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1.四川省医学科学院 四川省人民医院, 成都 610072
2.成都市第五人民医院, 成都 610000
王晨,住院医师,从事心功能及心血管疾病相关性研究的工作,E-mail:nerissa0530@163.com
杨雪梅,住院医师,从事心功能及心血管疾病相关性研究的工作,E-mail:6531736@qq.com
纸质出版日期:2020-07-20,
网络出版日期:2020-03-11,
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王晨,李仁东,刘学兵等.益心舒胶囊治疗病毒性心肌炎气阴两虚证的抗氧化、抗炎作用观察[J].中国实验方剂学杂志,2020,26(14):129-134.
WANG Chen,LI Ren-dong,LIU Xue-bing,et al.Anti-oxidation and Anti-inflammatory Effect of Yixinshu Capsule in Treatment of Qi-Yin Deficiency in Viral Myocarditis[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(14):129-134.
王晨,李仁东,刘学兵等.益心舒胶囊治疗病毒性心肌炎气阴两虚证的抗氧化、抗炎作用观察[J].中国实验方剂学杂志,2020,26(14):129-134. DOI: 10.13422/j.cnki.syfjx.20200531.
WANG Chen,LI Ren-dong,LIU Xue-bing,et al.Anti-oxidation and Anti-inflammatory Effect of Yixinshu Capsule in Treatment of Qi-Yin Deficiency in Viral Myocarditis[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(14):129-134. DOI: 10.13422/j.cnki.syfjx.20200531.
目的
2
探讨益心舒胶囊治疗病毒性心肌炎(VMC)气阴两虚证的临床疗效及抗氧化、抗炎的作用。
方法
2
将132例亚急性期VMC患者,采用随机按数字表法分为对照组和观察组各66例。两组均注射用磷酸肌酸钠,1 g/次,1次/d,静脉滴注,连续治疗14 d;辅酶 Q10 胶囊,1粒/次,3次/d,饭后服用;盐酸曲美他嗪片,1片/次,3次/d,三餐时服用;重症患者,给予地塞米松磷酸钠注射液,10~20 mg/次,1次/d,静脉滴注,连续治疗14 d。对照组口服稳心颗粒,每次1袋,3次/d。观察组口服益心舒胶囊,3粒/次,3次/d。两组疗程均连续治疗8周。监测血清肌钙蛋白 I(cTnI)和心肌肌酸磷酸激酶(CK-MB),记录治疗后cTnI,CK-MB的复常率;进行治疗前后心电图检查,记录心电图复常率;进行治疗前后气阴两虚证评分;检测治疗前后肌酸磷酸激酶(CPK),羟丁酸脱氢酶(HBDH),乳酸脱氢酶(LDH)和天门冬氨酸氨基转移酶(AST)水平;进行治疗前后超声心动图检查,记录治疗前后左心室射血分数(LVEF),心脏指数(CI)和舒张早期/舒张晚期最大血流速度(E/A);检测治疗前后超氧化物歧化酶(SOD),丙二醛(MDA),谷胱甘肽过氧化物酶(GSH-Px),干扰素-
γ
(IFN-
γ
),白细胞介素-10(IL-10),IL-17和IL-35水平。
结果
2
采用秩和检验分析两组临床疗效,观察组优于对照组(
Z
=2.151,
P<
0.05);观察组cTnI,CK-MB和心电图复常率分别为82.26%(51/62),90.32%(56/62)和80.65%(50/62)分别高于对照组的65.00%(39/60),73.33%(44/60)和63.33%(38/60)(
P<
0.05);观察组患者血清cTnI,CK-MB,CPK,HBDH,LDH和AST水平均低于对照组(
P<
0.01);观察组患者LVEF,CI和E/A均高于对照组(
P<
0.01);观察组SOD和GSH-Px水平均高于对照组(
P<
0.01),MDA水平低于对照组(
P<
0.01);观察组IL-10和IL-35水平均高于对照组(
P<
0.01),IFN-
γ
和IL-17水平均低于对照组(
P<
0.01)。
结论
2
在西医常规治疗的基础上,加用益心舒胶囊治疗亚急性期VMC气阴两虚证患者,可通过抗炎和抗氧化作用而保护心肌,临床能起到降低心肌酶,促进心电图、心酶等恢复,改善心功能,提高临床治疗的效果。
Objective
2
To discuss the clinical efficacy of Yixinshu capsule for viral myocarditis (VMC) with deficiency of Qi and Yin
and to investigate its antioxidant and anti-inflammatory effect.
Method
2
One hundred and thirty-two patients were randomly divided into control group (66 cases) and observation group (66 cases) by random number table. Patients in two group got comprehensive treatment of Western medicine
i.e. intravenous drip of creatine phosphate injection for 14 days
1 g/time
1 time/day. Coenzyme Q10 capsule
1 grain/time
3 times/day after meals. Trimetazidine dihydrochloride tablets
1 tablet/time
3 times/day during meals. And critically ill patients got intravenous drip of dexamethasone sodium phosphate injection for 14 days
10-20 mg/time
1 time/day. The control group took Wenxin granules orally
One bag at a time
3 times/day. Patients in observation group additionally got Yixinshu capsule
3 grains/time
3 times/days. The courses of treatment were 8 weeks in both groups. The serum troponin I (cTnI) and creatine phosphokinase (CK-MB) were monitored
and after treatment
the recovery rates of cTnI
CK-MB were recorded. Before and after treatment
the electrocardiogram was observed and the recovery rate after treatment was recorded. Before and after treatment
the scores of deficiency of Qi and Yin were graded
and levels of creatine phosphokinase (CPK)
hydroxybutyrate dehydrogenase (HBDH)
lactate dehydrogenase (LDH)
aspartate aminotransferase (AST)
superoxide dismutase (SOD)
malondialdehyde (MDA)
glutathione peroxidase (GSH-Px)
interferon-
γ
(IFN-
γ
)
interleukin-10 (IL-10)
IL-17 and IL-35 were detected. Echocardiography
left ventricular ejection fraction (LVEF)
cardiac index (CI)
and maximum velocity values between early and late diastolic (E/A) were detected.
Result
2
In the analysis of rank sum test
clinical efficacy in observation group was better than that in control group (
Z
=2.151
P<
0.05). Recovery rates of cTnI
CK-MB and electrocardiogram in observation group were 82.26% (51/62)
90.32% (56/62) and 80.65% (50/62)
higher than 65.00% (39/60)
73.33% (44/60) and 63.33% (38/60) in control group (
P<
0.05). Levels of serum cTnI
CK-MB
CPK
HBDH
LDH
AST
MDA
IFN-
γ
and IL-17 were lower than those in control group (
P<
0.01)
while levels of LVEF
CI
E/A
SOD
GSH-Px
IL-10 and IL-35 were higher than those in control group (
P<
0.01).
Conclusion
2
On the basis of comprehensive anti-infection treatment
Yixinshu capsule can additional protect myocardium by anti-inflammatory and antioxidant effect
reduce myocardial enzyme
promote the recovery of ECG and cardiac enzyme
improve cardiac function and improve the effect of clinical treatment.
病毒性心肌炎亚急性期气阴两虚证益心舒胶囊抗氧化应激抗炎
viral myocarditissubacute phasedeficiency of Qi and YinYixinshu capsuleantioxidant stressantiinflammatory
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