目的 探討大黃利膽膠囊聯(lián)合水飛薊賓葡甲胺片治療非酒精性脂肪性肝病患者的臨床療效。方法 選取2019年6月-2020年3月在許昌市中心醫(yī)院治療的非酒精性脂肪性肝病患者124例，隨機(jī)分為對(duì)照組和治療組，每組各62例。對(duì)照組口服水飛薊賓葡甲胺片，100 mg/次，3次/d。治療組在對(duì)照組的基礎(chǔ)上口服大黃利膽膠囊，2粒/次，3次/d。兩組患者均連續(xù)治療12周。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者肝功能、血脂水平、肝纖維化指標(biāo)、炎性因子單核細(xì)胞趨化蛋白-1（MCP-1）、白細(xì)胞介素-17A（IL-17A）和IL-10水平及脂質(zhì)過(guò)氧化損傷產(chǎn)物水平。結(jié)果 治療后，對(duì)照組總有效率為75.81%，顯著低于治療組的90.32%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者丙氨酸氨基轉(zhuǎn)移酶（ALT）、天氨酸氨基轉(zhuǎn)移酶（AST）、谷氨酰轉(zhuǎn)移酶（GGT）、血清總膽固醇（TC）、血清三酰甘油（TG）、透明質(zhì)酸（HA）、層黏連蛋白（LN）、IV型膠原蛋白（IV-C）、丙二醛（MDA）和8-異前列腺素F2α（8-iso-PGF2α）水平均顯著降低（P<0.05），且治療組降低更為明顯（P<0.05）。治療后，兩組MCP-1、IL-17A均顯著降低，IL-10水平顯著升高（P<0.05），且治療組患者M(jìn)CP-1、IL-17A、IL-10水平改善程度更為明顯（P<0.05）。結(jié)論 大黃利膽膠囊聯(lián)合水飛薊賓葡甲胺片可顯著改善非酒精性脂肪性肝病患者的肝功能、血脂、肝纖維化指標(biāo)，有效抑制炎性反應(yīng)，減輕脂質(zhì)過(guò)氧化損傷，療效較佳，安全性高。

Objective To investigate the clinical effect of Dahuang Lidan Capsules combined with silybin meglumine in treatment of nonalcoholic fatty liver disease. Methods Patients (124 cases) with nonalcoholic fatty liver disease in Xuchang Central Hospital from June 2019 to March 2020 were randomly divided into control and treatment groups, and each group had 62 cases. Patients in the control group were po administered with Silibin Meglumine Tablets, 100 mg/time, three times daily. Patients in the treatment group were po administered with Dahuang Lidan Capsules on the basis of the control group, 2 grains/time, three times daily. After treatment, the clinical efficacy was evaluated, and the liver function and blood lipid levels, liver fibrosis indexes, inflammatory factors of MCP-1, IL-17A and IL-10 levels, the levels of lipid peroxidation damage products in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 75.81%, which was significantly lower than 90.32% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the levels of ALT, AST, GGT, TC, TG, HA, LN, IV-C, MDA and 8-iso-PGF2α in two groups were significantly decreased (P<0.05), and the indexes in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the MCP-1 and IL-17A levels in two groups were significantly decreased (P<0.05), but the IL-10 levels were significantly increased (P<0.05), and the improvement of MCP-1, IL-17A and IL-10 in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Dahuang Lidan Capsules combined with silybin meglumine in treatment of nonalcoholic fatty liver disease can significantly improve liver function, blood lipid, liver fibrosis indexes, effectively control inflammatory reaction, reduce lipid peroxidation damage, with better clinical efficacy and higher safety.

R975