曲美他嗪或生脉饮联合黄芪注射液治疗急性病毒性心肌炎的临床对比分析

摘要

Objective:To explore the clinical curative effect of trirnetazidine or Shengmai decoction combined with astragalus injection in the treatment of acute viral myocarditis (AVMC).Methods:A total of 140 patients with AVMC,who were treated in Sichuan Provincial People's Hospital from April 2013 to April 2016,were selected and randomly divided into control group (n=45),Qu Huang group (n=46) and Sheng Huang group (n=49).The control group received routine drug treatment.On the basis of the control group's therapy,the Qu Huang group received trimetazidine combined with astragalus injection and the Sheng Huang group received Shengrnai decoction combined with astragalus injection.The serum creatine kinase-MB (CK-MB),cardiac troponin Ⅰ (cTnⅠ),electrocardiogram indexs,clinical total effective rate,improvement of clinical symptoms and adverse reaction were compared among the three groups.Results:After treatment,the total effective rate in the Qu Huang group and Sheng Huang group was significantly higher than that in the control group,and the total effective rate in the Qu Huang group was higher than that in the Sheng Huang group (P＜0.05).The incidence of heart palpitations and chest pain in the Qu Huang group and the Sheng Huang group were lower than that in the control group,the differences were statistically significant (P＜0.05).The levels of serum CK-MB and cTnⅠ in the Qu Huang group and the Sheng Huang group were lower than those in the control group,and the levels of above indexes in the Qu Huang group was lower than that in the Sheng Huang group (P＜0.05).The incidence of atrioventricular heart-block,ST-T change,premature ventricular contractions in the Qu Huang group were lower than those in the control group (P＜0.05).There was no significant difference in the incidence of adverse reactions among the three groups (P＞0.05).Conclusion:In the treatment of patients with AVCM.The total effective rate of trimetazidine combined with astragalus injection is higher than that of Shengmai decoction combined with astragalus injection.It can reduce the degree of myocardial injury and improve clinical symptoms,without serious adverse reactions,which is worthy of clinical application.%目的:探讨曲美他嗪或生脉饮分别与黄芪注射液联用治疗急性病毒性心肌炎(AVMC)的临床疗效.方法:选取2013年4月～2016年4月我院收治的AVMC患者140例,按随机数字表法分为对照组(n=45)、曲黄组(n=46)及生黄组(n=49).对照组患者给予常规药物治疗,曲黄组在对照组的基础上给予曲美他嗪联合黄芪注射液治疗,生黄组在对照组的基础上给予生脉饮联合黄芪注射液治疗.比较三组患者中血清肌酸磷酸激酶同工酶(CK-MB)、心肌钙蛋白Ⅰ(cTnⅠ)水平、心电图指标、临床总有效率、临床症状改善及不良反应情况.结果:治疗后,曲黄组和生黄组总有效率均显高于对照组,曲黄组总有效率高于生黄组(P＜0.05).曲黄组和生黄组患者的心悸和胸痛发生率低于对照组,差异具有统计学意义(P＜0.05).曲黄组和生黄组患者血清CK-MB、cTnⅠ水平低于对照组,且曲黄组低于生黄组(P＜0.05).曲黄组患者房室传导阻滞、ST-T变化、室性期前收缩发生率低于对照组(P＜0.05).三组患者不良反应发生率比较无统计学差异(P＞0.05).结论:曲美他嗪联合黄芪注射液治疗AVCM的总有效率高于生脉饮联合黄芪注射液治疗,降低心肌损伤程度,改善临床症状,无严重不良反应,值得临床推广应用.