目的 探究清化方治疗痰浊内阻型非酒精性脂肪肝（nonalcoholic fatty liver disease，NAFLD）的临床疗效。方法 将72例痰浊内阻证NAFLD患者随机分为治疗组36例，对照组36例；治疗组予清化方联合生活方式干预（饮食调理加运动锻炼），对照组予强肝胶囊联合生活方式干预；治疗时间为24周，分别在12周和24周时观察两组患者肝脂肪变性程度和影像学改变、血清ALT、AST、GGT、TC、TG水平，并评估中医症状积分。结果 24周时，肝脂肪变性程度测定结果显示，治疗组总有效率明显高于对照组（77.8% vs 52.8%,P < 0.05）。治疗组ALT、AST、GGT、TG下降程度均显著大于同期对照组（P < 0.01），疗效优于对照组。结论 清化方对痰浊内阻型NAFLD患者临床疗效较好，明显降低了肝脏脂肪变性程度，减轻肝细胞炎症。

Objective To observe the clinical efficacy of Qinghua prescription in the treatment of nonalcoholic fatty liver disease (NAFLD) with phlegm wet resistance.Methods The 72 patients who with phlegm-obstruction type NAFLD were randomly into 2 groups, treatment group and control group, with 36 cases in each group. The treatment group was treated with Qinghua decoction and life-style, and the control group was treated with Qianggan Capsule and life-style. At 24 weeks of treatment, the degree of hepatic steatosis and imaging changes, serum ALT, AST, GGT, TC and TG levels of the 2 groups of patients were observed at 12 weeks and 24 weeks, and the TCM symptom scores were evaluated.Results After 24 weeks of treatment, the total effective rate of the treatment group was 77.8%. The total effective rate of the control group was 52.8%, and the difference was statistically significant (P < 0.05). The decrease of ALT, AST, GGT and TG in the treatment group was significantly higher than that in the control group at the same time, and the difference was statistically significant (P < 0.01).Conclusion Qinghua decoction could reduce hepatic steatosis and reduce hepatocyte inflammation.

R289.5

基金项目： 上海中医药大学中医学学科项目（Y1534）：清化方治疗痰浊内阻型非酒精性脂肪性肝病患者的临床研究，负责人：李莹；国家中医药管理局第四批全国中医优秀人才项目（国中医药人教发【2017】24号），负责人：李莹；上海中医药大学领军人才学术共同体培养计划（ZY3-RCPY-1-1001），负责人：李莹。