目的 观察双歧杆菌三联活菌散联合复方甘草酸苷片治疗儿童非酒精性脂肪性肝病的临床疗效。方法 选取2016年2月-2017年11月深圳市龙华区妇幼保健院收治的儿童非酒精性脂肪性肝病患儿104例，随机分为对照组和治疗组，每组各52例。对照组饭后口服复方甘草酸苷片，1片/次，3次/d。治疗组在对照基础上温水冲服双歧杆菌三联活菌散，3~5岁儿童，1 g/次，6岁以上儿童，2 g/次，3次/d。两组患儿连续治疗24周。观察两组患者临床疗效，同时比较治疗前后两组患者血清炎症因子和肝功能指标及肝纤维化四项指标。结果 治疗后，对照组临床有效率为75.0%，显著低于治疗组的90.4%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患儿白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、天门冬氨酸氨基转移酶（AST）和丙氨酶氨基转移酶（ALT）均显著降低，同组比较差异具有统计学意义（P<0.01），且治疗组IL-6、TNF-α、AST和ALT水平明显低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组肝纤维化四项指标显著低于治疗前（P<0.05、0.01），且治疗后治疗组透明质酸酶（HA）、层黏连蛋白（LN）、Ⅲ型前胶原（PCⅢ）和Ⅳ型胶原（PCⅣ）水平显著低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 双歧杆菌三联活菌散联合复方甘草酸苷片治疗儿童非酒精性脂肪性肝病可抑制炎症反应和肝纤维化进程，临床疗效显著，安全高。

Objective To evaluate the clinical effect of Bifid Triple Viable Powder combined with Compound Glycyrrhizin Tablets in treatment of non-alcoholic fatty liver disease in children. Methods Children (104 cases) with non-alcoholic fatty liver disease in Shenzhen Longhua Maternal and Child Healthcare Hospital from February 2016 to November 2017 were randomly divided into control and treatment groups, and each group had 52 cases. Children in the control group were po administered with Compound Glycyrrhizin Tablets after meal, 1 tablet/time, three times daily. Children in the treatment group were po administered with Bifid Triple Viable Powder with warm water on the basis of the control group, 1 g/time for 3-5 years children, 2 g/time for more than 6 years children, three times daily. Children in two groups were treated for 24 weeks. After treatment, the clinical efficacy was evaluated, and the serum inflammatory factors, liver function indexes, four indicators of liver fibrosis in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 75.0%, which was significantly lower than 90.4% in the treatment group, and there were differences between two groups (P<0.05). After treatment, IL-6, TNF-α, AST and ALT levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.01), and the IL-6, TNF-α, AST and ALT levels in the treatment group after treatment were significantly faster than that in the control group, with significant difference between two groups (P<0.05). After treatment, the four indicators of liver fibrosis in two groups were significantly decreased (P<0.05, 0.01), and the HA, LN, PCⅢ, and PCⅣ levels in the treatment group after treatment were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Bifid Triple Viable Powder combined with Compound Glycyrrhizin Tablets in treatment of non-alcoholic fatty liver disease in children can inhibit inflammatory reaction and hepatic fibrosis progression with significant clinical efficacy and high safety.