小陷胸汤合丹参饮加减治疗痰热互结型病毒性心肌炎患者的临床疗效及其对免疫功能、氧自由基的影响
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河南省教育厅科学技术研究重点项目(15A360595)


Clinical Efficacy of Xiaoxianxiong Decoction Combined with Modified Danshen Decoction in the Treatment of Viral Myocarditis with Intermingled Phlegm and Heat and Effects on Immune Function and Level of Oxygen Free Radicals
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    摘要:

    目的:观察小陷胸汤合丹参饮加减治疗痰热互结型病毒性心肌炎(VMC)患者的临床疗效及其对血清炎性反应递质、免疫功能、氧自由基水平的影响。方法:选取2015年9月至2017年9月河南中医药大学第一附属医院收治的VMC患者148例,按照随机数字表法随机分为对照组和观察组,每组74例。对照组给予补液、营养心肌等常规支持治疗,观察组在对照组治疗的基础上加用小陷胸汤合丹参饮方剂,观察2组的临床疗效及血管内皮功能、氧自由基、炎性反应递质、免疫功能、心肌酶的变化情况。结果:2组治疗前白细胞介素-6(IL-6)、白细胞介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(INF-γ)、血清超氧化物歧化酶(SOD)、内皮素-1(ET-1)、一氧化氮(NO)、血清丙二醛(MDA)谷草转氨酶(AST)、乳酸脱氢酶(LDH)、肌酸肌酶(CK)、肌酸肌酶同功酶(CK-MB)、CD3+、CD4+、CD8+、CD4+/CD8+比较,差异无统计学意义(P>0.05);2组治疗后IL-6、IL-2、TNF-α、INF-γ、CD8+、AST、LDH、CK、CK-MB、ET-1、MDA水平较本组治疗前明显降低,CD4+、CD4+/CD8+、CD3+、NO、SOD较本组治疗前明显升高,差异有统计学意义(P<0.05);观察组治疗后上述指标变化更明显,2组比较差异有统计学意义(P<0.05)。观察组的治疗总有效率(91.89%)明显高于对照组(78.38%),2组比较差异有统计学意义(P<0.05)。结论:小陷胸汤合丹参饮加减可通过降低血清炎性反应递质水平,抗氧化,改善血管内皮功能,调节免疫功能,从而提高痰热互结型病毒性心肌炎患者的临床治疗效果。

    Abstract:

    To observe the clinical efficacy of Xiaoxianxiong Decoction combined with Danshen Decoction in the treatment of viral myocarditis (VMC) with intermingled phlegm and heat and its effects on the level of inflammatory cytokines,immune function,oxygen free radicals.Methods:A total of 148 patients with VMC treated in First Affiliated Hospital of Henan university of Chinese Medicine from September 2015 to September 2017 were selected and divided into the control group and the observation group according to random number table method,with 74 cases in each group.The control group was given conventional medicine such as rehydration and myocardial nutrition.The observation group was given Xiaoxianxiong Decoction and Danshen Decoction on the basis of the same treatment in control group.The changes of clinical efficacy,endothelial function,oxygen free radicals,inflammation factors,immune function and the myocardial enzyme of the 2 groups were observed.Results:There was no statistically significant difference of IL-6,IL-2,TNF-α,INF-γ,NO,ET-1,SOD,MDA,CD4+,CD4+/CD8+,CD3+,CD8+,AST,LDH,CK,CK-MB of two groups before treatment (P>0.05).The levels of IL-6,IL-2,TNF-α,INF-γ,CD8+,AST,LDH,CK,CK-MB,ET-1,MDA of the 2 groups were decreased after treatment (P<0.05).The levels of NO,SOD,CD4+,CD4+/CD8+,CD3+ of the 2 groups were increased after treatment (P<0.05).The total effective rate of the observation group (91.89%) was significantly higher than the control group (78.38%).The difference between the two groups was statistically significant (P<0.05).Conclusion:The Xiaoxianxiong Decoction combined with Danshen Decoction can reduce the levels of the inflammatory cytokines,anti-oxidation,and improve the endothelial function,regulate the immune function to improve the clinical efficacy of in treating viral myocarditis.

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管志伟,陈小松,宋桂华,于素平,张岩,吕伟刚.小陷胸汤合丹参饮加减治疗痰热互结型病毒性心肌炎患者的临床疗效及其对免疫功能、氧自由基的影响[J].世界中医药,2019,(01).

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  • 收稿日期:2018-02-28
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  • 在线发布日期: 2019-01-22
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