小柴胡汤合炙甘草汤治疗新型冠状病毒感染相关性心肌炎临床研究  

Observation on the effect of Xiaochaihu decoction combined with Zhigancao decoction in intervening myocarditis associated with novel coronavirus infection

作　　者：刘果果 龙卫平 石磊[1] 曹雪倩 朱仕现 LIU Guoguo;LONG Weiping;SHI Lei;CAO Xueqian;ZHU Shixian(The Third Affiliated Hospital of Guangxi University of Chinese Medicine,Liuzhou Traditional Chinese Medical Hospital,Liuzhou 545001,China)

机构地区：[1]广西中医药大学第三附属医院柳州市中医医院心病科,广西柳州545001

出　　处：《陕西中医》2024年第12期1634-1639,共6页Shaanxi Journal of Traditional Chinese Medicine

基　　金：广西壮族自治区中医药管理局科研课题(GXZYB20230480)。

摘　　要：目的:探讨小柴胡汤合炙甘草汤干预新型冠状病毒(COVID-19)感染相关病毒性心肌炎(VMC)的临床疗效。方法:选取COVID-19相关VMC患者60例,采用随机对照原则分为对照组和观察组,各30例。对照组给予曲美他嗪、辅酶Q10、维生素C等治疗,观察组在此基础上加用小柴胡汤合炙甘草汤治疗,疗程均为4周。分别在治疗后2、4周,对比两组心肌损伤指标、心功能指标、炎症指标、心律失常疗效、中医症候疗效、不良事件发生率。结果:治疗后2、4周,观察组心肌损伤标志物肌酸激酶同工酶(CKMB)、肌钙蛋白(cTnI)、谷草转氨酶(AST)均优于对照组(均P<0.05);心功能指标N末端-B型利钠肽前体(NT-proBNP)、左室收缩指数(LVEF)、左室舒张期末径(LVEDD)优于对照组(均P<0.05);炎症指标C反应蛋白(CRP)、血沉(ESR)、白介素-6(IL-6)、铁蛋白(SF)、淋巴细胞计数(LY)优于对照组(均P<0.05)。观察组心律失常总有效率为70.00%和83.33%,高于对照组的46.67%和63.33%(均P<0.05);观察组中医症候总有效率为76.67%和93.33%,高于对照组的56.67%与70.00%(均P<0.05)。结论:小柴胡汤合炙甘草汤治疗COVID-19相关VMC,可改善患者心肌损伤,保护心脏功能,降低炎症反应,改善心律失常。Objective:To investigate the clinical effect of Xiaochaihu decoction and Zhigancao decoction on novel coronavirus(COVID-19)associated viral myocarditis(VMC).Methods:Sixty COVID-19 related VMC patients were selected and randomly divided into a control group and an observation group,with 30 patients in each group.The control group was treated with trimetazidine,coenzyme Q10,vitamin C,while the observation group was treated with Xiaochaihu decoction combined with Zhigancao decoction on this basis.The treatment course is all 4 weeks.Myocardial injury index,cardiac function index,inflammation index,arrhythmia effect,TCM syndrome effect and incidence of adverse events were compared between the two groups two and four weeks after treatment.Results:At two and four weeks after treatment,the myocardial injury markers of creatine kinase isoenzyme(CKMB),troponin(cTnI)and aspartate aminotransferase(AST)in observation group were better than those in control group(all P<0.05),the cardiac function indexes of NT-B-type natriuretic peptide precursor(NT-proBNP),left ventricular systolic index(LVEF)and left ventricular end-diastolic diameter(LVEDD)were better than those of control group(all P<0.05),the inflammatory indexes C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),interleukin-6(IL-6),ferritin(SF)and lymphocyte count(LY)were better than those of control group(all P<0.05).The total effective rates of arrhythmia in the observation group were 70.00%and 83.33%,which were higher than 46.67%and 63.33%in the control group(all P<0.05).The total effective rate of TCM syndrome in observation group was 76.67%and 93.33%,which was higher than that of control group 56.67%and 70.00%(all P<0.05).Conclusion:Xiaochaihu decoction combined with Zhigancao decoction in the treatment of COVID-19 related VMC can improve myocardial injury,protect heart function,reduce inflammatory response and improve arrhythmia.

关 键 词：病毒性心肌炎 小柴胡汤 炙甘草汤 心肌损伤 心脏功能 中医症候 

分 类 号：R542.2[医药卫生—心血管疾病]