从“透邪外出”法对邪毒侵心型急性病毒性心肌炎心肌功能指标及预后的影响

Effect of“Getting Rid of Evil”Method on Myocardial Function Index and Prognosis of Acute Viral Myocarditis with Evil Invading Heart

目的 研究分析从“透邪外出”法对邪毒侵心型急性病毒性心肌炎心肌功能指标及预后的影响。方法 以2019年11月—2021年7月于医院心内科收治入院的156例急性病毒性心肌炎患者作为本次研究对象,全部患者采用随机数字表法分层抽样随机分为观察组(78例)和对照组(78例),对照组患者常规营养心肌、抗病毒治疗,观察组患者在对照组基础上给予自拟透邪清心汤治疗。对比治疗效果、治疗前后中医症状评分和心肌酶谱。结果 经不同方案治疗后,观察组患者治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者心悸、发热、胸闷、咽痛等中医症状评分差异无统计学意义(P>0.05)。治疗后,两组各项评分均明显低于治疗前,观察组各项评分明显低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组患者血清肌酸激酶(creatine kinase, CK),肌钙蛋白I(cardiac troponin, cTnI)及肌酸激酶同工酶-MB(creatine kinase isoenzyme, CK-MB)含量差异无统计学意义(P>0.05)。治疗后,两组血清CK、nTnl及CK-MB含量均明显低于治疗前,且观察组明显低于对照组,差异均有统计学意义(P<0.05)。结论 采用“透邪外出”法治疗邪毒侵心型急性病毒性心肌炎可以有效降低患者血清心肌酶含量,治疗效果显著,值得临床推广应用。

Objective To study the effect of“getting rid of evil”method on myocardial function index and prognosis of acute viral myocarditis with evil invading heart.Methods A total of 156 patients with acute viral myocarditis admitted to the Department of Cardiology of the hospital from November 2019 to July 2021 were taken as the research object.All patients were randomly divided into observation group(78 cases)and control group(78 cases)by stratified sampling with random number table.Patients in the control group were given conventional myocardial nutrition and antiviral treatment,while those in the observation group were given self-made"Touxie Qingxin Decoction(透邪清心汤)"on the basis of the control group.The treatment effect,TCM symptom score and myocardial enzyme spectrum were compared before and after treatment.Results After treatment with different schemes,the total effective rate of the observation group was higher than that of the control group and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference of the scores of TCM symptoms such as palpitation,fever,chest tightness or sore throat between the two groups(P>0.05).After treatment,the scores of the two groups were significantly lower than those before treatment,and those of the observation group were significantly lower than those of the control group(P<0.05).Before treatment,there was no significant difference in serum creatine kinase(CK),cardiac troponin(cTnI)or creatine kinase isoenzyme(CK-MB)between the two groups(P>0.05).After treatment,the levels of serum CK,cTnl and CK-MB in both groups were significantly lower than those before treatment,and those in the observation group were significantly lower than those in the control group(P<0.05).Conclusion The method of"getting rid of evil"can effectively reduce the serum content of myocardial enzyme spectrum of patients,improve the therapeutic effect and have remarkable therapeutic effect when treating acute viral myocarditis with evil invading heart,worthy of clinical popularization and application.