目的 探讨肝胆舒康胶囊联合硫普罗宁治疗非酒精性脂肪肝病的临床疗效。方法 选取2019年4月—2020年4月在驻马店市中心医院治疗的非酒精性脂肪肝病患者116例，根据就诊顺序分为对照组（58例）和治疗组（58例）。对照组口服硫普罗宁片，0.2 g/次，3次/d；治疗组在对照组的基础上口服肝胆舒康胶囊，2 g/次，3次/d。两组患者均经8周治疗。观察两组患者临床疗效，同时比较治疗前后两组患者中医症候积分及总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、谷氨酸转移酶（GGT）、胆碱酯酶（CHE）、脂肪素（visfatin）、人瘦素（LEP）、内脂素（apelin）、转化生长因子-β1（TGF-β1）和胰岛素样生长因子-21（FGF-21）水平。结果 治疗后，对照组临床有效率为81.03%，显著低于治疗组的96.55%，两组比较差异有统计学意义（P<0.05）。治疗后，两组中医症候积分均显著降低（P<0.05），且治疗组比对照组更低（P<0.05）。治疗后，两组TC、TG、LDL-C、ALT、AST、GGT、CHE、LEP、Apelin、FGF-21水平均显著降低，而HDL-C、Visfatin和TGF-β1水平均显著升高（P<0.05），且治疗组这些指标水平明显好于对照组（P<0.05）。结论 肝胆舒康胶囊联合硫普罗宁片治疗非酒精性脂肪肝病可有效改善患者临床症状，利于患者肝功及血脂水平改善，具有一定的临床推广应用价值。

Objective To explore the clinical effect of Gandan Shukang Capsules combined with tiopronin in treatment of nonalcoholic fatty liver disease. Methods Patients (116 cases) with nonalcoholic fatty liver disease in Zhumadian Central Hospital from April 2019 to April 2020 were divided into control (58 cases) and treatment (58 cases) groups according with treatment order. Patients in the control group were po administered with Tiopronin Tablets, 0.2 g/time, three times daily. Patients in the treatment group were po administered with Gandan Shukang Capsules on the basis of the control group, 2 g/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and the TCM symptom scores, the level of TC, TG, LDL-C, HDL-C, ALT, AST, GGT, CHE, visfatin, LEP, apelin, FGF-21 and TGF-β1 in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 81.03%, which was significantly lower than 96.55% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the TCM symptom scores in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than that in the control group (P<0.05). After treatment, the level of TC, TG, LDL-C, ALT, AST, GGT, CHE, LEP, apelin and FGF-21 in two groups was significantly decreased (P<0.05), but the level of HDL-C, visfatin, and TGF-β1 were significantly increased (P<0.05), and these indexes levels in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Gandan Shukang Capsules combined with tiopronin in treatment of nonalcoholic fatty liver disease can effectively improve the clinical symptoms, improve the liver function and blood lipid level, which has a certain clinical application value.

R975

河南中医学院博士科研基金资助项目（BSJJ2015-05）