生脉散辨证加减联合西医常规治疗小儿心肌炎的疗效观察

摘要

目的：探讨生脉散辨证加减联合西医常规治疗小儿心肌炎的临床疗效。方法选择2012年6月至2014年9月在平邑县中医医院接受治疗的小儿心肌炎患者54例，采用随机数字表法分成观察组和对照组，各27例。对照组患儿应用西医常规方法予以治疗；观察组患儿在对照组基础上加用生脉散予以治疗，以水煎服，每日2次，疗程2周。比较两组患儿的临床效果，心肌酶指标（肌酸激酶、乳酸脱氢酶、肌酸激酶同工酶）和心肌蛋白指标（心肌肌红蛋白、高敏心肌肌钙蛋白）的变化及不良反应发生情况。结果治疗后，观察组患儿的总有效率为92.6％（25／27），明显优于对照组的70.4％（19／27），差异有统计学意义（P＜0.05）。治疗后，两组患儿的心肌酶指标和心肌蛋白指标均较治疗前显著改善，且观察组患儿改善更加显著，差异有统计学意义（ P＜0.05）。观察组患儿治疗过程中不良反应发生率为18.5％（5／27），低于对照组的48.1％（13／27），差异有统计学意义（ P ＜0.05）。结论小儿心肌炎患者应用生脉散辨证加减联合西医常规治疗，能获得较为满意的临床效果，并且能降低单用西药治疗引起的不良反应发生率，具有重要的临床意义。%Objective To analyze and discuss the clinical efficacy of conventional western medicine and differentiation modified shengmaisan in treatment of pediatric myocarditis .Methods A total of 54 children with myocarditis admitted to Pingyi Traditional Chinese Medicine Hospital from Jun .2012 to Sep.2014 were included in the study,and were randomly divided into observation group and control group,27 cases in each group.The patients of control group were treated by conventional western methods,and the patients of obser-vation group were treated by Shengmaisan(in decoction,2 times/day for 2 weeks) based on the control group.The clinical effects, changes in enzymes indicators ( creatine kinase, lactate dehydrogenase, isoenzymes) and myocardial protein index(cardiac myoglobin,superb sensitive cardiac troponin) and adverse reactions of the two groups were observed and compared.Results After treatment,total effective rate of the observation group was 92.6%(25/27),which was significantly better than 70.4%(19/27) of the control group(P <0.05).The index of cardiac enzymes and cardiac protein of two groups were significantly improved compared with before treatment,and the improvement of the observation group was more significant (P<0.05).The adverse reaction rate of the observation group[18.5%(5/27)] were significantly less than the control group[48.1%(13/27)],the difference was statistically significant (P<0.05).Conclusion Pediatric patients with myocarditis can achieve better clinical efficacy by treatment with conventional western treatment and Shengmaisan dialectical addition and subtraction, which also can reduce the occurrence of adverse reactions,and has a great clinical significance.