Objective:To observe the clinical effect of self-formulated Shugan Jianpi Huazhuo Decoction combined with conventional therapy on juvenile nonalcoholic fatty liver disease (NAFLD) of liver depression and spleen deficiency syndrome. MethodsThe clinical data of 81 adolescent NAFLD patients with liver depression and spleen deficiency syndrome diagnosed and treated in our hospital from April 2017 to April 2019 were retrospectively analyzed. According to the treatment methods, they were divided into treatment group(43 cases) and control group(38 cases). The treatment group was treated with self-formulated Shugan Jianpi Huazhuo Decoction combined with conventional therapy, while the control group was treated with conventional therapy alone. After 12 weeks of continuous treatment, the clinical efficacy of the two groups was evaluated. The index changes of serum lipid metabolism, liver function, adiponectin, insulin-like growth factor-1 (IGF-1) and ultrasound imaging score were comparatively analyzed, and treatment safety was assessed simultaneously.  Results:①The total effective rates of the treatment group and the control group were 90.70% and 73.68% respectively, suggesting better clinical effects in the treatment group than that in the control group (P<0.05). ②After treatment, the levels of serum triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and Gamma-Glutamyl Transpeptidase (GGT) decreased (P<0.05), while the levels of high density lipoprotein cholesterol (HDL-C), adiponectin and IGF-1 increased in both groups (P<0.05). After treatment, the levels of serum TG, TC, LDL-C, ALT, AST and GGT in the treatment group were lower than those in the control group (P<0.05), while the levels of adiponectin and IGF-1 were higher than those in the control group (P<0.05), and there was no significant difference in HDL-C level (P>0.05). ③After treatment, ultrasound imaging scores of fatty liver grades in both groups decreased (P<0.05), and the scores in treatment group were lower than those in the control group (P<0.05). ④There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).  Conclusion:Compared with conventional therapy alone, self-formulated Shugan Jianpi Huazhuo Decoction combined with conventional therapy can achieve satisfactory results in treating adolescents with NAFLD of liver depression and spleen deficiency syndrome as it can better regulate lipid metabolism, protect liver function, increase adiponectin and IGF-1 levels and improve ultrasound imaging results while having good safety.