摘要
目的 探讨生脉注射液对病毒性心肌炎的疗效及T辅助细胞1/T辅助细胞2（Th1/Th2）平衡的影响.方法 126例病毒性心肌炎患儿采用随机数字表法分为两组,观察组63例,对照组63例.两组患儿均给予卧床休息、吸氧、营养心肌、预防并发症处理.观察组在以上治疗的基础上给予生脉注射液静脉滴注,每天1次,10 d为1个疗程.两组共治疗2个疗程.治疗前后测定患儿血清肌酸激酶同工酶（CK-MB）、肌钙蛋白I（cTnI）、白细胞介素-4（IL-4）和干扰素-γ（IFN-γ）.结果 治疗后对照组总有效率81.0％,观察组总有效率90.5％,观察组总有效率明显高于对照组（χ^2=6.78,P〈0.05）.对照组治疗前CK-MB、cTnI分别为（142.92±36.51）IU/L、（6.31±0.66）μg/L;治疗后分别为（29.16±2.62）IU/L、（2.71±0.51）μg/L.观察组治疗前CK-MB、cTnI分别为（140.18±33.14）IU/L、（6.42±0.58）μg/L;治疗后分别为（13.42±1.29）IU/L、（1.62±0.38）μg/L.两组治疗后CK-MB、cTnI均明显降低（t=12.306,14.072,4.172,8.334,P〈0.05,P〈0.01）,并且观察组降低更明显（t=4.118,2.462,P〈0.05）.对照组治疗前IL-4、IFN-γ、IL-4/IFN-γ分别为（22.34±9.46）μg/L、（52.19±13.26）μg/L、（0.42±0.12）;治疗后分别为（15.26±8.17）μg/L、（60.48±15.23）μg/L、（0.25±0.09）.观察组治疗前IL-4、IFN-γ、IL-4/IFN-γ分别为（23.09±8.84）μg/L、（51.19±14.06）μg/L、（0.45±0.17）;治疗后分别为（9.15±5.48）μg/L、（69.42±16.03）μg/L、（0.13±0.05）.两组治疗后IL-4、IL-4/IFN-γ均有明显降低（t=11.626、15.306、3.014、5.771,P〈0.05,P〈0.01）;并且与对照组治疗后比较,观察组治疗后降低更明显（t=4.992、3.042,P〈0.05,P〈0.01）.两组治疗后患儿血清IFN-γ均明显升高（t=2.774、3.618,P〈0.05）;并且与对照组治疗后比较,观察组治疗后升高更明显（t=2.148,P〈0.05）.结论 病毒性心肌炎患儿采用生脉注射液治疗可以明显提高疗效,可能与其改善Th1/Th2平衡有关.
Objective To study the effect of Shengmai injection on the efficacy and Th 1/Th2 balance in children with viral myocarditis .Methods 126 cases with viral myocarditis were randomly divided into observation group and control group,63 cases in each group.The two groups were given bed rest,oxygen inhalation,nutrition, myocardial and prevention of complications .On the basis of the above treatment , the observation group was given Shengmai injection,1 time a day,and 10d for 1 course.The two groups were treated for 2 courses.The serum creatine kinase isoenzyme（CK-MB）,troponin I（cTnI）,interleukin-4（IL-4）,and interferon gamma（IFN-γ） were measured before and after treatment .Results After treatment,the total effective rate of the control group was 81.0%,which was significantly lower than 90.5%of the observation group （χ^2 =6.78,P〈0.05）.Before treatment,CK-MB and cTnI of the control group were （142.92 ±36.51）IU/L,（6.31 ±0.66）μg/L,respectively,which after treatment were （29.16 ±2.62）IU/L,（2.71 ±0.51）μg/L,respectively.Before treatment,the CK-MB and cTnI in the observation group were （140.18 ±33.14） IU/L,（6.42 ±0.58）μg/L,respectively,which after treatment were （13.42 ± 1.29）IU/L,（1.62 ±0.38）μg/L,respectively.The serum levels of CK -MB and cTnI were significantly lower in the two groups after treatment（t=12.306,14.072,4.172,8.334,P 〈0.05,P 〈0.01）,and the decrease was more significant in the observation group（t=4.118,2.462,all P〈0.05）.Before treatment,the IL-4,IFN-γ,IL-4/IFN-γin the control group were （22.34 ±9.46）μg/L,（52.19 ±13.26）μg/L,（0.42 ±0.12）,respectively,which after treatment were （15.26 ±8.17）μg/L,（60.48 ±15.23）μg/L,（0.25 ±0.09）,respectively.Before treatment, the IL-4,IFN-γ,IL-4/IFN-γin the observation group were （23.09 ±8.84）μg/L,（51.19 ±14.06）μg/L, （0.45 ±0.17）,respectively,which after treatment were （9.15 ±5.48）μg/L,（69.42 ±16.03）μg/L,（0.13 ± 0.05）,respectively.The serum IL-4 and IL-4/IFN-γin the two groups after treatment were significantly lower （t=11.626,15.306,3.014,5.771,P〈0.05,P〈0.01）,and compared with the control group after treatment ,which in the observation group decreased significantly （t=4.992,3.042,P〈0.05,P〈0.01）.The levels of serum IFN-γin the two groups after treatment were significantly higher （t=2.774,3.618,P〈0.05）.Compared with the control group,IFN-γin the observation group increased more obviously after treatment （t=2.148,P〈0.05）.Conclusion Shengmai injection in the treatment of children with viral myocarditis can improve the curative effect obviously ,which may be related to the improvement of Th1/Th2 balance.
出处
《中国基层医药》
CAS
2018年第3期360-364,共5页
Chinese Journal of Primary Medicine and Pharmacy
