目的 探討參澤舒肝膠囊聯(lián)合谷胱甘肽治療非酒精性脂肪性肝炎的臨床療效。方法 以2019年3月-2020年3月在鄭州市第六人民醫(yī)院進(jìn)行診治的98例非酒精性脂肪性肝炎患者為研究對(duì)象，根據(jù)就診順序分成對(duì)照組（49例）和治療組（49例）。對(duì)照組口服谷胱甘肽片，0.4 g/次，3次/d；治療組在對(duì)照組治療基礎(chǔ)上口服參澤舒肝膠囊，1.5 g/次，3次/d。兩組均治療12周。觀察兩組的臨床療效，比較兩組治療前后肝功能指標(biāo)、血脂指標(biāo)和血清學(xué)炎性因子的變化情況。結(jié)果 經(jīng)治療，對(duì)照組總有效率為81.63%，顯著低于治療組（95.92%，P<0.05）。經(jīng)治療，兩組丙氨酸氨基轉(zhuǎn)移酶（ALT）、天冬氨酸氨基轉(zhuǎn)移酶（AST）、γ-谷氨酰轉(zhuǎn)肽酶（γ-GT）、總膽紅素（TBIL）水平均較治療前顯著下降（P<0.05）；治療后，治療組肝功能指標(biāo)顯著低于對(duì)照組（P<0.05）。經(jīng)治療，兩組總膽固醇（TC）、三酰甘油（TG）、低密度脂蛋白膽固醇（LDL-C）水平均顯著下降，但高密度脂蛋白膽固醇（HDL-C）均升高（P<0.05）；且治療后，治療組TC、TG、LDL-C水平均低于對(duì)照組，而HDL-C高于對(duì)照組（P<0.05）。經(jīng)治療，兩組絲氨酸蛋白酶抑制劑（Vaspin）、成纖維細(xì)胞生長因子-21（FGF21）、纖溶酶原激活物抑制劑-1（PAI-1）水平均顯著下降，而可溶性白細(xì)胞分化抗原163（sCD163）、脂聯(lián)素（APN）均顯著上升（P<0.05）；且治療后，治療組Vaspin、FGF21、PAI-1水平低于對(duì)照組，而sCD163、APN高于對(duì)照組（P<0.05）。結(jié)論 參澤舒肝膠囊聯(lián)合谷胱甘肽治療非酒精性脂肪性肝炎具有較好的療效，可有效改善患者肝功能，調(diào)節(jié)機(jī)體血脂水平，改善血清細(xì)胞因子水平，有著良好的臨床應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of Shenze Shugan Capsules combined with glutathione in treatment of nonalcoholic steatohepatitis. Methods A total of 98 patients with non-alcoholic steatohepatitis who received diagnosis and treatment in Zhengzhou Sixth People's Hospital from March 2019 to March 2020 were selected as the research subjects. According to the order of treatment, they were divided into control group (49 cases) and treatment group (49 cases). Patients in the control group were po administered with Glutathione Tablets, 0.4 g/time, three times daily. Patients in the treatment group were po administered with Shenze Shugan Capsules on the basis of the control group, 1.5 g/time, three times daily. Both groups were treated for 12 weeks. The clinical efficacy of the two groups was observed, and the changes of liver function indexes, blood lipid indexes and serological inflammatory factors were compared before and after treatment. Results After treatment, the total effective rate of the control group was 81.63%, significantly lower than that of the treatment group (95.92%, P<0.05). After treatment, the levels of ALT, AST, γ-GT and TBIL in two groups were significantly decreased compared with before treatment (P<0.05). After treatment, liver function indexes in treatment group were significantly lower than those in control group (P<0.05). After treatment, the levels of TC, TG and LDL-C in two groups were significantly decreased, but the levels of HDL-C were increased (P<0.05). After treatment, the levels of TC, TG and LDL-C in the treatment group were lower than those in the control group, while HDL-C was higher than those in the control group (P<0.05). After treatment, the levels of Vaspin, FGF21 and PAI-1 in two groups were significantly decreased, while the levels of sCD163 and APN were significantly increased (P<0.05). After treatment, the levels of Vaspin, FGF21 and PAI-1 in the treatment group were lower than those in the control group, while sCD163 and APN were higher than those in the control group (P<0.05). Conclusion Shenze Shugan Capsules combined with glutathione has good curative effect in treatment of non-alcoholic steatohepatitis, and can effectively improve the patient's liver function, also can regulate the body lipid level, improve the serum cytokine level, which has a good clinical application value.

R975

國家科技重大專項(xiàng)課題（2018ZX09201016）