP)level in the observation group decreased compared to before treatment,and the ALT,AST activity,and CAP levels in the observation group were lower than those in the control group,with statistical significance(P<0.05);the serum levels of hepatitis B virus DNA(HBV-DNA),hepatitis B e antigen(HBeAg)and liver hardness value(LSM)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 4.5%,lower than the 27.3%in the control group(P<0.05).Conclusion Treatment of patients with chronic hepatitis B combined with fatty liver using tenofovir disoproxil fumarate combined with bicyclol improves liver function and hepatic steatosis,suppresses viral load,and exhibits a high safety profile.