世界中医药

目的：探讨黄芪注射液联合牛磺酸对急性病毒性心肌炎（AVMC）患者免疫功能的影响。方法：选取2014年4月至2017年5月阜外华中心血管病医院收治的AVMC患者135例作为研究对象，按照随机数字表法分为对照组（n=67）和观察组（n=68）。对照组给予常规治疗+牛磺酸治疗，观察组在对照组的基础上给予黄芪注射液治疗，2组均连续治疗4周。统计2组治疗后临床疗效、各中医证候积分及总积分；检测2组治疗前后心肌酶谱指标、血清炎性反应递质及细胞免疫指标。结果：治疗后观察组临床总有效率为92.65%，显著高于对照组的68.66%，差异有统计学意义（P<0.05）；与治疗前比较，治疗后2组心悸、胸闷、肢冷出汗、头晕、气短乏力积分及总积分显著降低，且观察组显著低于对照组，差异有统计学意义（P<0.05）；与治疗前比较，治疗后2组血清乳酸脱氢酶（LDH）、肌酸激酶（CK）、磷酸肌酸激酶同工酶（CK-MB）、心肌肌钙蛋白（cTnI）水平和肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、超敏C反应蛋白（hs-CRP）水平显著降低，且观察组显著低于对照组，差异有统计学意义（P<0.05）；与治疗前比较，治疗后2组全血CD3+、CD4+、NK比例及观察组CD4+/CD8+显著升高，且观察组显著高于对照组，差异有统计学意义（P<0.05）；治疗后2组全血CD8+与治疗前及组间差异无统计学意义（P>0.05），对照组CD4+/CD8+与治疗前比较，差异无统计学意义（P>0.05）。结论：黄芪注射液联合牛磺酸可显著缓解AVMC患者临床症状，降低炎性反应，提高其免疫功能，改善心肌功能，且疗效优于单独牛磺酸治疗。

English Summary:

To explore the effects of astragalus injection combined with taurine on immune function of acute viral myocarditis (AVMC) patients.Methods:A total of 135 cases AVMC patients admitted to Fuwai Central China Cardiovascular Hospital from April 2014 to May 2017 were selected and divided into a control group (n=67) and an observation group (n=68) according to random number table method.The control group received conventional treatment+taurine treatment,and the observation group was treated with astragalus injection on the basis of the control group.Both groups were all treated continuously for 4 weeks.The clinical curative effect,traditional Chinese medicine syndrome scores and total scores in the 2 groups were calculated after treatment; the myocardial enzyme spectrum,serum inflammatory cytokines and cellular immunity index in the 2 groups were measured before and after treatment.Results:The total clinical efficiency in the observation group after treatment was 92.65%,which was significantly higher than that 68.66% in control group (P<0.01); compared with before treatment,the palpitations,chest tightness,limb cold and sweating,dizziness,shortness of breath and weakness scores and total scores in the 2 groups decreased significantly after treatment (P<0.01),and the observation group was significantly lower than the control group (P<0.05 or P<0.01); compared with before treatment,the serum LDH,CK,CK-MB,cTnI levels,and IL-6,TNF-α,hs-CRP levels in the 2 groups decreased significantly after treatment (P<0.01),and the observation group was significantly lower than the control group (P<0.01); compared with before treatment,the proportion of whole blood CD3+,CD4+,NK in the 2 groups and CD4+/CD8+ in the observation group increased significantly after treatment (P<0.01),and the observation group was significantly higher than the control group (P<0.01); there was no significant difference in the proportion of whole blood CD8+ between before and after treatment as well as the 2 groups after treatment.The CD4+/CD8+ of control group had no difference compared with before treatment (P>0.05).Conclusion:Astragalus injection combined with taurine can significantly alleviate the clinical symptoms of AVMC patients,reduce the inflammatory response,enhance their immune function and improve myocardial function,and the efficacy is significantly better than taurine treatment alone.

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