目的 探討三七脂肝丸聯(lián)合復(fù)方蛋氨酸膽堿片治療酒精性脂肪肝的臨床療效。方法 選擇2018年10月—2019年12月在鄭州大學(xué)第一附屬醫(yī)院治療170例酒精性脂肪肝患者，根據(jù)住院序號(hào)分成對(duì)照組（85例）和治療組（85例）。對(duì)照組口服復(fù)方蛋氨酸膽堿片，3片/次，3次/d；治療組在對(duì)照組基礎(chǔ)上口服三七脂肝丸，5 g/次，3次/d。兩組均治療2個(gè)月。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀改善時(shí)間，肝功指標(biāo)丙氨酸氨基轉(zhuǎn)移酶（ALT）、天冬氨酸氨基轉(zhuǎn)移酶（AST）、三酰甘油（TG）和膽固醇（TC），肝纖維化指標(biāo)透明質(zhì)酸（HA）、Ⅲ型前膠原N端肽（PCⅢ）、Ⅳ型膠原（Ⅳ-C）和層粘連蛋白（LN），血清學(xué)指標(biāo)過(guò)氧化酶體增殖體激活受體γ（PPARγ）、瘦素（Leptin）、脂聯(lián)素（APN）、轉(zhuǎn)化生長(zhǎng)因子β（TGF-β）和白細(xì)胞介素-18（IL-18）水平。結(jié)果 經(jīng)治療，對(duì)照組和治療組總有效率分別為84.71%、97.65%（P<0.05）。經(jīng)治療，治療組肝區(qū)不適、黃疸、痞滿、腹脹癥狀消失時(shí)間均明顯短于對(duì)照組（P<0.05）。經(jīng)治療，兩組血清AST、ALT、TC、TG、HA、LN、PCⅢ、IV-C水平均顯著下降（P<0.05），并以治療組最顯著（P<0.05）。經(jīng)治療，兩組血清PPARγ、Leptin、APN、TGF-β、IL-18水平均明顯改善（P<0.05），并以治療組改善最明顯（P<0.05）。結(jié)論 三七脂肝丸聯(lián)合復(fù)方蛋氨酸膽堿治療酒精性脂肪肝可有效改善患者臨床癥狀，促進(jìn)肝功能和肝纖維化指標(biāo)改善，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of Sanqi Zhigan Pills combined with compound methionine choline tablets in treatment of alcoholic fatty liver. Methods Patients (170 cases) with alcoholic fatty liver in the First Affiliated Hospital of Zhengzhou University from October 2018 to December 2019 were divided into control (85 cases) and treatment (85 cases) groups based on hospitalization serial numbers. Patients in the control group were po administered with Compound Methionine and Choline Bitartrate Tablets, 3 tablets/time, three times daily. Patients in the treatment group were po administered with Sanqi Zhigan Pills on the basis of the control group, 5 g/time, three times daily. Patients in two groups were treated for 2 months. After treatment, the clinical efficacy was evaluated, and the disappearance time of clinical symptoms, the liver function indexes of AST, ALT, TC, and TG, the liver fibrosis indexes of HA, LN, PCⅢ and CIV, the serological indexes of PPARγ, Leptin, TGF-β, IL-18, and APN in two groups before and after treatment were compared. Results After treatment, the effective rates of control group and treatment group were 84.71% and 97.65% respectively (P<0.05). After treatment, the disappearance time of liver discomfort, jaundice, puffiness and abdominal distension in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the serum levels of AST, ALT, TC, TG, HA, LN, PCⅢ, and IV-C were significantly decreased in two groups (P<0.05), especially in the treatment group (P<0.05). After treatment, the levels of serum PPAR γ, Leptin, APN, TGF-β, and IL-18 were significantly improved in two groups (P<0.05), especially in the treatment group (P<0.05).Conclusion Sanqi Zhigan Pills combined with compound methionine choline tablets in treatment of alcoholic fatty liver can effectively improve the clinical symptoms, promote the improvement of liver function and liver fibrosis indexes, which has a certain clinical application value.

R977

國(guó)家自然科學(xué)基金資助項(xiàng)目（U1904143）