中医辨证治疗对病毒性心肌炎患儿综合疗效及预后的影响  

Effect of syndrome differentiation and treatment with traditional Chinese medicine on the comprehensive curative effect and prognosis of children with viral myocarditis

作　　者：秦丽丽 郝恒瑞 安红[1] 高洁林 纪美霞[1] QIN Lili;HAO Hengrui;AN Hong;GAO Jielin;JI Meixia(Department of Pediatrics,Xingtai People’s Hospital,Xingtai 054000,China)

机构地区：[1]邢台市人民医院儿科,河北邢台054000

出　　处：《中国医科大学学报》2023年第11期999-1003,共5页Journal of China Medical University

基　　金：河北省中医药管理局科研计划(2021453)。

摘　　要：目的研究中医辨证治疗对病毒性心肌炎(VMC)患儿综合疗效及预后的影响。方法选取我院2019年1月至9月收治的VMC患儿121例,按照随机数字法分为对照组(60例)和观察组(61例),对照组行常规抗病毒治疗,观察组在此基础上加以清热利湿方辨证治疗。比较2组的治疗总有效率、心电图改善有效率、安全性以及治疗前后的中医证候积分、心肌酶水平、氧化应激指标水平。结果观察组治疗总有效率和心电图改善有效率均显著高于对照组(93.44%vs.68.33%,χ^(2)=10.810,P<0.05;77.05%vs.51.67%,χ^(2)=7.435,P<0.05)。治疗后,观察组中医证候计分(心悸胸闷、倦怠乏力、多汗头晕、夜寐不安)均显著低于对照组,观察组CK-MB、LDH、CK和MDA水平均显著低于对照组,SOD水平显著高于对照组(均P<0.05)。2组不良反应发生率比较无显著差异(13.33%vs.9.84%,P>0.05)。结论中医清热利湿方辨证治疗VMC患儿疗效明显,能有效改善患儿心电图、中医证候、心肌酶等,值得在临床推广。Objective To study the effect of traditional Chinese medicine(TCM)syndrome differentiation on the prognosis of viral myocarditis in children(VMC).Methods A total of 121 children with VMC were selected from January 2019 to September 2019 at our hospital and randomly divided them into a control group(n=60)and an observation group(n=61),which was treated with Qingre Lishi formula syndrome differentiation and treatment.The total effective rate,ECG improvement efficiency,safety,TCM syndrome score,myocardial enzyme level,and oxidative stress index were compared between the two groups before and after treatment.Results The total treatment efficiency and ECG improvement efficiency(93.44%,77.05%)of the observation group were significantly higher than those of the control group(68.33%,51.67%,χ^(2)=10.810,5.955,all P<0.05).After treatment,the TCM syndrome scores for palpitations,chest tightness,fatigue,sweating,dizziness,and sleeplessness were significantly lower in the observation group compared with those in the control group(all P<0.05).In addition,after treatment,the levels of myocardial enzymes(CK-MB,LDH,CK)and oxidative stress indicators(MDA)in the observation group were significantly lower than those in the control group,while the levels of oxidative stress indicators(SOD)were significantly higher in the observation group compared with those in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(13.33%vs.9.84%,P>0.05).Conclusion The effect of Qingre Lishi formula’on syndrome differentiation and treatment in children with viral myocarditis is significant,resulting in marked improvements in ECG readings,inflammatory factors,and liver function.

关 键 词：清热利湿方 小儿病毒性心肌炎 综合疗效 预后 安全性 

分 类 号：R272[医药卫生—中医儿科学]