中西医结合治疗小儿病毒性心肌炎临床研究

The Clinical Research into Children Viral Myocarditis Treated with Combined Therapy of Traditional Chinese and Western Medicine

目的:观察中西医结合治疗小儿病毒性心肌炎的临床疗效及对患儿心功能、心肌酶谱和血清白介素-4(IL-4)、干扰素-γ(IFN-γ)水平的影响。方法:选取2014年10月—2016年6月修武县人民医院和河南中医药大学第一附属医院儿科收治的小儿病毒性心肌炎患者100例,采用随机数字表法分为对照组和观察组各50例。对照组给予西医常规治疗,观察组在对照组治疗基础上加用益气解毒汤治疗。结果:观察组有效率96.00%,对照组有效率86.00%,观察组优于对照组(P<0.05);治疗后,观察组患儿血清IL-4水平升高,IFN-γ水平下降(P<0.05),且较对照组改善更加明显,差异有统计学意义(P<0.05);治疗后,观察组患儿EF、SV及CO水平均上调(P<0.05),且观察组SV及CO水平优于对照组(P<0.05);治疗后,观察组患儿AST、LDH、CK-MB及CPK水平均明显下调(P<0.05),且优于对照组(P<0.05);两组患儿均无明显不良反应(P>0.05)。结论:中西医结合治疗小儿病毒性心肌炎疗效显著,可有效缓解患者临床症状、体征,改善患儿心功能及心肌酶水平,提高血清IL-4水平,减少血清IFN-γ含量,有助于患者心肌功能恢复,且具有稳定安全性。

Objective：To observe the clinical curative effect of combined therapy of traditional Chinese and Western medicine on children viral myocarditis, and the ilffluence on their heart function, myocardial enzymes and serum interleukin -4 （IL-4） and in- terferon gamma （IFN-3,） levels. Methods：One hundred children with viral myocarditis who were treated in Xiuwu County People＇ s Hospital,Xiuwu or The First Hospital Attached to Henan University of TCM between Oct. 2014 and June 2016 were chosen as the research subjects, and divided into the control group and the observation group according to random number table method ,with 50 cases in each group. The ones in the control group were given routine Western medicine treatment ,while tile ones in tire obser- vation group were added Decoction for Supplementing Qi and Removing Toxin based on the treatment of the control group. Re- suits：The effective rate of observation group was 96%. while that off control group was 86% ;The observation group was better than the control group（ P 〈 0.05 ）. After the treatment, the serum level of IL-4. of the observation group increased, while its IFN-y level decreased （P 〈 0.05 ） ;The improved degree of the observation group was more obviously than the control group;And the differ- ence between them was statistically significant （ P 〈 0. 05 ） After the treatment, EF SV and CO levels of the observation group were up-regulated （ P 〈 0.05 ） ： And the observation group＇s SV and CO levels were hetter than those of the control group （ P 〈 0. 05 ）. After the treatment, AST,LDH, CK-MB and CPK levels of the observation group were significantly reduced （P 〈 0.05 ）; The observation group was better than the control group （ P 〈 0. 05 ）. The two groups had no obvious adverse reactions （ P 〉 0. 05 ）. Conclusion ： Combined therapy of traditional Chinese and Western medicine has significant curative effect on children viral myocarditis, can effectively relieve the clinical symptoms and signs, improve heart function and myocardial enzyme levels, increase the level of serum IL-4, decrease serum IFN-y content, help patients with myocardial function recovery, and has stable safety.