黄芪注射液治疗小儿病毒性心肌炎的临床疗效及其对心肌肌钙蛋白Ⅰ和心肌酶指标的影响

摘要

目的：探讨黄芪注射液治疗小儿病毒性心肌炎的临床疗效及其对心肌肌钙蛋白Ⅰ（ cTnI）和心肌酶指标的影响。方法选择2012年10月—2014年10月在陕西省安康市中医院儿科就诊的病毒性心肌炎患儿96例，采用随机数字表法分成对照组和观察组，各48例。对照组患儿给予常规对症治疗，观察组患儿在常规对症治疗基础上给予黄芪注射液进行治疗，两组患儿均治疗2周。比较两组患儿临床疗效及治疗前后血清炎性因子〔肿瘤坏死因子α（TNF-α）、白介素6（IL-6）、白介素8（IL-8）〕水平、cTnI、心肌酶指标〔肌酸激酶（CK）、肌酸激酶同工酶（ CK-MB）〕。结果观察组患儿显效26例，有效19例，无效3例；对照组患儿显效20例，有效18例，无效10例；观察组患儿临床疗效优于对照组（ u=1.978，P<0.05）。治疗前两组患儿血清TNF-α、IL-6、IL-8、CK、CK-MB及cTnI水平比较，差异无统计学意义（ P>0.05）；治疗后观察组患儿血清TNF-α、IL-6、IL-8、CK、CK-MB及cTnI水平均低于对照组（P<0.05）。结论黄芪注射液治疗小儿病毒性心肌炎的临床疗效确切，能有效减轻患儿炎性反应、降低cTnI及心肌酶指标，从而改善心功能。%Objective To investigate the clinical effect of huangqi injection on viral myocarditis in children and its impact on cTnI and myocardial enzyme indicators. Methods From October 2012 to October 2014,a total of 96 children with viral myocarditis were selected in the Department of Pediatrics,the Traditional Chinese Medicine Hospital of Ankang,and they were divided into control group and observation group according to random number table,each of 48 cases. Children of control group were given conventional symptomatic treatment,while children of observation group were given extra huangqi injection based on conventional symptomatic treatment,both groups treated for 2 weeks. Clinical effect,serum inflammatory cytokines levels(including TNF-α,IL-6 and IL-8),cTnI and myocardial enzyme indicators(including CK and CK-MB)before and after treatment were compared between the two groups. Results Of observation group,26 cases got excellent effect,19 cases got good effect,3 cases were invalid;of control group,20 cases got excellent effect ,18 cases got good effect,10 cases were invalid. The clinical effect of observation group was statistically significantly better than that of control group(u=1. 978,P<0. 05). No statistically significant differences of serum levels of TNF-α,IL-6,IL-8,CK,CK-MB or cTnI was found between the two groups before treatment(P>0. 05);while serum levels of TNF-α,IL-6,IL-8,CK,CK-MB and cTnI of observation group were statistically significantly lower than those of control group after treatment ( P<0. 05 ). Conclusion Huangqi injection has certain clinical effect on viral myocarditis in children,can effectively relieve the inflammatory reaction, reduce the cTnI and myocardial enzyme indicators,and eventually improve the cardiac function.