目的 探讨水飞蓟宾联合复方二氯醋酸二异丙胺治疗非酒精性脂肪肝的临床疗效。方法 选取2015年9月-2016年6月在驻马店市中心医院进行治疗的86例非酒精性脂肪肝患者，根据治疗方案不同分为对照组（43例）和治疗组（43例）。对照组患者口服复方二氯醋酸二异丙胺片，2片/次，3次/d。治疗组在对照组的基础上口服水飞蓟宾胶囊，3粒/次，3次/d。两组患者均连续治疗8周。观察两组患者的临床疗效，同时比较两组治疗前后肝功能、血脂水平和血清学指标变化情况。结果 治疗后，对照组和治疗组总有效率分别为72.09%和88.37%，两组总有效率比较差异有统计学意义（P<0.05）。治疗后，两组患者三酰甘油（TG）、胆固醇（TC）及丙氨酸转氨酶（ALT）和天氨酸转氨酶（AST）水平均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组降低程度优于对照组，两组比较差异具有统计学意义（P<0.05）。与治疗前相比，治疗后两组血清肿瘤坏死因子-α（TNF-α）、白细胞介素-18（IL-18）及降钙素原（PCT）均明显降低，IL-10则明显升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组上述指标改善程度优于对照组，两组比较差异具有统计学意义（P<0.05）。结论 水飞蓟宾联合复方二氯醋酸二异丙胺治疗非酒精性脂肪肝效果显著，可明显改善患者肝功能及血脂水平，并降低机体炎症反应，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of silibinin combined with compound diisopropylamine dichloroacetate in treatment of non-alcoholic fatty liver. Methods Patients (86 cases) with non-alcoholic fatty liver in Zhumadian Central Hospital from September 2015 to June 2016 were divided into the control (43 cases) and treatment (43 cases) groups based on different treatments. Patients in the control group were po administered with Compound Diisopropylamine Dichloroacetate Tablets, 2 tablets/time, three times daily. Patients in the treatment group were po administered with Silibinin Capsules on the basis of control group, 3 grains/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and blood lipid, liver function and serological indexes before and after treatment in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment group were 72.09% and 88.37%, respectively, and there were differences between two groups (P<0.05). After treatment, TG, TC, ALT, and AST levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the decrease degree of these indicators in the treatment group was better than that in the control group, with significant difference between two groups (P<0.05). And compared with those before treatment, TNF-α, IL-18, and PCT levels in two groups were significantly decreased, and IL-10 was significantly increased, and the difference was statistically significant in the same group (P<0.05). And these observation indexes in the treatment group were better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Silibinin combined with compound diisopropylamine dichloroacetate has a significant therapeutic effect in treatment of non-alcoholic fatty liver, can significantly improve the liver function and blood lipid level, and reduce the inflammatory reaction, which has a certain clinical application value.