摘要
目的:观察舒心通脉方联合常规西药治疗病毒性心肌炎的疗效及对心脏磁共振成像(CMR)参数的影响。方法:选取108例病毒性心肌炎患者,按随机数字表法分为对照组及观察组各54例。对照组给予抗病毒、营养心肌等常规西药治疗,观察组在对照组基础上给予舒心通脉方治疗。2组均连续治疗4周。比较2组临床疗效,观察2组治疗前后CMR参数、中医证候积分,炎症介质[白细胞介素-8(IL-8)、白细胞介素-21(IL-21)、肿瘤坏死因子-α(TNF-α)]、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、心肌肌钙蛋白T(cTnT)、心肌肌钙蛋白I(cTnI)心肌酶水平的变化,观察2组不良反应发生情况。结果:观察组临床疗效总有效率为94.44%,高于对照组81.48%,差异有统计学意义(P<0.05)。治疗后,2组左心室射血分数(LVEF)均较治疗前升高,左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)均较治疗前下降,差异均有统计学意义(P<0.05),每搏输出量(SV)、心输出量(CO)、心脏指数(CI)与治疗前相比,差异均无统计学意义(P>0.05);治疗后,观察组LVEF高于对照组,LVEDV、LVESV均低于对照组,差异均有统计学意义(P<0.05),SV、CO、CI与对照组治疗后比较,差异均无统计学意义(P>0.05)。治疗后,2组IL-8、IL-21、TNF-α水平均较治疗前下降,观察组上述3项水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组CK-MB、LDH、cTnT、cTnI水平均较治疗前下降,观察组上述4项水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组中医证候积分均较治疗前下降,观察组中医证候积分低于对照组,差异均有统计学意义(P<0.05)。2组用药期间,患者未发生明显皮疹、胃肠道不适、头痛等不良反应。结论:舒心通脉方联合常规西药治疗病毒性心肌炎可减轻患者心脏受损程度,改善心功能,减轻炎症反应,提高临床疗效。
Objective:To observe the therapeutic effect of Shuxin Tongmai prescription combined with conventional western medicine on the treatment of viral myocarditis and its influence on parameters of cardiac magnetic resonance imaging(CMR).Methods:A total of 108 patients with viral myocarditis were selected and divided into the control group and the observation group according to random number table method,with 54 cases in each group.The control group was treated with conventional western medicine such as antiviral and nourishing myocardium,while the observation group was additionally treated with Shuxin Tongmai prescription based on the treatment of the control group.Both groups were treated for four weeks.The clinical effects in the two groups were compared.The CMR parameters,Chinese medicine syndrome scores,inflammatory mediators including interleukin-8(IL-8),interleukin-21(IL-21)and tumor necrosis factor-α(TNF-α),creatine kinase-MB(CK-MB),lactate dehydrogenase(LDH),and levels of myocardial enzymes including cardiac troponin T(cTnT)and cardiac troponin I(cTnI)before and after treatment were observed.The incidence of adverse reactions in both groups was also observed.Results:The total effective rate was 94.44%in the observation group,higher than that of81.48%in the control group,the difference being significant(P<0.05).After treatment,the including left ventricular ejection fraction(LVEF)levels in both groups were increased when compared with those before treatment(P<0.05),and the levels of left ventricular end-diastolic volume(LVEDV)and left ventricular end systolic volume(LVESV)were decreased(P<0.05),and there was no significant difference in the levels of Stroke Volume(SV),Cardiac Output(CO)and Cardiac Index(CI)between the two groups when compared with those before treatment(P>0.05).After treatment,the LVEF level in the observation group were higher than that in the control group(P<0.05),and the levels of LVEDV and LVESV were lower than those in the control group(P<0.05),and there was no significant difference in
出处
《新中医》
CAS
2022年第5期83-87,共5页
New Chinese Medicine
关键词
病毒性心肌炎
舒心通脉方
心脏磁共振成像
心肌酶
心肌肌钙蛋白
Viral myocarditis
Shuxin tongmai prescription
Cardiac magnetic resonance imaging
Myocardial enzyme
Cardiac troponin
