OBJECTIVE： To investigate clinical efficacy and safety of tiopronin combined with lamivudine in the treatment of pulmonary tuberculosis complicated with chronic hepatitis B. METHODS： 150 cases diagnosed as pulmonary tuberculosis with chronic hepatitis B were randomly divided into group A （drug combination group）， group B （lamivudine group） and the group C （control group）， with 50 cases in each group. 3 groups were given isoniazid+rifapentine+ethambutol+levofloxacin （2HTELfx/4HT） anti-TB treatment and liver protection treatment， etc. Group B was additionally given Lamivudine tablet orally， 0.1 g， qd；  group A was additionally given Tiopronin tablet 0.3 g， tid， on the basis of group B. The treatment course of 3 groups lasted for 6 months.Liver damage，serum fibrosis indexes of 3 groups were observed in 3 groups before and after treatment as well as hepatitis B virology indexes， clinical efficacy and the occurrence of ADR after treatment. RESULTS： After treatment，serum levels of ALT， AST and TBIL weresignificantly increased in group C， significantly decreased in group A， with statistical significance （P＜0.05）.There was no statistical significance in above indexes of group B before and after treatment （P＞0.05）. Serum levels of ALT， AST and TBIL after the treatment： group A＜group B ＜group C ， with statistical significance（P＜0.05）. There were no significant difference in the negative rate of HBsAg， the negative rate of HBeAg， the negative rate of HBV-DNA among 3 groups after treatment （P＞0.05）.  Serum fibrosis indexes of group A and B decreased significantly compared to before treatment， with statistical significance （P＜0.05）；serum fibrosis indexes after the treatment： group A＜group B ＜group C， with statistical significance （P＜0.05）. The total effective rate were 94.00％， 76.00％ and 62.00％ respectively in group A， group B and group C， with statistical significance （P＜0.05）.  The incidence of ADR were 14.00％，16.00％ and 30.00％  respectively，without statistical significance （P＞0.05）. CONCLUSIONS： Tiopronin combined with lamivudine can significantly reduce liver function damage caused by anti-TB drugs. It is conducive to the smooth progress of tuberculosis chemotherapy with fewer adverse reactions.