目的 探讨水飞蓟宾葡甲胺片、复方甘草酸苷注射液、护肝宁片对大鼠非酒精性脂肪性肝炎的治疗作用及机制。 方法 雄性SD大鼠82只，正常喂养1周后随机分为正常对照组(n=10)和实验组(n=72)，正常对照组予标准饮食，实验组予高脂饮食。12周末验证造模成功后，剩余的正常对照组大鼠(X组)6只，随机分为正常对照灌胃组(X1组)3只和正常对照注射组(X2组)3只；将剩余的65只实验组大鼠按体重层次再随机分为13组：(1)Z1组为高脂灌胃组，5只；(2)Z2组为高脂注射组，4只；(3)Y1为饮食治疗灌胃组，5只；(4)Y2为饮食治疗注射组，5只；(5)A1组、A2组、A3组分别为水飞蓟宾葡甲胺片高剂量治疗组(5只)、中剂量治疗组(5只)、低剂量治疗组(5只)；(6)B1组、B2组、B3组分别为复方甘草酸苷注射液高剂量治疗组(6只)、中剂量治疗组(5只)、低剂量治疗组(5只)；(7)C1组、C2组、C3组分别为护肝宁片高剂量治疗组(5只)、中剂量治疗组(5只)、低剂量治疗组(5只)。饮食方面除Z1组及Z2组继续饲以高脂饲料外，其余各组均予标准饲料喂养。于每日上午对各组大鼠进行灌胃或腹腔注射治疗一次，其中X1组、Y1组、Z1组每日灌服等容量的生理盐水；X2组、Y2组、Z2组每日腹腔注射等容量的生理盐水；而A1组、A2组、A3组则分别予以水飞蓟宾葡甲胺片高剂量、中剂量、低剂量的混悬液灌胃一次，；B1组、B2组、B3组则予以高剂量、中剂量、低剂量的复方甘草酸苷注射液腹腔注射一次；C1组、C2组、C3组则予以护肝宁片混悬液灌胃一次。第16周末处死大鼠，检测肝指数、体脂比、血清丙氨酸转氨酶(ALT)、天冬氨酸氨基转氨酶(AST)、甘油三酯(TC)、总胆固醇(TG)、低密度脂蛋白(LDLC)、高密度脂蛋白(HDLC)、丙二醛(MDA)、游离脂肪酸(FFA)、血糖(GLU)、超氧化物歧化酶(SOD)并行肝组织病理检查及肝匀浆TC、TG、HDLC、 LDLC和MDA测定。 结果 1.各组大鼠的体重呈现出随着饲养时间的延长而不断地增长的趋势，各组大鼠的起始体重及实验结束时的体重间无显著性差异。2.实验第11w末实验组大鼠(n=5)肝湿重、肝指数较正常对照组(n=4)明显增高；实验组大鼠的血清AST、TC、TG、LDLC、GLU，MDA水平较正常对照组增高(P＜0.05)，实验组大鼠的血清SOD水平较正常对照组降低(P＜0.05)；实验组大鼠的肝匀浆TC、TG、 MDA水平较正常对照组增高(P＜0.05)；肝组织学显示实验组脂肪变、炎症及纤维化程度较正常对照组加重(P＜0.05)，故验证造模成功。3.实验结束时药物水飞蓟宾葡甲胺片(A药组)的作用(P＜0.05)呈现为：A1组及A2组体脂比较Y1组降低；A1组血清AST水平、TC水平明显低于Y1组，A2组血清MDA水平明显低于Y1组；A2组肝勻浆TC水平、LDLC水平明显低于Y1组；肝组织学显示A1组、A2组及A3组脂肪变、炎症及纤维化程度较Y1组减轻。4.实验结束时药物复方甘草酸苷注射液(B药组)的作用(P＜0.05)呈现为：B2组体脂比较Y2组降低；B1组、B3组血清ALT水平明显低于Y2组，B1组血清AST水平明显低于Y2组，B2组血清TG水平明显低于Y2组，B1组血清SOD水平明显高于Y2组； B1组、B3组肝匀浆TC水平明显低于Y2组，B3组肝匀浆LDLC水平低于Y2组；肝组织学显示B1组脂肪变、炎症及纤维化程度较Y2组减轻。5.实验结束时药物护肝宁片(C药组)的作用(P＜0.05)呈现为：C2组、C3组体脂比较Y1及Z1组降低；C1组血清AST水平、TC水平、血糖水平明显低于Y1组，C1组血清SOD水平明显高于Y1组；C1组肝匀浆TC水平明显低于Y1组；肝组织学显示C1组脂肪变、炎症及纤维化程度较Y1组减轻。6.实验结束时三种药物的作用(P＜0.05)比较：C药组血清ALT水平明显高于B药组，A药组及B药组的血清AST水平明显低于C药组；A药组血清TC水平明显低于B药组及C药组，C药组血清TG水平明显高于B药组，A药组血清HDLC水平高于B药组，C药组血清LDLC水平明显高于A药组；A药组肝匀浆的MDA水平明显低于B药组及C药组。三组大鼠肝组织脂肪变、炎症及纤维化程度进行比较，差异无显著性(P＞0.05)。7.改变饮食的作用(P＜0.05)呈现为：饮食治疗组大鼠肝湿重、肝指数较实验组明显减低；饮食治疗组血清AST、ALP、TG、TC、LDLC、MDA较实验组降低；饮食治疗组大鼠的肝匀浆MDA水平较实验组减低。饮食治疗组大鼠肝组织脂肪变、炎症及纤维化程度较实验组减轻，但差异无显著性(P＞0.05)。 结论 水飞蓟宾葡甲胺片、复方甘草酸苷注射液、护肝宁片可通过抗炎、调节血脂及抗氧化应激和脂质过氧化而有效治疗大鼠非酒精性脂肪性肝炎。 关键词：[非酒精性脂肪性肝炎]；[高脂饮食]；[水飞蓟宾葡甲胺片]；[复方甘草酸苷注射液]；[护肝宁片]；[大鼠]。

 Objective Nonalcoholic steatohepatitis (NASH) is characterized by diffuse fatty infiltration in the liver and ballooning degeneration and inflammation in hepatocytes. We aimed to investigate the protective effect and mechanism of Silybin Meglumine Tablets, Stronger Neu-Minophagen C, Huganning Pian on rat model of NASH. Methods After one week of a standard diet eighty-two male SD rats were randomly divided into the normal control group (n=10) and the experimental group (n=72). The normal control group rats were fed with a standard diet, while those of the experimental group with a high-fat diet. After ten weeks nine rats were sacrificed to verify whether the model was established successfully. Then the experimental group was randomly subdivided into thirteen groups: Group Z1 (n=5) with a high-fat diet and gastric with saline , Group Z2 (n=4) with a high-fat diet and intraperitoneal injected with saline , Group Y1 ( n=5) with a standard diet and gastric with saline, Group Y2 ( n=5) with a standard diet and intraperitoneal injected with saline, Group A1 (n=5), Group A2 (n=5) and Group A3 (n=5) with a standard diet and gastrically infused with the solution of Silybin Meglumine Tablets of high-dosage, middle-dosage and low-dosage respectively, Group B1 (n=6), Group B2 (n=5) and Group B3 (n=5) with a standard diet and intraperitoneal injected with the injection of Stronger Neu-Minophagen C of high-dosage, middle-dosage and low-dosage respectively , Group 1 (n=5), Group C2 (n=5) and Group C3 (n=5) with a standard diet and gastrically infused with the solution of Huganning Pian of high-dosage, middle-dosage and low-dosage respectively. Four weeks later, all rats were sacrificed. Blood samples