目的 探讨强肝胶囊联合盐酸吡格列酮片治疗代谢相关脂肪性肝病的临床疗效。方法 将秦皇岛市第二医院在2023年4月—2025年10月收治的代谢相关脂肪性肝病患者共计88例作为研究对象，按照随机数字表法将患者分为对照组和治疗组，各包括44例。对照组口服盐酸吡格列酮片，1片/次，1次/d。治疗组在对照组治疗基础上口服强肝胶囊，5粒/次，2次/d。两组患者持续治疗24周。比较两组的临床疗效、肝脏受控衰减参数（CAP）、糖脂指标和肝功能指标。结果 治疗组的总有效率（95.45%）明显高于对照组（79.55%），组间差异显著（P＜0.05）。治疗后，两组的CAP值显著降低（P＜0.05），且治疗组CAP值明显低于对照组（P＜0.05）。两组治疗后的三酰甘油/高密度脂蛋白胆固醇（TG/HDL-C）、载脂蛋白B/载脂蛋白A1（ApoB/ApoA1）明显低于治疗前（P＜0.05）；治疗组治疗后的TG/HDL-C、ApoB/ApoA1低于对照组（P＜0.05）。两组治疗后的γ-谷氨酰转移酶（GGT）、天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）显著降低（P＜0.05），且治疗组GGT、AST、ALT低于对照组（P＜0.05）。结论 强肝胶囊联合盐酸吡格列酮片可提高代谢相关脂肪性肝病的治疗效果，进一步减轻肝脏脂肪，改善糖脂代谢和肝功能。

Objective To explore the clinical efficacy of Qianggan Capsules combined with Pioglitazone Hydrochloride Tablets in treating metabolic dysfunction-associated fatty liver disease. Methods 88 Patients with metabolic dysfunction-associated fatty liver disease admitted to The Second Hospital of Qinhuangdao from April 2023 to October 2025 were selected as the research subjects. The patients were divided into control group and treatment group using a random number table method, with 44 patients in each group. The control group took Pioglitazone Hydrochloride Tablets orally, 1 tablet/time, once daily. The treatment group took Qianggan Capsules orally on the basis of the control group's treatment, 5 capsules/time, twice daily. The two groups were treated continuously for 24 weeks. The clinical efficacy, controlled attenuation parameters (CAP), glucose and lipid indicators, and liver function indicators were compared between two groups. Results The total effective rate of the treatment group (95.45%) was significantly higher than that of the control group (79.55%), and the difference was significant between two groups (P < 0.05). After treatment, the CAP values of two groups significantly decreased (P < 0.05), and the CAP value of the treatment group was significantly lower than that of the control group (P < 0.05). After treatment, the levels of triglycerides/high-density lipoprotein cholesterol (TG/HDL-C) and apolipoprotein B/apolipoprotein A1 (ApoB/ApoA1) in two groups were significantly reduced (P < 0.05). The TG/HDL-C and ApoB/ApoA1 levels in the treatment group were lower than those in the control group after treatment (P < 0.05). After treatment, the levels of γ-glutamyl transferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) in two groups were significantly reduced (P < 0.05), and the GGT, AST, and ALT levels in the treatment group were lower than those in the control group (P < 0.05). Conclusion The combination of Qianggan Capsules and Pioglitazone Hydrochloride Tablets can improve the therapeutic effect of metabolic dysfunction-associated fatty liver disease, further reduce liver fat, improve glucose and lipid metabolism, and liver function.

R975

河北省医学科学研究项目(20240384)