生脉散合小柴胡汤加减联合西药对病毒性心肌炎患者的疗效及预后影响
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摘要
目的观察生脉散合小柴胡汤加减联合西药对病毒性心肌炎患者的疗效及预后的影响。方法选取92例病毒性心肌炎患者,随机分为观察组与对照组各46例。对照组采用常规西医治疗,观察组在对照组基础上联合生脉散合小柴胡汤治疗,疗程4周。比较两组治疗总有效率、治疗前后的中医证候积分、血清乳酸脱氢酶(lactate dehydrogenase, LDH)、肌酸激酶(creatine kinase,CK)、肌酸激酶同功酶(creatine kinase-MB, CK-MB)水平及不良反应总发生率。结果观察组治疗总有效率为95.65%,显著高于对照组82.61%(P<0.05)。两组治疗后的中医证候积分、血清LDH、CK及CK-MB水平均较治疗前显著降低(P<0.05),且观察组降低更显著(P<0.05,P<0.01)。观察组不良反应总发生率为8.70%,对照组为4.35%,差异无统计学意义(P>0.05)。结论生脉散合小柴胡汤加减联合西药治疗病毒性心肌炎可提高治疗总有效率,改善患者证候,减轻心肌损伤,预后更佳,具有较高安全性。
Objective To observe the effect of modified Shengmai Powder-Xiaochaihu Decoction Combined with Western medicine on the outcome and prognosis of patients with viral myocarditis. Methods A total of 92 patients with viral myocarditis were randomly divided into observation group and control group(n=46 in each group). The patients in the control group received conventional Western medicine treatment, and those in the observation group were treated with Shengmai Powder-Xiaochaihu Decoction in addition to the treatment for the control group; the course of treatment was 4weeks for both groups. The overall response rate, the improvements in traditional Chinese medicine(TCM) syndrome score and serum levels of lactate dehydrogenase(LDH), creatine kinase(CK), and creatine kinase isoenzyme(CK-MB) after treatment,and the overall incidence of adverse events were compared between the two groups. Results The observation group had a significantly higher overall response rate than the control group(95.65% vs 82.61%, P <0.05). After treatment, both groupsshowed significant reductions in TCM syndrome score and serum levels of LDH, CK, and CK-MB(P<0.05), and the observation group had significantly greater reductions than the control group(P <0.05,P <0.01). There was no significant difference in the overall incidence of adverse events between the observation group and the control group(8.70% vs 4.35%, P>0.05). Conclusion For patients with viral myocarditis, modified Shengmai Powder-Xiaochaihu Decoction combined with Western medicine can increase the overall response rate, improve TCM syndrome, and reduce myocardial damage, resulting in better prognosis and higher safety.
Objective To observe the effect of modified Shengmai Powder-Xiaochaihu Decoction Combined with Western medicine on the outcome and prognosis of patients with viral myocarditis. Methods A total of 92 patients with viral myocarditis were randomly divided into observation group and control group(n=46 in each group). The patients in the control group received conventional Western medicine treatment, and those in the observation group were treated with Shengmai Powder-Xiaochaihu Decoction in addition to the treatment for the control group; the course of treatment was 4weeks for both groups. The overall response rate, the improvements in traditional Chinese medicine(TCM) syndrome score and serum levels of lactate dehydrogenase(LDH), creatine kinase(CK), and creatine kinase isoenzyme(CK-MB) after treatment,and the overall incidence of adverse events were compared between the two groups. Results The observation group had a significantly higher overall response rate than the control group(95.65% vs 82.61%, P <0.05). After treatment, both groupsshowed significant reductions in TCM syndrome score and serum levels of LDH, CK, and CK-MB(P<0.05), and the observation group had significantly greater reductions than the control group(P <0.05,P <0.01). There was no significant difference in the overall incidence of adverse events between the observation group and the control group(8.70% vs 4.35%, P>0.05). Conclusion For patients with viral myocarditis, modified Shengmai Powder-Xiaochaihu Decoction combined with Western medicine can increase the overall response rate, improve TCM syndrome, and reduce myocardial damage, resulting in better prognosis and higher safety.
引文
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[15]于学康.麦冬的药理作用研究进展[J].天津药学,2012,24(4):69-70.
[16]仝欣.黄芪主要活性成分的药理作用[J].时珍国医国药,2011,22(5):1246-1249.
[2]白成斌.中西医结合治疗急性病毒性心肌炎疗效观察[J].现代中西医结合杂志,2014,23(16):1784-1785.
[3]李倩,高晓峰.丹参川芎嗪注射液联合曲美他嗪治疗病毒性心肌炎急性期的临床观察[J].中国药房,2016,27(32):4568-4569,4570.
[4]刘英杰,刘艳红.扶正益心汤治疗病毒性心肌炎疗效及对心功能和免疫功能的影响[J].现代中西医结合杂志,2017,26(17):1915-1917.
[5]陈灏珠,林果为.实用内科学[M].13版.北京:人民卫生出版社,2010:56-58.
[6]中华中医药学会.中医内科常见病诊疗指南(西医疾病部分)病毒性心肌炎[J].中国中医药现代远程教育,2011,9(18):148-150.
[7]国家中医药管理局.中医病证诊断疗效标准[M].北京:中国医药科技出版社.2012:39-40.
[8]黄磊,马沛然.病毒性心肌炎治疗进展[J].中华实用儿科临床杂志,2011,9(12):694-695.
[9]杨维华,刘祖贻.国医大师刘祖贻辨治小儿病毒性心肌炎[J].湖南中医药大学学报,2017,37(3):233-235.
[10]覃艳.小柴胡汤联合黄芪注射液治疗儿童病毒性心肌炎54例[J].环球中医药,2016,9(8):1015-1017.
[11]宋芳芳.小柴胡汤联合黄芪注射液对病毒性心肌炎患者心肌酶谱及心电图变化的影响[J].中医临床研究,2017,9(22):45-47.
[12]张亚平,陶振刚,宋振举,等.疏风解毒胶囊对小鼠病毒性心肌炎模型的影响[J].中草药,2016,47(1):110-113.
[13]闫婕,卫莹芳,龙飞,等.马尔康柴胡不同药用部位解热、保肝作用与急性毒性研究[J].世界科学技术-中医药现代化,2016,18(8):1368-1373.
[14]杨思敏,陈瑞战,董航,等.高效液相色谱-质谱联用快速筛选并鉴定黄芩甲醇提取物中抗氧化活性成分[J].分析化学,2012,40(6):888-892.
[15]于学康.麦冬的药理作用研究进展[J].天津药学,2012,24(4):69-70.
[16]仝欣.黄芪主要活性成分的药理作用[J].时珍国医国药,2011,22(5):1246-1249.