were collected to measure serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TG), total cholesterol (TC), low density lipoprotein-cholesterol (LDLC), glucose (GLU), free fatty acid (FFA), superoxide dismutase (SOD) and malondialdehyde (MDA). Liver tissue samples were duly taken for histopathological examination and measurement of tissue TC, TG, LDLC,HDLC and MDA levels. Results 1. At the end of the week 11 there was a significant difference (P＜0.05) in the hepatic index, the levels of serum AST, TC, TG, LDLC, GLU,SOD,MDA , the levels of liver tissue TC, TQ MDA, and the histological changes of liver injury between the experimental group and the normal control group. 2. At the end of the week 16, for the drug of Silybin Meglumine Tablets (drug A) (P＜0.05) , visceral adiposity ratio, serum AST and TC levels were higher in Group Y1 than in Group A1. Liver tissue TC and LDLC levels were also higher in Group Y1 compared to Group A2. A significant reduction was observed in Group A1, Group A2 and Group A3 in the hepatic steatosis, the grade of inflammation and the stage of fibrosis compared to Group Y1 and Group Z1. 3. For the drug of Stronger Neu-Minophagen C (drug B) (P＜0.05) , visceral adiposity ratio and serum TG levels were higher in Group Y2 than in Group B2. There were low levels of serum ALT, AST and liver tissue TC in Group B1 compared to Group Y2. There were low levels of serum ALT and liver tissue TC in Group B3 compared to Group Y2. A significant increase was found in the serum SOD levels in Group B1 compared to Group Y2. Liver tissue TC and LDLC levels were higher in Group Y2 compared to Group B3. A significant reduction was observed in Group B1 in the hepatic steatosis, the grade of inflammation and the stage of fibrosis compared to Group Y2 and Group Z2. 4. For the drug of Huganning Pian (drug C) (P＜0.05) , there were low levels of visceral adiposity ratio in Group C2 and Group C3 compared to Group Y1. There were low levels of serum AST, TC , GLU and liver tissue TC in Group C1 compared to Group Y1. A significant increase was found in the serum SOD levels in Group C1 compared to Group Y1. A significant reduction was observed in Group C1 in the hepatic steatosis, the grade of inflammation and the stage of fibrosis compared to Group Y1 and Group Z1. 5. When made a comparation among the Group of drug A, drug B and drug C (P＜0.05) , we found that the levels of serum ALT, AST and TG were lower in the Group of drug B than in the Group of drug C. There were low levels of serum TC and liver tissue MDA in the Group of drug A compared to the Group of drug C and drug B. The levels of serum LDLC were higher in the Group of drug C than in the Group of drug A. But there was no significant difference in the histological changes of liver injury among these three groups. 6. Meanwhile compared the therapy group changing a high-fat diet into a standard diet for four weeks with the experimental group continuing fed with a high-fat diet (P＜0.05 ) , we found that there was a significant difference in the hepatic index, the levels of serum AST, ALP,TC, TG, LDLC, MDA , the levels of liver tissue MDA between these two Group. But there was no significant difference in the histological changes of liver injury between the experimental group and the therapy group. Conclusion We conclude that Silybin Meglumine Tablets, Stronger Neu-Minophagen C, Huganning Pian seem to be effective in attenuating hepatic damage by regulation lipid metabolism and decreasing hepatic inflammation and lipid peroxidation in the NASH model induced by a high-fat diet. They may become potential drugs for NASH treatment in the future. Keywords: nonalcoholic steatohepatitis; a high-fat diet; Silybin Meglumine Tablets; Stronger Neu-Minophagen C; Huganning Pian; rat.