益气解毒汤对病毒性心肌炎患儿心肌酶谱、血清细胞因子及心功能的影响  

Effect of Yiqi Jiedu Decoction on Myocardial Enzyme,Serum Cell Factor,Cardiac Function in Children with Viral Myocarditis

作　　者：孔蕊 崔利宏[2] KONG Rui;CUI Lihong(Xuehang Central Hospital,Xuehang Henan China 461000;Henan University of Chinese Medicine, Zhengzhou Henan China 450046)

机构地区：[1]许昌市中心医院,河南许昌461000 [2]河南中医药大学,河南郑州450046

出　　处：《中医学报》2018年第5期891-894,共4页Acta Chinese Medicine

基　　金：国家社会科学基金重点项目(12A2D094);河南中医药大学博士启动基金项目(BSJJ2010-38)

摘　　要：目的:观察益气解毒汤治疗病毒性心肌炎的临床疗效,以及对病毒性心肌炎患儿心肌酶谱、血清细胞因子及心功能的影响。方法:将82例病毒性心肌炎患儿根据随机数字表法分为观察组和对照组,每组41例。对照组进行常规治疗,观察组在对照组基础上加用益气解毒汤治疗,方药组成:丹参、玄参、炒白芍、太子参各15 g,五味子、金银花、酸枣仁、桂枝、板蓝根各10 g,黄芪25 g,炙甘草6 g。观察两组患者的临床疗效、心肌酶谱、血清细胞因子、心功能和不良反应发生情况。结果:观察组有效率为97.56%,对照组有效率为80.49%,两组比较,差异有统计学意义(P<0.05);治疗后,两组患儿血清中乳酸脱氢酶(lactate dehydrogenase,LDH)、肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)、天门冬氨酸氨基转移酶(aspartate amino transferase,AST)、磷酸肌酸激酶(creatine phosphokinase,CPK)含量均明显降低,且观察组各指标明显低于对照组,差异有统计学意义(P<0.05);与治疗前比较,两组患儿治疗后心功能指标及血清干扰素-γ(interferon-γ,IFN-γ)水平、白细胞介素-4(interleukin-4,IL-4)水平有均改善,且观察组IL-4水平及心功能指标高于对照组、IFN-γ水平低于对照组,差异均有统计学意义(P<0.05);治疗过程中两组患者均出现轻微不良反应,但未影响研究进展,差异无统计学意义(P>0.05)。结论:益气解毒汤治疗小儿病毒性心肌炎疗效显著,在改善患儿心功能、血清因子指标的同时对心肌酶谱也有较好改善作用。Objective： To study the effect of Yiqi Jiedu Decoction on myocardial enzyme,serum cell factor,cardiac function in children with viral myocarditis(VMC）. Methods： 82 VMC children treated in our hospital from January 2016 to January 2017 were selected and they were divided into observation group and control group by random number table,with 41 cases in each group. The control group was given routine treatment,while the observation group was given Yiqi Jiedu Decoction in addition to that of the control group. The curative effect,myocardial enzyme,serum cell factor,cardiac function,adverse reactions were compared between the two groups. Results： The total effective rate of observation group was 97. 56%,which was significantly higher than that of the control group(P 〈 0. 05）. After treatment,the LDH,CK-MB,AST,CPK content in two groups significantly decreased,and the levels of indexes in observation group were significantly lower than those in the control group(P 〈 0. 05）. Compared with that before treatment,the indexes of cardiac function,IL-4,IFN-γ levels in two groups improved after treatment,and the IL-4 and indexes cardiac function in observation group were significantly higher than those in control group,and the IFN-γ level was significantly lower than that of the control group(P 〈 0. 05）. There were slight adverse reaction in two groups during treatment,and that did not influence treatment,and there was no statistical difference between the both groups(P 〉 0. 05）. Conclusion： Yiqi Jiedu Decoction in treatment of VMC is effective and it can improve cardiac function and serum factors and myocardial enzyme,with higher safety.

关 键 词：病毒性心肌炎 益气解毒汤 心肌酶谱 血清细胞因子 心功能 中医药疗法 中西医结合 

分 类 号：R272.6[医药卫生—中医儿科学]