目的 探讨采用肝爽颗粒与硫普罗宁协同治疗代谢相关脂肪性肝病的临床疗效。方法 选取2023年1月—2024年8月南阳南石医院消化内科收治的82例代谢相关脂肪性肝病患者，依据随机数字法分为对照组41例和治疗组41例。对照组患者给予iv注射用硫普罗宁，0.2 g溶于5%葡萄糖注射液250 mL稀释，1次/d。治疗组患者在对照组的基础上口服肝爽颗粒，3 g/次，3次/d。两组用药28 d。观察两组的治疗效果，比较两组的中医症状积分、三酰甘油（TG）、胆固醇（TC）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、血清正五聚体蛋白3（PTX3）、磷脂酰肌醇蛋白聚糖-4（GPC-4）、谷胱甘肽过氧化物酶（GSH-Px）、白脂素（Asprosin）水平。结果 治疗后，治疗组总有效率97.56%，高于对照组的78.05%（P＜0.05）。治疗后，两组口干口苦积分、肢体困重积分、肝区隐痛积分、脘腹胀满积分均低于治疗前（P＜0.05）；且与对照组相比，治疗组口干口苦积分、肢体困重积分、肝区隐痛积分、脘腹胀满积分均更低（P＜0.05）。治疗后，两组TG、TC、ALT、AST水平均低于治疗前（P＜0.05）；且与对照组相比，治疗组的TG、TC、ALT、AST水平均更低（P＜0.05）。治疗后，两组PTX3、GPC-4、Asprosin水平均低于同组治疗前，两组GSH-Px水平显著升高（P＜0.05）；且与对照组对比，治疗组PTX3、GPC-4、Asprosin水平更低，GSH-Px水平更高（P＜0.05）。结论 肝爽颗粒与硫普罗宁协同治疗代谢相关脂肪性肝病效果确切，可有效降低TG、TC水平及恢复肝功能状态，并能改善相关因子水平，值得借鉴与应用。

Objective To explore the clinical effect of Ganshuang Granules combined with tiopronin in treatment of metabolic associated fatty liver disease. Methods From January 2023 to August 2024, 82 patients with metabolic associated fatty liver disease who were admitted to the Gastroenterology Department of Nanyang Nanshi Hospital were selected. They were divided into control group of 41 cases and treatment group of 41 cases according to the random number method. Patients in control group were given intravenous injection of Tiopronin for injection, 0.2 g dissolved in 250 mL of 5% glucose injection for dilution, once daily. Patients in treatment group were orally administered Ganshuang Granules on the basis of control group, 3 g per time, 3 times daily. Both groups were treated for 28 d. The therapeutic effects of two groups were observed, and the Chinese medicine symptom scores, TG, TC, ALT, AST, serum PTX3, GPC-4, GSH-Px, and asprosin levels were compared between two groups. Results After treatment, the total effective rate of treatment group was 97.56%, which was higher than that of control group (78.05%) (P < 0.05). After treatment, the scores of dry mouth and bitter taste, limb heaviness, pain in the liver area, and abdominal distension in both groups were all lower than those before treatment (P < 0.05). Compared with control group, the scores of dry mouth and bitter taste, limb heaviness, pain in the liver area, and abdominal distension in treatment group were all lower (P < 0.05). After treatment, the levels of TG, TC, ALT, and AST in both groups were lower than those before treatment (P < 0.05). And compared with control group, the levels of TG, TC, ALT, and AST in treatment group were all lower (P < 0.05). After treatment, the levels of PTX3, GPC-4, and Asprosin in both groups were lower than those before treatment in the same group, and the level of GSH-Px was significantly increased (P < 0.05). And compared with control group, the levels of PTX3, GPC-4, and Asprosin in treatment group were lower, and the level of GSH-Px was higher (P < 0.05). Conclusion The combination therapy of Ganshuang Granules and tiopronin for the treatment of metabolic associated fatty liver disease has proven to be highly effective. It can significantly reduce TG and TC levels, restore liver function, and improve the levels of related factors. This treatment method is worthy of being studied and applied.

R975

国家自然科学基金项目(82360825）