目的 探討肝膽舒康膠囊聯(lián)合硫普羅寧治療非酒精性脂肪肝病的臨床療效。方法 選取2019年4月—2020年4月在駐馬店市中心醫(yī)院治療的非酒精性脂肪肝病患者116例，根據(jù)就診順序分為對(duì)照組（58例）和治療組（58例）。對(duì)照組口服硫普羅寧片，0.2 g/次，3次/d；治療組在對(duì)照組的基礎(chǔ)上口服肝膽舒康膠囊，2 g/次，3次/d。兩組患者均經(jīng)8周治療。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者中醫(yī)癥候積分及總膽固醇（TC）、三酰甘油（TG）、低密度脂蛋白膽固醇（LDL-C）、高密度脂蛋白膽固醇（HDL-C）、丙氨酸氨基轉(zhuǎn)移酶（ALT）、天冬氨酸氨基轉(zhuǎn)移酶（AST）、谷氨酸轉(zhuǎn)移酶（GGT）、膽堿酯酶（CHE）、脂肪素（visfatin）、人瘦素（LEP）、內(nèi)脂素（apelin）、轉(zhuǎn)化生長(zhǎng)因子-β1（TGF-β1）和胰島素樣生長(zhǎng)因子-21（FGF-21）水平。結(jié)果 治療后，對(duì)照組臨床有效率為81.03%，顯著低于治療組的96.55%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組中醫(yī)癥候積分均顯著降低（P<0.05），且治療組比對(duì)照組更低（P<0.05）。治療后，兩組TC、TG、LDL-C、ALT、AST、GGT、CHE、LEP、Apelin、FGF-21水平均顯著降低，而HDL-C、Visfatin和TGF-β1水平均顯著升高（P<0.05），且治療組這些指標(biāo)水平明顯好于對(duì)照組（P<0.05）。結(jié)論 肝膽舒康膠囊聯(lián)合硫普羅寧片治療非酒精性脂肪肝病可有效改善患者臨床癥狀，利于患者肝功及血脂水平改善，具有一定的臨床推廣應(yīng)用價(jià)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

河南中醫(yī)學(xué)院博士科研基金資助項(xiàng)目（BSJJ2015-05）