大剂量参麦注射液治疗小儿病毒性心肌炎的临床研究  

Clinical Study for Treatment of Viral Myocarditis with Large-dose Shenmai Injection in Children

作　　者：刘晓东[1] 赵媛菊[1] 赵建强[1] 张爱梅[1] 刘克花[1] 魏根福[1] 

机构地区：[1]潍坊医学院附属潍坊市人民医院儿科,山东潍坊261041

出　　处：《潍坊医学院学报》2002年第1期14-17,共4页Acta Academiae Medicinae Weifang

基　　金：潍坊市科委资助课题 (课题号 :2 0 0 0 0 4 1 )

摘　　要：目的　探讨大剂量参麦注射液治疗小儿病毒性心肌炎 (VMC)的疗效和作用机制。方法　将 86例VMC患儿随机分为 3组 ,大剂量参麦组 (大剂量组 )、常规剂量参麦组 (常规剂量组 )和西药组 ,前两组在西药组的基础上分别每日给予参麦注射液 5～ 7ml kg和 1.5～ 3ml kg ,静脉注射 ,疗程 10～ 14d。观察症状、体征及心脏器械检查情况 ,治疗前后测定血心肌肌钙蛋白I(CTnI)、心肌酶谱、T细胞亚群、免疫球蛋白、抗氧化酶及产物的变化。结果　治疗后大剂量组和常规剂量组血CD3 ,CD4,CD8和CD4 CD8比值、IgA ,IgG ,SOD ,GSH Px水平均显著升高 (P <0 .0 1) ,常规剂量组增高幅度相对较小 (P <0 .0 5 ) ,西药组仅SOD增高明显 (P <0 .0 5 )。 3组血CK ,CK MB ,LDH ,LDH1,α HBDH均显著降低 (P <0 .0 1) ,西药组下降幅度相对较小 (P <0 .0 5 )。大剂量组和常规剂量组血CTnI、丙二醛 (MDA)含量显著降低 (P <0 .0 1) ,后组降低幅度相对较小 (P <0 .0 5 )。总有效率分别为 92 .8% ,84 .6 % ,75 .0 % .结论　参麦注射液能调节VMC患儿体液和细胞免疫功能 ,加速自由基清除 ,促进心肌细胞的修复 ,大剂量应用疗效更明显。Objective To explore the therapeutic effects and mechanisms of large dose shenmai injection on viral myocarditis (VMC) in children.Method Eight six cases of VMC in chlidren were divided into three groups by random according to different treatment :GroupA,B with large dose and routine dose shenmai injection respectively ; Group C with western medicine.The signes and symptoms and the heart instrument examination results of all groups were observated.Serum cardiac tropuin (CTnI),myocardial zymogram,T cell subpopulation,immunoglobulins(Ig) and antioxidase and its metablite in 86 chlidren with VMC were determined before and after treatment.Result Serum CD 3,CD 4,CD 8,CD 4/CD 8,IgG,IgA,superoxide dismutase(SOD),glutathione peroxidase (GSH Px) levels were significantly higher than those before treatment (all P< 0.01),but the increase ranges in groupB were relatively smaller(P<0.05).It was noticed that the five parameter levels of myocardial zymgram decreased significantly in all groups after treatment(all P<0.01),but the increase ranges in group C were smaller(P<0.05).Serum CTnI,malonyldiadehyde (MDA concentrations of groupA,B decreased significantly (all P<0.01),but the decrease ranges in group B were smaller (P<0.05).Total effective rate of group A,B,C was 92.8%,84.6%and 75.0% respectively.Conclusion Shenmai injection can regulate immunological fanctions,speed up free radical clearance and promote myocardial cell repair of VMC patients.The large dose therapy is superior to the routine dose one in the functions above and the therapeutic effects.Large dose shenmai injection is a safe and effective way in treating VMC in children.

关 键 词：参麦注射液 病毒性心肌炎 儿童 

分 类 号：R542.21[医药卫生—心血管疾病]