心肌康颗粒联合磷酸肌酸钠治疗小儿病毒性心肌炎50例临床观察

Clinical observation on 50 cases of Xinjikang Keli (心肌康颗粒) combined with creatine phosphate sodium in the treatment of infantile viral myocarditis

目的观察心肌康颗粒联合磷酸肌酸钠治疗小儿病毒性心肌炎的临床效果及对心肌酶水平的影响。方法选取2015年1月至2018年1月在荆门市京山仁和医院儿科就诊的100例病毒性心肌炎患儿,采用随机数字表法分为对照组和治疗组,各50例,对照组给予西医常规治疗+磷酸肌酸钠治疗,治疗组在对照组治疗方法的基础上联合心肌康颗粒治疗,比较2组的临床疗效、治疗前后心肌酶指标[天门冬氨酸氨基转移酶(AST)、肌酸激酶同工酶(CK-MB)、磷酸肌酸酶(CPK)、羟丁酸脱氢酶(HBDH)、乳酸脱氢酶(LDH)]、肌钙蛋白指标[肌钙蛋白I(cTnI)、肌钙蛋白T(cTnT)]、血清炎症因子指标[C-反应蛋白(CRP)、白细胞介素-6(IL-6)]的变化以及不良反应发生情况。结果治疗组总有效率为96%,显著高于对照组的82%,2组比较,差异有统计学意义(P<0.05)。与同组治疗前比较,2组治疗后AST、CK-MB、CPK、HBDH、LDH、cTnI、cTnT、CRP、IL-6均显著降低(P<0.05),且治疗组的上述指标值均低于对照组,2组比较,差异有统计学意义(P<0.05)。对照组不良反应发生率为6%,治疗组为8%,2组比较,差异无统计学意义(P>0.05)。结论心肌康颗粒联合磷酸肌酸钠治疗小儿病毒性心肌炎疗效满意,可有效降低心肌酶指标、肌钙蛋白和血清炎症因子水平,安全可靠,值得临床推广应用。

Objective To observe the clinical efficacy of Xinjikang Keli(心肌康颗粒)combined with creatine phosphate sodium in the treatment of infantile viral myocarditis and analysis on myocardial enzyme level.Methods Totally 100 cases of viral myocarditis children patients consulted in department of pediatrics in Jingmen Municipal Jingshan Renhe Hospital from January 2015 to January 2018 were chosen and divided into control group and treatment group according to random number table method,with 50 cases in each.The control group was given routine Western medicine plus creatine phosphate sodium,while the treatment group was given Xinjikang Keli on the basis of the control group.The clinical efficacy,the changes of myocardial enzyme index[aspartate amino transferase(AST),creatine kinase isoenzyme(CK-MB),creatine phosphokinase(CPK),hydroxybutyrate dehydrogenase(HBDH),lactate dehydrogenase(LDH)],troponin index[troponin I(cTnI),troponin T(cTnT)],serum inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6)]before and after treatment and the incidence of adverse reactions of the 2 groups were compared.Results The total effective rate of the treatment group was 96%,which was significantly higher than 82%of the control group,the difference was statistically significant between the two groups(P<0.05).Compared with the same groups before treatment,AST,CK-MB,CPK,HBDH,LDH,cTnI,cTnT,CRP and IL-6 of the two groups after treatment all significantly decreased(P<0.05),moreover,the above-mentioned index value of the treatment group were all lower than those of the control group,there was statistically significant difference between the two groups(P<0.05).The incidence of adverse reactions rate of the control group was 6%,that of the treatment group was 8%,and the difference was not statistically significant(P>0.05).Conclusion It has satisfactory curative effect to use Xinjikang Keli combined with creatine phosphate sodium in the treatment of infantile viral myocarditis,which can effectively reduce myocardial enzymes index,troponin and serum inflammatory factors levels with good safety and reliability.It deserves clinical promotion and application.