Abstract: OBJECTIVE To investigate the effects of TCM syndrome differentiation combined with adefovir dimethoate on liver function， liver fibrosis and inflammatory reaction in patients with chronic hepatitis B (CHB). METHODS 164 patients with chronic hepatitis B in our hospital from December 2010 to December 2017 were divided into two groups， 82 patients in each group. The control group were treated with adefovir dimethoate orally， while the treatment group were treated with TCM syndrome differentiation on the basis of oral adefovir dipivoxil， the course of treatment for 3 months. The changes of liver function， liver fibrosis and inflammatory reaction of two groups were compared. RESULTS The obvious efficiency， effective rate and reduction of TCM syndrome score after treatment of the treatment group were significantly improved compared with those before treatment (P<0.05，P<0.01). The improvement of liver function in treatment group was significantly better than that of the control group and significantly improved than that before treatment(P<0.01). HBV-DNA negative conversion rate was significantly higher than that of the control group and significantly improved than that before treatment (P<0.05). Hyaluronic acid (HA)， type Ⅳ collagen (Ⅳ-C) and laminin (LN) were significantly lower in the treatment group than in the control group and significantly improved than that before treatment (P<0.01). The content of transforming growth factor(TGF-β1)， the hypersensitive C-reactive protein (hs-CRP)， tumor necrosis factor-α (TNF-α) were significantly decreased than that of the control group， and are obviously improved before the treatment. There was statistical significance(P<0.01). CONCLUSION The combination of the syndrome differentiation and adefovir dipivoxil in the treatment of chronic hepatitis B can significantly improve the liver function， liver fibrosis and inflammation of the body.