Abstract: Objective The aim of this study was to investigate the combination therapy of reduced glutathione and herbal medicine compound, Hugan Qingzhi tablet in treatment of patients with non-alcoholic fatty liver diseases (NAFLD). Methods 61 patients with NAFLD were admitted to our hospital between February 2020 and February 2022, and were randomly divided into control (n=30) and observation group (n=31), receiving reduced glutathione or reduced glutathione and herbal medicine compound, Hugan Qingzhi tablets therapy for six months. The TCM symptoms were evaluated based on Chinese literature, and serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-8, high sensitivity C-reactive protein (hs-CRP), serine protease inhibitor (vaspin), soluble leukocyte differentiation antigen 163 (sCD163), fibroblast growth factor-21 (FGF21), plasminogen activator inhibitor-1 (PAI-1) and adiponectin (APN) levels were detected by ELISA. Results At the end of six month treatment, the mental fatigue, abdominal distension, right epigastric region discomfort, unsmooth defecation, dark urine, overweight, yallow complexion and tastelessness scores in observation group were(0.6±0.1), (0.9±0.1), (0.8±0.1), (0.6±0.1), (0.8±0.1), (0.8±0.1),(0.7±0.1) and (1.2±0.2), significantly lower than [(1.2±0.1),(1.4±0.2),(1.6±0.2), (1.1±0.1), (1.4±0.2),(1.6±0.2),(1.1±0.2) and (1.9±0.3), P＜0.05] in the control; serum TNF-α, IL-6, IL-8 and hs-CRP levels (20.3±4.1)ng/L, (22.9±3.4)mg/L, (132.9±16.6)ng/L and (12.5±2.1)mg/L, all much lower than [(27.9±3.6)ng/L,(27.5±3.1)mg/L,(167.5±18.2)ng/L and (16.5±2.7)mg/L, P＜0.05] in the control; plasma total cholesterol, triglyceride and low-density lipoprotein cholesterol levels were (4.2±0.4)mmol/L,(1.5±0.2)mmol/L and (2.3±0.4)mmol/L, much lower than [(6.3±0.5)mmol/L, (2.9±0.3)mmol/L and (3.1±0.4)mmol/L, P＜0.05] in the control; serum vaspin, PAI-1 and FGF21 levels sere (1.1±0.2)μg/L, (8.2±1.6)ng/mL and (143.5±16.8)pg/mL, much lower than [(1.5±0.2)μg/L, (10.4±2.3)ng/mL and (181.6±19.7)pg/mL, P＜0.05], while serum APN and sCD163 levels were (15.7±2.4)μg/mL and (76.8±9.1)ng/mL, much higher than [(12.1±3.5)μg/mL and (62.3±7.4)ng/mL, respectively, P＜0.05] in the control. Conclusion The combination of reduced glutathione and herbal medicine compound in treatment of patients with NAFLD could greatly ameliorate TCM symptoms and decrease blood lipid levels, which needs further clinical investigation.

Key words: Non-alcoholic fatty liver disease, Reduced glutathione, Herbal medicine, Fibroblast growth factor-21, Adiponectin, Therapy